Medical Surgical Renal Lab values & Urine analysis #4

Question

The nurse is caring for an elderly client who has been very pleasant and cooperative until this afternoon and the client has become confused, agitated, and upset for no reason known. Which of these interventions should the nurse implement as priority?

Answers

  1. Try to calm the client and call the family to come sit with the client.
    • Rationale:

      This answer is not correct because trying to calm the client is important, but calling the family before other options have been checked would not be priority. Calling the healthcare provider to obtain an order for a urinalysis culture and sensitivity would be priority for the nurse to implement. It is important to recognize when an elderly client’s demeanor changes from being pleasant and cooperative to being confused, agitated, and upset for no reason.

  2. Try to calm the client and get a certified nursing assistant to sit with the client.
    • Rationale:

      This answer is not correct because trying to calm the client is important, but the certified nursing assistant has many other clients to care for and would not be a priority for the nurse to implement. Calling the healthcare provider to obtain an order for a urinalysis culture and sensitivity would be priority for the nurse to implement. It is important to recognize when an elderly client’s demeanor changes from being pleasant and cooperative to being confused, agitated, and upset for no reason.

  3. Call the healthcare provider and obtain an order for an anti-anxiety medication.
    • Rationale:

      This answer is not correct because calling the healthcare provider to obtain an order for anti-anxiety before other options have been implemented would not be a priority. Calling the healthcare provider to obtain an order for a urinalysis culture and sensitivity would be priority for the nurse to implement. It is important to recognize when an elderly client’s demeanor changes from being pleasant and cooperative to being confused, agitated, and upset for no reason.

  4. Call the healthcare provider and obtain an order for a urinalysis culture and sensitivity.
    • Rationale:

      This answer is correct because calling the healthcare provider to obtain an order for a urinalysis culture and sensitivity would be priority for the nurse to implement. It is important to recognize when an elderly client’s demeanor changes from being pleasant and cooperative to being confused, agitated, and upset for no reason.

Overview

The first sign of a urinary tract infection (UTI) in the elderly is confusion and agitation, so it’s important to recognize this sign and call the healthcare provider to obtain an order for a urinalysis culture and sensitivity.

Explanation

Learning Outcomes

Because the elderly have a decreased immune system, their response to a UTI is different from the normal symptoms of burning and pain with urination. It is important to recognize when an elderly client’s demeanor changes from being pleasant and cooperative to being confused, agitated, and upset for no reason. The nurse should call the healthcare provider for an order to obtain a urinalysis culture and sensitivity to rule out UTI. Indications of a UTI taken from a urinalysis test can result with increased white blood cells, increased red blood cells, leukocyte esterase would be positive, bacteria would be seen, and the urine ph would probably be more alkaline.

Test Taking Tip

An important tip to remember in the elderly. Due to the elderly’s compromised immune system, the symptoms exhibited with a UTI would be very different than with younger clients. The elderly become confused, agitated, and sometimes withdrawn. The normal symptoms of a UTI in younger adults would be burning and pain with urination and frequent urination.

Video Rationale