The nurse is caring for an elderly patient whose dementia has ...

[mia]

The nurse is caring for an elderly patient whose dementia has become worse over the last 24 hours. The nurse suspects that the patient may have developed a urinary tract infection and obtains a urine sample.
 
  Which assessment findings prompt the nurse to contact the physician to obtain an order for urine culture and sensitivity testing? (Select all that apply.)
  a.
  Urinary dipstick testing is positive for nitrates.
  b.
  The urine appears cloudy with a foul odor.
  c.
  The urine is concentrated and dark amber in color.
  d.
  The urine smells faintly like nail polish remover.
  e.
  The patient is urinating more frequently than usual.
  f.
  The patient is normally continent but wet herself twice.

Question 2

The nurse is caring for a patient who is to undergo computed tomography (CT) of the kidneys and ureters. Which assessment finding by the nurse must be reported to the physician and radiologist before the patient has the procedure?
 
  a. The patient is allergic to bananas and latex.
  b. The patient thinks that she might be pregnant.
  c. The patient has a family history of bladder cancer.
  d. The patient currently has a urinary tract infection.

[todom5090]

Answer to Question 1

ANS: A, B, E, F
Concentrated dark urine indicates dehydration rather than infection of the urinary
tract. Urine that smells of nail polish remover contains ketones from high blood sugar. Urine that is cloudy with a foul odor and positive for nitrites is most likely due to urinary tract infection. Frequent urination and incontinence are signs of urinary tract infection in the elderly.

Answer to Question 2

ANS: B
CT requires exposure to radiation similar to an x-ray, so the patient's physician and radiologist should be notified promptly of the possibility of pregnancy. The other conditions do not preclude CT scan examination for the patient.