An adult client is admitted to the hospital with a diagnosis of kidney stones. The healthcare provider prescribes IV fluids, x-rays, blood work, and a Foley catheter for the client
The nurse is caring for the client 3 days after admission and documents morning vital signs of 101 °F, heart rate 92, respirations 25, and blood pressure 120/80. The urinary output has decreased, and the urine is cloudy and dark amber. Based on this data, which conclusion by the nurse is the most appropriate?
A) The client has passed the kidney stones.
B) The client is in acute renal failure.
C) The client has developed a respiratory infection.
D) The client has a probable urinary tract infection.
Answer: D
The client has developed a urinary tract infection that was not present upon admission. This is a healthcare-associated infection (HAI) and is likely due to poor technique when placing the Foley catheter. There is no evidence of a respiratory infections, renal failure, or the passage of kidney stones.
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