The nurse is assessing the laboratory findings of a client with a urinary tract infection. The laboratory report notes a "shift to the left" in a client's white blood cell count. Which action by the nurse is most appropriate?
a. Request that the laboratory perform a dif-ferential analysis on the white blood cells.
b. Notify the health care provider and start an IV line for parenteral antibiotics.
c. Instruct the client to begin straining all urine for renal calculi.
d. Document the finding in the client's chart and continue to monitor.
B
A left shift most commonly occurs with urosepsis and is seen rarely with uncomplicated urinary tract infections. The nurse will be administering antibiotics, most likely via IV, so he or she should notify the provider and prepare to give the antibiotics. The shift to the left is part of a dif-ferential white blood cell count. The client would not need to strain urine for stones, and because sepsis carries a high mortality rate, the nurse should not just note the findings as the only action.
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