An older adult client is experiencing confusion, a temperature of 101.5 °F, bruising to the arms and legs, and decreased urine output
The medical diagnosis is a urinary tract infection. Which is the most appropriate nursing diagnosis for this client?
A) Risk for Injury
B) Ineffective Breathing Pattern
C) Activity Intolerance
D) Impaired Memory
Answer: A
The client has bruising and is confused. A priority nursing diagnosis would focus on client safety. The bruising and confusion place the client at risk for injury related to falls. There is no evidence that the client is having difficulty breathing. Activity intolerance could be a problem; however, the nurse cannot assume that the client has intolerance to activity due to age. Because the client is exhibiting confusion, which is a typical symptom of urinary infection in the elderly, the nurse would choose risk for injury as a priority over memory because it is not possible to assess the client's memory during confusion.
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