Question

A nurse on a medical unit has just received change-of-shift report. Which of the following clients should the nurse assess first?

a. A 68-year-old client who had a myocardial infarction 2 days ago and reports chest pain as a 4 on a scale of 0 to 10

b. A 48-year-old client who has AIDS, pneumocystis pneumonia, and a temperature of 38.3° C (101° F)

c. A 60-year-old client who has COPD, is receiving 2 L/min O2 via a nasal cannula, and has an oxygen saturation of 89%

d. A 26-year-old female client who has pelvic inflammatory disease and is unable to void.

Answer 1

Option D: we have to attend the PID patient first, who's unable to void urine.

• Causes : urinary retention

Neurogenic bladder

UTI (urinary tract infection)

Urethral structure

Spinal cord problems

Bladder stone & etc..

It can be an emergency situation which needs immediate medical attention, damage to bladder can happen or if prolonged situation can lead to kidney failure.

• Treatment: first we have to put the catheter to drain the stocked up urine.
• Get the investigations done
• Treat the root cause
• Antibiotics for the PID too

Complications

1. Due to PID : ectopic pregnancy, due to prevention of fertilised egg from moving in to uterus.
2. Chronic pelvic pain
3. Infertility : because of inflammatory scarring of Fallopian tubes >blockage >prevent egg to get fertilised.
4. Due to urinary retention : kidney failure
5. Urinary tract infections.
6. Acute pain.