A nurse is caring for a client on the medical-surgical unit.

Gonococcal urethritis: Typically presents with purulent discharge and is sexually transmitted. The client denies being sexually active and has no genital discharge, making this an unlikely cause. Urinary Tract Infection: The client has symptoms typical of a UTI, including urinary urgency, frequency, burning, nocturia, and dark, cloudy urine. A mild fever (100.4°F) and changes in urinalysis findings support this diagnosis. Urinary incontinence: The client is voiding voluntarily and reporting urgency, not involuntary leakage. Incontinence is not suggested by the history or symptoms. Urinary retention: The post-void residual is only 22 mL, which is well below the threshold of concern (>100 mL), ruling out significant retention. Request a prescription for an anti-spasmodic agent: Clients with UTIs often experience bladder spasms and discomfort. An antispasmodic can reduce urgency and pain during voiding. Advise the client that their partner will also need to be treated with antibiotics: This is relevant in sexually transmitted infections, not a simple UTI. The client is not sexually active, so this is inappropriate. Check a urine culture and sensitivity: A urine culture is essential to confirm infection and identify antibiotic sensitivity for effective treatment. Assist the client in keeping a voiding diary: Useful for incontinence or frequency without infection, but not a priority for an acute UTI presentation. Assess the client for constipation: While constipation can contribute to urinary retention, it is not linked to the client’s current symptoms or test findings. Development of perineal skin breakdown: More relevant in clients with incontinence or limited mobility. This client is mobile and continent, so it's not a priority concern. Fluid intake: Increased fluid intake helps flush bacteria from the urinary tract and supports recovery from infection. Compliance with safe sex practices: Important in preventing STIs, but the client denies sexual activity, making this unrelated to the current condition. Temperature: Monitoring for fever helps detect progression of infection or response to treatment. An increasing temperature may signal worsening or systemic spread. Post-void residual: Already assessed and normal. Ongoing monitoring is unnecessary since retention is not a concern.