Exhibits Use an X for the nursing actions listed below that are Indicated (appropriate or necessary), Contraindicated (could be harmful), or Nonessential (makes no difference or not necessary) for the patient's care at this time. Only one selection can be made for each nursing action.

Assessing for bowel sounds every 4 hours is nonessential in this case since the patient’s primary problem is pyelonephritis with acute kidney injury. Bowel sounds are not directly affected by this condition, so frequent monitoring adds little benefit to her care at this time. Administering ibuprofen is contraindicated because NSAIDs reduce renal blood flow by inhibiting prostaglandins, which can worsen acute kidney injury. Alternative pain control methods should be used to avoid further kidney damage. Carefully considering the type, frequency, and dosage of antibiotics is indicated because impaired kidney function affects drug metabolism and clearance. Adjusting antibiotic therapy prevents drug accumulation and ensures effectiveness against the infection. Focusing on holistic nursing care is indicated since the patient is disoriented, anxious, and has her daughter present. Addressing emotional, psychological, and family support needs promotes overall well-being alongside medical management. Obtaining daily weights is indicated because weight changes reflect fluid retention or loss, which is critical in monitoring renal function and guiding fluid management in acute kidney injury. Consulting with a dietician for a low caloric diet is nonessential because the primary nutritional focus in kidney injury is adjusting protein, electrolytes, and fluid intake rather than caloric restriction. A low-calorie diet could even be harmful if it impairs recovery.