Question

Choose the correct answer

• Indicate a rational for the answer

IIII. A 26-year-old female presents to the emergency department with complaints of fever, chills, and flank pain. After an initial assessment, she is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The patient reports she had a UTI the previous month.

20) When assessing this patient, what additional findings support this diagnosis?

a) Weight gain, general malaise, and urinary urgency

b) Costovertebral tenderness, vomiting, and painful urination

c) Fatigue, polyuria, and excessive thirst

d) Hypotension and bradycardia

21) What is the underlying pathophysiology associated with this condition?

a) Bacteria from a urinary tract infection that ascends to the kidneys

b) Lodging of a kidney stone in a ureter leading to urine back-flow into the kidney

c) Poor circulation to the kidneys because of cardiovascular disease

d) Poor perfusion to the renal system related to cardiovascular disease

22) What interventions will you expect to provide for this patient?

a) Allopurinol and a low-purine diet

b) NPO status except for oral antibiotics

c) Parenteral fluids and IV antibiotics

d) NPO status except for oral fluids

23) The patient is now ready for discharge. Which of the following will you will you include in your discharge teaching for this patient?

a) The patient must continue to take prescribed antibiotics for full 2 weeks

b) Restrict oral fluids to 1 liter/day

c) The patient should see the provider 1 week after completing antibiotics to provide urine specimen for culture

24) What is the primary complication of concern for a patient with chronic pyelonephritis?

a) Increased risk for UTI

b) End-stage renal disease

c) Chronic low-back pain

d) Decrease risk for UTI

Answer 1

Answer 1: (C) Fatigue, polyuria and excessive thirst.

( Patient is suffering from UTI as well as polynephritis. Due to fever fatigue and weakness occurs. The improper function of nephrons may cause polyuria.)

Answer 2 : (A) Bacteria from UTI that ascend to the kidney.

( When UTI is left untreated for long period of time, the infection increases and may reach to the kidney as well. In most of the woman, UTI infection reach to the uterus if left untreated)

Answer 3: (C) Parenteral fluids and antibiotics.

Answer 4: (C) Patient should see the provider after one week completing the antibiotics and for the specimen.

( After the course of antibiotics for a week, the urine test is performed to check whether the condition is improved or not.)

Answer 5: ( B) End stage renal disease.

( People with chronic pyelonephritis are more risk to the renal disease as whole process of filtering of fluid get disturbed, and accumulation of waste fluid and materials occurs which leads to failure of renal system.)