A nurse is gathering medical history from a client admited for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?
The client states that they consume a high calcium diet and have had high calcium in their blood.
The client reports that they had two urinary tract infections (UTI) in the past 10 months.
The client reports that they took a lot of ibuprofen for arthritis for many years.
The client states that they remember their mother saying their grandmother had this same genetic disease.
The Correct Answer is B
Choice A reason: A high calcium diet and high blood calcium levels are not directly related to pyelonephritis.
Choice B reason: Recurrent UTIs can lead to pyelonephritis, especially if the infections ascend to the kidneys.
Choice C reason: Long-term use of ibuprofen can affect kidney function but is not a direct cause of pyelonephritis.
Choice D reason: Genetic diseases can affect kidney health, but there is no common genetic disease that directly causes pyelonephritis.
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Correct Answer is C
Explanation
Choice A reason: Decreasing the IV fluid infusion rate and limiting oral fluid intake may not be appropriate without further assessment, as the client's BUN level is elevated, which could indicate dehydration or renal impairment. The normal range for BUN is typically 7-20 mg/dL.
Choice B reason: Collecting a urine specimen for culture and sensitivity may be necessary if there is a suspicion of infection, but there is no indication of infection based solely on the provided lab values.
Choice C reason: Evaluating urine for amount and specific gravity can help assess the client's hydration status and kidney function, which is pertinent given the elevated BUN level and ongoing nausea and vomiting.
Choice D reason: Continuing routine care may not be appropriate because the BUN level is above the normal range, indicating that further assessment and intervention may be necessary.
Correct Answer is D
Explanation
Choice A reason: Hypernatremia, which is an abnormally high level of sodium in the blood, is not typically associated with prerenal AKI. Prerenal AKI is often related to hypovolemia, which can lead to hyponatremia rather than hypernatremia.
Choice B reason: Hypophosphatemia, or low levels of phosphate in the blood, is not a common finding in prerenal AKI. Phosphate levels are more often affected in intrinsic renal diseases or refeeding syndrome.
Choice C reason: Hypercalcemia, or high levels of calcium in the blood, is not commonly seen in prerenal AKI. It is more frequently associated with malignancies or hyperparathyroidism.
Choice D reason: Hyperkalemia, which is an elevated level of potassium in the blood, is a common electrolyte imbalance in prerenal AKI. This occurs due to decreased renal perfusion and the kidney's reduced ability to excrete potassium.

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