A nurse is teaching a group of nursing students about pyelonephritis. Which of the following statements should the nurse include in the teaching?

"Pyelonephritis increases a person's risk for kidney damage."

"Pyelonephritis is an infection of the lower urinary tract."

"Pyelonephritis often causes no symptoms in affected clients."

"Pyelonephritis is most often caused by Staphylococcus saprophyticus."

Answer and Explanation

The Correct Answer is A

A. "Pyelonephritis increases a person's risk for kidney damage." - Pyelonephritis is a bacterial infection of the renal parenchyma and renal pelvis, typically caused by the ascent of bacteria from the lower urinary tract into the kidneys. If left untreated, it can lead to kidney damage, including scarring of the renal tissue and impaired kidney function.

B. "Pyelonephritis is an infection of the lower urinary tract." - This statement is incorrect. Pyelonephritis specifically involves the upper urinary tract, affecting the kidneys. In contrast, infections of the lower urinary tract (such as cystitis) affect the bladder and urethra.

C. "Pyelonephritis often causes no symptoms in affected clients." - This statement is incorrect. Pyelonephritis typically presents with symptoms such as fever, chills, flank pain, painful urination (dysuria), and frequent urination. Clients with pyelonephritis usually experience noticeable symptoms.

D. "Pyelonephritis is most often caused by Staphylococcus saprophyticus." - This statement is incorrect. While Staphylococcus saprophyticus is a common cause of urinary tract infections, pyelonephritis is more commonly caused by gram-negative bacteria, such as Escherichia coli, which often ascend from the lower urinary tract into the kidneys.

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Correct Answer is B

Explanation

A. Venous thromboembolism (VTE) - While VTE can cause leg pain and swelling, the presence of fever, chills, and localized trauma history in this scenario points more toward cellulitis.

B. Cellulitis
The client's symptoms, including pain, swelling, fever, chills, and sweating, are indicative of cellulitis, which is a bacterial skin infection. The history of trauma to the leg (hitting the leg on the car door) could have introduced bacteria into the skin, leading to the infection. The client's diabetes mellitus type 2 also increases the risk of developing skin infections due to impaired immune function and circulation. Cellulitis often presents with localized pain, swelling, warmth, redness, and systemic symptoms like fever and chills. Immediate medical evaluation and appropriate antibiotic treatment are necessary for cellulitis.

C. Arterial insufficiency - Arterial insufficiency typically presents with symptoms like intermittent claudication, rest pain, and non-healing wounds due to poor circulation. The symptoms described in the scenario are more consistent with an acute infection (cellulitis) rather than chronic arterial insufficiency.

D. Thrombocytopenia - Thrombocytopenia is a condition characterized by low platelet count and does not directly cause localized pain, swelling, and redness in the leg as described in the scenario.

A. The longer the joint is displaced, the more difficult it is to get it back in place. B. Avascular necrosis may develop at the site if it is not promptly resolved. C. The client's pain will increase until the joint is realigned. D. Dislocation can become permanent if the process of bone remodeling begins.

Correct Answer is A

Explanation

A. The longer the joint is displaced, the more difficult it is to get it back in place:
This statement is correct. Prompt reduction of a dislocated joint is important because the longer the joint remains out of place, the more difficult it becomes to realign it. Delayed reduction can lead to complications and makes the process more challenging for healthcare providers.

B. Avascular necrosis may develop at the site if it is not promptly resolved:
Avascular necrosis is a condition where bone tissue dies due to a lack of blood supply. While it is a potential complication of hip dislocation, it is not the immediate rationale for considering hip dislocation a medical emergency. The urgency primarily lies in the difficulty of reducing the dislocation and preventing further complications.

C. The client's pain will increase until the joint is realigned:
This statement is partially correct. While it is true that dislocated joints are extremely painful, the urgency in reducing the dislocation is not solely based on pain management. It is essential to prevent complications, restore joint function, and minimize long-term damage to the affected area.

D. Dislocation can become permanent if the process of bone remodeling begins:
This statement is accurate. If a dislocated joint is not promptly reduced, the surrounding tissues may undergo changes, and the process of bone remodeling can begin. This can lead to the dislocation becoming more difficult or even impossible to reduce, resulting in a permanent dislocation. Early intervention is essential to prevent this outcome.

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A nurse is teaching a group of nursing students about pyelonephritis. Which of the following statements should the nurse include in the teaching?

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Correct Answer is B

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