During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?

A history of chronic headaches and migraines

A history of gastrointestinal issues such as irritable bowel syndrome

A history of cardiovascular problems such as hypertension

A history of frequent urinary tract infections

Answer and Explanation

The Correct Answer is D

A. A history of chronic headaches and migraines: While chronic headaches and migraines can affect overall health, they are not directly related to pyelonephritis.

B. A history of gastrointestinal issues such as irritable bowel syndrome: Gastrointestinal issues like irritable bowel syndrome (IBS) are generally unrelated to kidney function or urinary tract infections.

C. A history of cardiovascular problems such as hypertension: While hypertension can have indirect effects on renal function, it is not a common historical detail specifically associated with pyelonephritis.

D. A history of frequent urinary tract infections: Frequent urinary tract infections (UTIs) are a significant risk factor for developing pyelonephritis, as the infection can ascend from the bladder to the kidneys.

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Correct Answer is A

Explanation

A. Measure abdominal girth daily. Measuring abdominal girth daily helps assess for changes in distention, which is important in monitoring the effectiveness of the decompression.

B. Moisten the client's lips with lemon-glycerin swabs: This is incorrect because lemon-glycerin swabs can dry the oral mucosa. Using plain water or normal saline swabs would be more appropriate.

C. Maintain the client in Fowler's position: This is appropriate as it helps promote drainage from the nasogastric tube and reduces the risk of aspiration.

D. Use sterile water to irrigate the nasogastric tube: Irrigation is typically done with normal saline to maintain electrolyte balance. Sterile water is not recommended for this purpose.

A. increased fluid intake and patient education on hydration B. Blood cultures C. Urine culture and sensitivity testing D. Repeat urinalysis after antibiotic treatment completion. E. Foley catheter placement F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin

Correct Answer is ["A","C","D","F"]

Explanation

A. Increased fluid intake and patient education on hydration: Encouraging increased fluid intake helps to flush bacteria from the urinary tract and prevent further infection. Hydration is a key component of managing UTIs, as it dilutes urine and promotes frequent urination, reducing bacterial colonization.

B. Blood cultures: Blood cultures are not typically indicated for uncomplicated UTIs, especially in a patient without signs of systemic infection or sepsis (e.g., high fever, hypotension, tachycardia). Blood cultures are more relevant in severe or complicated UTIs, or when there is concern for urosepsis.

C. Urine culture and sensitivity testing: A urine culture and sensitivity is essential for identifying the specific bacteria causing the infection and determining the appropriate antibiotic for treatment. This is especially important for patients with a history of recurrent UTIs to ensure the right antibiotic is selected and to avoid antibiotic resistance.

D. Repeat urinalysis after antibiotic treatment completion: A repeat urinalysis after antibiotic treatment is often ordered to ensure that the infection has been resolved, particularly in patients with recurrent infections.

E. Foley catheter placement: A Foley catheter is not appropriate for this patient, as there is no indication of urinary retention, and catheterization increases the risk of introducing new infections.

F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin: Oral antibiotics like trimethoprim-sulfamethoxazole (TMP-SMX) or ciprofloxacin are commonly prescribed for treating uncomplicated UTIs. Given the patient’s history of recurrent UTIs, empiric antibiotic therapy is appropriate pending urine culture results.

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During the process of collecting a comprehensive medical history from a client who has been admitted with pyelonephritis, which of the following symptoms or historical details would the nurse most likely expect the client to report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who has an intestinal obstruction and is receiving continuous gastrointestinal decompression using a nasogastric tube. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is A

Explanation

Correct Answer is ["A","C","D","F"]

Explanation

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