A nurse on an acute medical unit of a hospital has admitted a 62 year old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching?
Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis
Most cases of acute pyelonephritis are attributable to poorly controlled hypertension
Flank pain, dysuria and nausea and vomiting are likely assessment findings
The infection in the kidney is most likely a manifestation of a systemic infection
The Correct Answer is C
A. Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis: These findings are more typical of chronic pyelonephritis, which results from repeated or persistent kidney infections. Acute pyelonephritis usually presents with more subtle imaging changes.
B. Most cases of acute pyelonephritis are attributable to poorly controlled hypertension: While hypertension can complicate kidney disease, it is not a common cause of acute pyelonephritis. Most cases are due to ascending urinary tract infections, particularly from organisms like E. coli.
C. Flank pain, dysuria and nausea and vomiting are likely assessment findings: These are hallmark symptoms of acute pyelonephritis. Flank pain results from inflammation of the renal capsule, while dysuria and systemic symptoms like nausea, vomiting, and fever indicate infection.
D. The infection in the kidney is most likely a manifestation of a systemic infection: Acute pyelonephritis is typically caused by local ascending infections from the lower urinary tract, not systemic bacteremia. Though it can lead to systemic illness if not treated, its origin is usually localized.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Potential Condition: Hepatic Encephalopathy
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The client has very high ammonia levels (236 mcg/dL), elevated liver enzymes, and low albumin, all pointing toward hepatic encephalopathy. Additional signs include a history of alcohol abuse, cirrhosis, and altered liver function, which commonly contribute to ammonia accumulation and neurotoxicity.
Actions to Take:
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Administer lactulose: Helps lower serum ammonia by promoting its excretion via the GI tract.
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Assess for asterixis: A classic sign of hepatic encephalopathy characterized by a flapping tremor of the hands.
Parameters to Monitor:
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Neurologic status: To detect changes in mental status or worsening encephalopathy.
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Safety measures: Clients with hepatic encephalopathy are at high risk for confusion, falls, and injury, necessitating close supervision and safety interventions.
Correct Answer is ["B","C","E"]
Explanation
A. Itching: Pruritus typically develops during the icteric phase of hepatitis when bilirubin accumulates in the tissues. It is not considered an early or prodromal symptom but occurs later as jaundice becomes evident.
B. Vomiting: Nausea and vomiting are common prodromal symptoms of hepatitis due to liver inflammation and its impact on digestion. These gastrointestinal symptoms often occur before jaundice or other late signs become apparent.
C. Fatigue: Fatigue is one of the most frequently reported early symptoms of hepatitis. It results from the body's immune response and reduced liver function and may begin days or weeks before jaundice or dark urine appears.
D. Jaundice: Jaundice typically marks the transition to the icteric phase of hepatitis and follows the prodromal phase. It appears as liver dysfunction progresses and bilirubin accumulates in the bloodstream and tissues.
E. Hyperalgia (increased sensitivity to pain): Increased pain sensitivity, particularly in the upper right quadrant, can occur early in hepatitis due to liver inflammation. This symptom may accompany general malaise and precedes more visible signs like jaundice.
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