Share This Link

Administering acetaminophen for pain is not the priority because it does not address the underlying pathophysiological emergency. While pain control is appropriate in most situations, giving analgesics before confirming diagnosis or before urgent intervention can mask symptoms and delay definitive management. The focus must remain on preserving testicular viability, which cannot be achieved through pain relief alone.

Initiating a consult for a urologist is appropriate and necessary in suspected testicular torsion; however, it is not the first priority. The nurse must first initiate preoperative preparation while simultaneously alerting the urologist or surgical team. Waiting for a formal consult before beginning preoperative protocols could delay surgical intervention and worsen outcomes. Thus, this option is secondary to initiating preoperative preparation.

Obtaining a urine specimen is not a priority because urinary analysis does not aid in the immediate diagnosis or management of testicular torsion. Urine testing may be used later to rule out other causes such as epididymitis or urinary tract infection, but it is non-urgent in an acute emergency involving compromised circulation to the testis. Any delay in surgical treatment increases the risk of infarction and testicular loss.
 

Kidney agenesis refers to the congenital absence of one or both kidneys. This condition is present at birth, not acquired after an infection. It would not present with sudden-onset hematuria, proteinuria, or a history of recent streptococcal infection. Therefore, it is not consistent with the symptoms described in this scenario.

A urinary tract infection (UTI) may cause hematuria and abdominal discomfort, but it would not result in significant proteinuria (4+) or occur following a strep throat infection. UTIs are typically associated with dysuria, urgency, and frequency rather than reddish-brown urine and systemic symptoms. Therefore, it is not the correct diagnosis.

Polycystic kidney disease (PKD) is a genetic disorder characterized by multiple cysts in the kidneys that progressively impair renal function. It presents chronically with hypertension, flank pain, and palpable abdominal masses—not acute post-infectious hematuria. The abrupt onset of symptoms following strep infection rules out PKD.

While increased fluid intake may indirectly reduce discomfort by diluting the urine, the primary goal of hydration in a UTI is not pain reduction. Pain relief is managed more effectively with medications such as analgesics or urinary tract analgesics (e.g., phenazopyridine). Thus, this choice is not the most important reason for fluid intake.

Filling the bladder to obtain a specimen is a short-term goal that may apply when a urine sample is required for diagnosis. However, this does not justify the ongoing need for increased fluids throughout treatment. Continuous hydration serves a therapeutic function beyond specimen collection.

While hydration is generally beneficial for overall health, it does not directly prevent fever. Fever results from the body’s immune response to infection, and while fluids may support temperature regulation, they do not prevent fever development. Therefore, this is not the most important reason.

A VCUG does not determine whether an infection has resolved. The resolution of infection is typically assessed using urinalysis and urine culture after completing antibiotic therapy. Therefore, this statement is inaccurate and provides false reassurance.

VCUG is not used to detect kidney stones. The proper diagnostic tools for stones include renal ultrasound, non-contrast CT, or intravenous pyelogram. VCUG is focused on imaging the lower urinary tract, specifically assessing urine flow and bladder emptying function.

The VCUG is a diagnostic procedure, not a preventive one. It helps identify structural or functional abnormalities such as vesicoureteral reflux but does not directly prevent infection or its complications. Preventive measures would include antibiotic prophylaxis and good perineal hygiene practices.

While increased fluid intake may indirectly reduce the pain of urination by diluting the urine and reducing bladder irritation, this is not the primary therapeutic goal. Pain relief is a secondary benefit, not the most important reason for encouraging fluids in urinary tract infections (UTIs). Pain is typically managed with analgesics and antibiotics, not hydration alone.

Filling the bladder to obtain a specimen is a procedural need, not a therapeutic one. While hydration may help ensure enough urine for testing, this is a one-time requirement and does not address the ongoing pathophysiology of the infection. It is not the most important reason for sustained increased fluid intake during treatment.

Preventing fever is not the primary goal of hydration in UTIs. Fever is a systemic response to infection and is managed with antipyretics and antibiotics. While dehydration can exacerbate fever, fluids are not administered primarily to prevent it in this context. The focus is on urinary tract clearance and renal support.

Kidney agenesis refers to the congenital absence of one or both kidneys. It does not present acutely and would not cause sudden abdominal pain or reddish-brown urine. It is typically diagnosed in infancy or prenatally via imaging. This choice does not fit the clinical scenario.

A urinary tract infection may cause abdominal pain and hematuria, but it is less likely to cause significant proteinuria (4+) and is not typically associated with a recent streptococcal infection. UTIs are more common in females and usually present with dysuria, frequency, and urgency rather than systemic signs of glomerular damage.

Polycystic kidney disease is a genetic disorder that leads to the development of multiple renal cysts over time. It is usually diagnosed through imaging and presents with hypertension, flank pain, and progressive renal dysfunction. It does not present acutely with reddish-brown urine and is not triggered by a recent infection.