A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting?
(Select All that Apply.)
Frothy urine
Hypertension
Fish-type urine odor
Mental confusion
Lower abdominal pain
Weak urine stream
Correct Answer : B,C,D,E
A. Frothy urine: Frothy urine is typically associated with proteinuria, seen in nephrotic syndrome, not pyelonephritis.
B. Hypertension: Hypertension can occur due to kidney inflammation and impaired function in pyelonephritis.
C. Fish-type urine odor: A foul or fishy-smelling urine odor is often associated with a urinary tract infection, including pyelonephritis.
D. Mental confusion: Mental confusion can occur in elderly patients with pyelonephritis due to systemic infection or sepsis.
E. Lower abdominal pain: Lower abdominal pain can occur with pyelonephritis due to infection in the urinary tract.
F. Weak urine stream: A weak urine stream is more characteristic of lower urinary tract issues, such as benign prostatic hyperplasia (BPH), rather than pyelonephritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Low back pain: While this can be a symptom of a UTI, it is not unique to older adults and can be seen in various age groups.
B. Confusion: In older adults, UTIs often present with atypical symptoms, such as confusion or delirium, rather than the classic symptoms like dysuria or frequency. This can be a sign of infection in this population.
C. Urinary retention: This is not specific to UTIs in older adults and can occur for other reasons, such as benign prostatic hyperplasia (BPH).
D. Incontinence: Although older adults may experience incontinence, it is not a unique sign of UTI and could be related to other conditions like weakened pelvic muscles.
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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