A patient has a positive Chvostek sign. The nurse interprets this as a sign of:

Choice A reason: Anuria, which is the absence of urine production, is not a typical symptom of acute pyelonephritis. This condition usually presents with symptoms related to inflammation and infection of the kidneys rather than complete cessation of urine output.

Choice B reason: Edema, or swelling due to fluid accumulation, is more commonly associated with chronic kidney diseases or conditions like nephrotic syndrome. Acute pyelonephritis primarily involves an active infection and inflammation rather than fluid retention.

Choice C reason: Fever is a common and significant symptom of acute pyelonephritis. This condition is an infection of the kidneys that often presents with systemic signs of infection such as fever, chills, and malaise. Patients may also experience flank pain, nausea, and vomiting.

Choice D reason: Hypertension, or high blood pressure, can be seen in chronic kidney disease but is not a hallmark symptom of acute pyelonephritis. The acute infection of the kidneys primarily manifests with fever, pain, and urinary symptoms rather than elevated blood pressure.

Choice A reason: Preventing constipation is not the primary reason for prescribing metoprolol alongside nifedipine. While managing side effects is important in patient care, metoprolol does not have a notable effect on gastrointestinal motility to address constipation.

Choice B reason: Reducing flushing is not the main purpose of metoprolol. Flushing can sometimes be a side effect of vasodilatory medications, but it is not the specific reason for adding a beta-blocker like metoprolol to a treatment regimen involving a calcium channel blocker like nifedipine.

Choice C reason: Minimizing gingival hyperplasia is not the intended effect of metoprolol. Gingival hyperplasia can be a side effect of certain medications, such as calcium channel blockers like nifedipine, but metoprolol does not specifically counteract this effect.

Choice D reason: Preventing reflex tachycardia is the primary reason for prescribing metoprolol alongside nifedipine. Nifedipine, a calcium channel blocker, can cause vasodilation, which may lead to a reflex increase in heart rate (tachycardia) as the body tries to maintain blood pressure. Metoprolol, a beta-blocker, helps prevent this reflex tachycardia by slowing the heart rate and reducing the workload on the heart, thus complementing the antihypertensive effect of nifedipine.