A person with acute pyelonephritis would most typically experience:

Choice A reason: Crackles in the lung bases may indicate fluid overload or pulmonary edema, which could be a reason to administer a loop diuretic to help remove excess fluid from the body. Therefore, this assessment would not typically lead to withholding the diuretic.

Choice B reason: A serum potassium level of 2.6 mEq/L is significantly low (hypokalemia). Loop diuretics, such as furosemide, can further decrease potassium levels, which can be dangerous and lead to severe complications such as cardiac arrhythmias. Therefore, the nurse should withhold the diuretic and address the low potassium level before considering further diuretic therapy.

Choice C reason: +2 pitting peripheral edema indicates fluid retention, which is commonly treated with loop diuretics. The presence of edema would not usually warrant withholding the diuretic; instead, it suggests a need for the medication to help reduce the fluid buildup.

Choice D reason: Weight gain of 2 pounds in 2 days could indicate fluid retention, especially in patients with conditions such as heart failure. This would be an indication to use a loop diuretic rather than to withhold it, as the medication would help remove the excess fluid from the body.

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.