The nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which individuals are at risk of developing urinary obstructions? (Select all that apply).
A 69 year old female with anemia secondary to insufficient erythropoietin production
A 70 year old male with benign prostatic hyperplasia (BPH)
A 58 year old male with renal calculi
A 29 year old female, pregnant for the first time
Correct Answer : B,C,D,E
A. A 69-year-old female with anemia secondary to insufficient erythropoietin production: While anemia can occur due to chronic kidney disease, it does not directly cause urinary tract obstruction. The lack of erythropoietin affects red blood cell production, not urine flow.
B. A 70-year-old male with benign prostatic hyperplasia (BPH): BPH is a common cause of urinary obstruction in older men. The enlarged prostate compresses the urethra, leading to impaired urine outflow and increased risk of urinary retention.
C. A 58-year-old male with renal calculi: Kidney stones are a frequent cause of urinary tract obstruction. They can block the flow of urine in the ureters, renal pelvis, or bladder, leading to pain, hydronephrosis, and infection risk.
D. A 29-year-old female, pregnant for the first time: Pregnancy can cause urinary obstruction due to the enlarged uterus compressing the ureters, especially in the second and third trimesters, resulting in reduced urine flow and potential hydronephrosis.
E. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury: Neurogenic bladder disrupts normal bladder function and control, which can lead to urinary retention and obstruction due to poor coordination of bladder muscle and sphincter activity.
F. A 43-year-old male with an acid-base imbalance secondary to malnutrition: While malnutrition can affect many organ systems, acid-base imbalance by itself is not a direct cause of urinary tract obstruction.
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Related Questions
Correct Answer is C
Explanation
A. Glomerulonephritis: This is an immune-mediated condition involving inflammation of the glomeruli and typically presents with proteinuria, hematuria, hypertension, and edema rather than urinary frequency, burning, or foul-smelling urine. The presence of E. coli and leukocytes does not support this diagnosis.
B. Kidney calculi: Kidney stones may present with flank pain, hematuria, and sometimes nausea or vomiting, but are not usually associated with urinary frequency, burning, or bacterial growth on urine culture. Randi’s symptoms point more toward an infectious etiology rather than a structural obstruction.
C. Lower UTI: cystitis (bladder infection) and possibly lower ureters: The burning, itching, frequent urination, and foul smell are classic signs of cystitis. The absence of flank pain and only a slightly elevated temperature further supports a lower tract infection rather than an upper one.
D. Upper UTI (pyelonephritis): Pyelonephritis typically presents with fever over 101°F, chills, nausea, vomiting, and significant costovertebral angle (CVA) tenderness or back/flank pain. Since Randi denies back pain and has only a mild temperature elevation, an upper UTI is unlikely.
Correct Answer is B
Explanation
Acute gastritis is indeed a transient inflammation of the gastric mucosa and often results from local irritants like aspirin, NSAIDs, alcohol, caffeine, and contaminated food. It is typically self-limiting and resolves once the irritant is removed. However, the statement is incorrect in describing it as "very serious" in most cases. While complications can occur, acute gastritis is usually mild and not considered very serious unless left untreated.
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