What lower urinary tract symptoms would the nurse expect to find if a patient has a urinary tract infection? Select all that apply.
Fever.
Hesitancy.
Nocturia.
Dysuria.
Incomplete emptying.
Hematuria.
Chills.
Correct Answer : B,C,D,E,F
Choice A rationale
Fever is a systemic manifestation of infection, indicating a generalized inflammatory response, and is typically not classified as a lower urinary tract symptom. Lower urinary tract symptoms are directly related to bladder and urethral irritation. While a UTI can cause fever, it's a systemic sign, not a localizing symptom. Normal body temperature ranges from 36.5°C to 37.5°C orally.
Choice B rationale
Hesitancy refers to difficulty initiating urination, a symptom directly linked to lower urinary tract dysfunction. Inflammation and irritation of the bladder neck or urethra, often due to bacterial presence in a UTI, can impede smooth detrusor muscle contraction and sphincter relaxation, leading to this symptom. It reflects impaired micturition coordination.
Choice C rationale
Nocturia, the need to wake up and urinate multiple times during the night, is a common lower urinary tract symptom in UTIs. Inflammation of the bladder lining increases bladder sensitivity and reduces its functional capacity, leading to more frequent urges to void, even during sleep, disrupting normal sleep patterns.
Choice D rationale
Dysuria, or painful urination, is a hallmark lower urinary tract symptom of a UTI. The inflammation and irritation of the urethral mucosa and bladder trigone by bacterial toxins and the host immune response cause direct stimulation of nociceptors during the passage of urine, resulting in a burning sensation.
Choice E rationale
Incomplete emptying describes the sensation that the bladder has not been fully emptied after urination. This symptom arises from bladder irritation and detrusor muscle dysfunction or spasm due to inflammation in a UTI, leading to residual urine and persistent urge, even after voiding efforts.
Choice F rationale
Hematuria, the presence of blood in the urine, is a lower urinary tract symptom that can occur with UTIs. Inflammation and irritation of the urothelium by bacterial colonization can lead to micro-erosions and increased vascular permeability in the bladder and urethra, causing red blood cells to leak into the urine.
Choice G rationale
Chills are systemic symptoms, often accompanying fever, indicating a generalized inflammatory response and potential systemic spread of infection. Like fever, chills are not considered a direct lower urinary tract symptom, which specifically relates to local irritation and dysfunction of the bladder and urethra.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Bright red blood in the urine, especially in large amounts or clots, after a cystoscopy is an abnormal finding. While some pink-tinged urine is expected, significant bright red bleeding can indicate hemorrhage or bladder wall injury requiring immediate medical intervention to prevent complications.
Choice B rationale
Urinary frequency is a common and expected finding after a cystoscopy due to irritation of the bladder mucosa from the procedure. This typically resolves within a day or two as the bladder recovers from instrumentation.
Choice C rationale
Pink-tinged urine is considered a normal and expected finding after a cystoscopy. The procedure involves instrumentation of the urethra and bladder, which can cause minor trauma to the mucosal lining, leading to a small amount of blood in the urine.
Choice D rationale
Burning on urination, also known as dysuria, is a common and expected sensation after a cystoscopy due to irritation and inflammation of the urethra and bladder from the scope. This discomfort usually subsides within 24 to 48 hours.
Correct Answer is A
Explanation
Choice A rationale
Stopping topical fluorouracil when the skin appears worse is incorrect. The medication often causes an inflammatory reaction, including erythema, crusting, and erosion, which indicates the drug is working by causing cellular necrosis of abnormal cells. Premature discontinuation compromises treatment efficacy and may lead to inadequate destruction of cancerous cells, necessitating prolonged or alternative therapies.
Choice B rationale
Avoiding sun exposure while using topical fluorouracil is crucial due to the medication's photosensitizing properties. Fluorouracil enhances the skin's sensitivity to ultraviolet radiation, increasing the risk of severe sunburn, erythema, and blistering. This phototoxicity can exacerbate local inflammatory reactions and compromise treatment outcomes, necessitating strict photoprotection.
Choice C rationale
Applying topical fluorouracil only to affected areas is essential to minimize systemic absorption and reduce adverse effects on healthy skin. Fluorouracil is a cytotoxic agent that nonspecifically inhibits DNA and RNA synthesis, leading to cell death. Accidental application to unaffected skin can cause unnecessary irritation, inflammation, and discomfort without therapeutic benefit.
Choice D rationale
Washing hands before and after applying topical fluorouracil is a fundamental infection control and safety measure. Handwashing before application prevents the introduction of microbes to the treatment site, reducing infection risk. Post-application handwashing removes residual medication, preventing accidental transfer to other body parts or individuals, minimizing systemic exposure.
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