A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?
The client states that they consume a high calcium diet and have had high calcium in their blood.
The client reports that they had two urinary tract infections (UTI) in the past months
The client states that they remember their mother saying their grandma had this same genetic disease.
The client reports that they took a lot of ibuprofen for arthritis for many years.
The Correct Answer is B
A. The client states that they consume a high calcium diet and have had high calcium in their blood. A high calcium diet or hypercalcemia is more associated with kidney stones, not typically with pyelonephritis.
B. The client reports that they had two urinary tract infections (UTI) in the past months. Recurrent UTIs are a risk factor for pyelonephritis, as untreated or recurrent infections can ascend from the bladder to the kidneys, leading to this condition.
C. The client states that they remember their mother saying their grandma had this same genetic disease. Pyelonephritis is not typically a genetic disease but rather an infection of the kidneys, often secondary to urinary tract infections.
D. The client reports that they took a lot of ibuprofen for arthritis for many years. Long-term NSAID use can impact kidney function but does not directly cause pyelonephritis.
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Correct Answer is C
Explanation
A. Share personal items like razors and toothbrushes. Sharing personal items that may come in contact with blood or body fluids, like razors and toothbrushes, increases the risk of spreading hepatitis, so clients should avoid sharing these items.
B. Drink alcohol in moderation to avoid liver strain. Clients with hepatitis should avoid alcohol entirely, as alcohol can worsen liver inflammation and damage, which would strain the liver further.
C. Wash your hands thoroughly after using the bathroom. Hand hygiene is crucial, especially for hepatitis A, which can spread through fecal-oral transmission. Washing hands can prevent the spread of the virus to others.
D. Avoid all physical activities to conserve energy. Although clients may need to rest, they do not need to avoid all physical activity. Light, tolerated activity can help maintain strength and prevent complications from immobility.
Correct Answer is ["A","C","E"]
Explanation
A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.
B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.
C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.
D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.
E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.
F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.