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 A
Explanation
A. Increased pulse, respirations and blood pressure with dysphagia and respiratory distress. A myasthenic crisis is characterized by severe muscle weakness that can lead to respiratory failure, dysphagia, and increased vital signs due to the stress of respiratory distress.
B. Hypotension, diarrhea, and increased salivation. These symptoms are more indicative of a cholinergic crisis, which is due to excess acetylcholine.
C. Bradycardia and hypothermia. Bradycardia and hypothermia are not characteristic signs of a myasthenic crisis.
D. Tachypnea and hyperactive deep tendon reflexes. While tachypnea can occur in respiratory distress, hyperactive reflexes are not typical in myasthenic crisis, as it involves neuromuscular weakness.
Correct Answer is B
Explanation
A. Conjunctivitis. Conjunctivitis generally presents with redness and discharge but does not cause elevated intraocular pressure, severe pain, or visual disturbances like halos.
B. Acute angle-closure glaucoma. Acute angle-closure glaucoma is characterized by sudden severe eye pain, blurred vision, halos around lights, nausea, and vomiting, along with elevated intraocular pressure and a cloudy cornea.
C. Retinal detachment. Retinal detachment may cause sudden vision loss or flashing lights but typically lacks pain, nausea, or vomiting, and does not affect intraocular pressure.
D. Migraine with aura. A migraine with aura may cause visual disturbances but does not present with eye pain, red eye, or elevated intraocular pressure.