Medical Surgical UTI & Pyelonephritis #5

Question

A client presents to the outpatient clinic with fever and dysuria and voices concern of another urinary infection. The client has a history of 6 urinary infections over the past year. After assessing the client, the nurse interprets findings to be consistent with pyelonephritis. Which finding is characteristic of pyelonephritis? Select all that apply.

Answers

  1. Cloudy, bloody, or foul-smelling urine.
    • Rationale:

      This answer is correct because bloody, cloudy, and foul-smelling urine are clinical manifestations associated with pyelonephritis. Fever, frequent urination, and pain (e.g., back, side, groin) are common symptoms of pyelonephritis as well.

  2. Costovertebral angle tenderness.
    • Rationale:

      This answer is correct because costovertebral angle tenderness, or flank pain, is a clinical manifestation associated with pyelonephritis. Bloody, cloudy, and foul-smelling urine are clinical manifestations associated with pyelonephritis

  3. Hypotension.
    • Rationale:

      This answer is not correct because hypertension, not hypotension, is an expected clinical manifestation associated with pyelonephritis – specifically, chronic pyelonephritis which is suspected based on the client’s current clinical data.

  4. Proteinuria.
    • Rationale:

      Proteinuria or protein within the urine, is a clinical manifestation associated with pyelonephritis. Fever, frequent urination, and pain (e.g., back, side, groin) are common symptoms of pyelonephritis. Other clinical manifestations include bloody, cloudy, or foul-smelling urine; costovertebral angle tenderness (i.e., flank pain), and proteinuria.

  5. Urinary frequency
    • Rationale:

      Urinary frequency occurs when the bladder is so irritated and inflamed from infection, it makes you feel like you have to urinate, even if you do not have much urine in the bladder. The bladder muscle is under the brain’s control and it tells it when to relax and contract. This infection causes pressure and tells your brain that it needs to go, even if your bladder is empty.

Overview

Pyelonephritis is defined as a bacterial kidney infection. Pyelonephritis is due to a specific type of urinary tract infection (UTI) that begins in the urethra or bladder and then travels to the client’s kidneys.

Explanation

Learning Outcomes

Pyelonephritis is due to a specific type of urinary tract infection (UTI) that begins in the urethra or bladder and then travels to the client’s kidneys. Fever, frequent urination, and pain (e.g., back, side, groin) are common symptoms of pyelonephritis. Other clinical manifestations include bloody, cloudy, or foul-smelling urine; costovertebral angle tenderness (i.e., flank pain), and proteinuria. This condition can lead to bacteremia or chronic pyelonephritis and fibrosing of the ureters.

Test Taking Tip

Consider the pathophysiology of pyelonephritis to determine clinical manifestations associated with this disease process.

Video Rationale