A client has come to the health care provider's office with symptoms of a urinary tract infection (UTI). She states that she had no symptoms when she went to bed last night but woke this morning with severe burning with urination

Question

A urine culture is completed and grows Escherichia coli. The client asks the nurse why these symptoms occurred so suddenly. The nurse's best response is:
1. "You probably had the symptoms for some time, but you didn't notice it until it became severe."
2. "The severity of your symptoms indicates a hygiene problem."
3. "Do you often have complaints of severe pain when you awaken?"
4. "The bacteria that caused your infection grow very rapidly, so it is possible you had no symptoms the night before."

Answer 1

Correct Answer: 4
Rationale 1: The client usually won't complain of urinary tract discomfort until the bacterial level is sufficient to cause symptoms.
Rationale 2: This answer is not therapeutic or true. Poor perineal hygiene does not cause a severe UTI. It is true, though, that poor hygiene can make it more likely that a client will have a UTI at some point.
Rationale 3: This is not therapeutic and does not address the question that the client asked.
Rationale 4: E. coli can replicate every 20 minutes, producing a billion cells in as little as 10 hours.
Global Rationale: E. coli can replicate every 20 minutes, producing a billion cells in as little as 10 hours. The client usually won't complain of urinary tract discomfort until the bacterial level is sufficient to cause symptoms. Implying that the patient has poor hygiene is not therapeutic and does not answer the patient's question. Asking about pain in the morning does not address the patient's question.