The nurse is discussing signs and symptoms of both upper and lower urinary tract infections with a client who has a history of both. Which of the following statements by the client reflects the best understanding of the differing symptomatology?
1. "When I get cloudy urine, I figure I have an infection."
2. "Burning when I urinate is usually the first symptom I notice."
3. "I have a big problem when I feel like I have the flu but with back pain too."
4. "When I see blood in my urine, I know I need to call my health care provider."
ANS: 3
Clients with lower UTIs have pain or burning during urination (dysuria) as urine flows over in-flamed tissues. Fever, chills, nausea, vomiting, and malaise develop as the infection worsens. An irritated bladder (cystitis) causes a frequent and urgent sensation of the need to void. Irritation to bladder and urethral mucosa results in blood-tinged urine (hematuria). The urine appears concen-trated and cloudy because of the presence of WBCs or bacteria. If infection spreads to the upper urinary tract (kidneys—pyelonephritis, a serious renal condition), flank pain, tenderness, fever, and chills are common. The remaining options identify general symptoms that are not condition specific.
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