A 28-year-old female client presents to the emergency department with a temperature of 102.4°F
She states that she began experiencing frequency and burning upon urination yesterday and in the middle of the night woke up with the fever and chills. She also states that her back is hurting. These symptoms describe what type of infection?
1. Urethritis
2. Acute pyelonephritis
3. Acute renal failure
4. Cystitis
Correct Answer: 2
Rationale 1: The client with urethritis would have discomfort during voiding but would not have other symptoms of irritative voiding, or have fever or back pain.
Rationale 2: Acute pyelonephritis is an inflammation of the kidney, pelvis, and other renal cells. The symptoms include irritative voiding symptoms, vomiting, fever, chills, and acute costovertebral angle and flank tenderness.
Rationale 3: Acute renal failure (ARF)—or acute kidney injury (AKI), as it is now referred to in the literature—is defined as an abrupt or rapid decline in renal filtration function. ARF has few symptoms initially; in its second phase it is marked by fluid retention, azotemia, and metabolic acidosis.
Rationale 4: Cystitis is a bladder infection. The client usually complains of symptoms such as dysuria and increased urgency and frequency. There is discomfort over the suprapubic area, not in the back or flank area. Temperature would be mildly elevated if at all.
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