Answer to Question 1
B
Acute pyelonephritis is an infection of the kidneys. It is thought to occur when bacteria (such as Escherichia coli) from a bladder infection travel up the ureters to infect the kidneys. A frequent cause of pyelonephritis is an obstruction, causing stasis of urine and stones that cause irritation of the tissue. Both situations provide an environment in which bacteria can grow. When bacteria enter the renal pelvis, inflammation and infection occur. Pyelonephritis causes nausea and vo-miting, flank pain, temperature elevation with chills, headache, and malaise. Urethritis and cysti-tis often cause dysuria. Glomerulonephritis commonly occurs about 2 to 3 weeks after a group A beta-hemolytic streptococcal infection, such as strep throat or impetigo. The patient with acute glomerulonephritis usually becomes suddenly ill with fever, chills, flank pain, widespread edema, puffiness about the eyes, visual disturbances, and marked hypertension.
Answer to Question 2
B
Frequent swallowing or clearing of the throat may indicate bleeding. Further assessment is indi-cated, and the nurse should look in the patient's mouth to assess for bleeding.
The fully alert adult patient should be placed in semi-Fowler position to ensure adequate ventila-tion. Offering the patient a grape popsicle is an appropriate intervention once the nurse confirms that the patient is not bleeding. While removing the straw from the tray is an appropriate inter-vention to prevent bleeding that may result from sucking, the nurse should first ensure that the patient is not currently bleeding.