A 25-year-old man comes to the college clinic with fever of 101 ...

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A 25-year-old man comes to the college clinic with fever of 101 F, nausea, and flank pain that radiates into the thigh and genitals. The nurse anticipates that the patient will undergo workup for which infection?
 
  a. Urethritis
  b. Pyelonephritis
  c. Glomerulonephritis
  d. Cystitis

Question 2

The nurse is caring for a 20-year-old patient who recently underwent a tonsillectomy. The patient is fully awake and clearing his throat frequently but denies pain. Which action is most important for the nurse to take first?
 
  a. Place the patient in a side-lying position.
  b. Look in the patient's mouth.
  c. Offer the patient a grape popsicle.
  d. Remove the straw from the patient's tray.

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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.

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TYSM

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