Answer to Question 1
ANS: C
Clients with long-standing diabetes mellitus are at risk for pyelonephritis for many reasons. Chronically elevated blood glucose levels spill glucose into the urine, changing the pH and providing a favorable climate for bacterial growth. The neuropathy associated with diabetes reduces bladder tone and reduces the client's sensation of bladder fullness. Thus, even with large amounts of urine, the client voids less frequently, allowing stasis and overgrowth of microorganisms. Increasing fluid intake (specifically water) and voiding frequently prevent stasis and bacterial overgrowth. Testing urine and using tampons will not help prevent pyelonephritis. A hemoglobin A1c of 9 is too high.
Answer to Question 2
ANS: A
Fluid retention is a major feature of acute GN. This weight loss represents fluid loss, indicating that the glomeruli are performing the function of filtration. A urine specific gravity of 1.048 is high. Blood is not usually seen in GN, so this finding would be expected. A blood pressure of 152/88 mm Hg is too high; this may indicate kidney damage or fluid overload.
Female African elephant with calf, in Kenya.
Hemophilia inheritance pattern between a female hemophilia carrier and a male without hemophilia.
Testing the Achilles tendon reflex with client in a sitting position
Male and female Lions (Panthera leo)
A female Agile Wallaby (Macropus agilis) with young in pouch feeds on grass in Green Bowling Bay Nat