Title: Acute Pyelonephritis, Acute Kidney Injury Scenario: A 75-year-old female with a history of asthma and type 2 diab

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Title: Acute Pyelonephritis, Acute KidneyInjury
Scenario: A 75-year-old female with a historyof asthma and type 2 diabetes mellitus began to experience burningupon urination, lower abdominal pain, and frequent urination a fewdays ago. After trying to manage her symptoms by increasing fluids,she arrived at the emergency department with her daughter withcomplaints of right flank pain, fever, and malaise. Her daughtersaid that the patient who is normally alert and oriented is nowexperiencing some confusion. Urinalysis results show bacteriuria,hematuria, and white blood cell casts. The nurse documents thefollowing assessment findings:
____ Temperature 102.2◦F(39◦C)
____ Heart rate = 94 bpm
____ Blood pressure = 138/76 mmHg
____ Respirations = 20 breaths per minute
____ Right sided costovertebral angletenderness
____ Patient reports malaise
____ Reports 1 pack per day cigarette use
____ Patient not oriented to place andtime
____ Patient reports nausea
Cognitive Skill: Recognize Cues
1. NGN Item Type: Extended MultipleResponse
Place a check mark next to the assessment findings thatrequire follow-up by the nurse.
Answers:
___ Temperature 102.2◦F (39◦C)
____ Heart rate = 94 bpm
____ Blood pressure = 138/76 mm Hg
____ Respirations = 20 breaths per minute
___ Right sided costovertebralangle tenderness
___ Patient reports malaise
____ Reports 1 pack per day cigarette use
___ Patient not oriented to placeand time
____ Patient reports nausea
Rationale for your choices:
Cognitive Skill: Recognize Cues
2. NGN Item Type: Cloze
Choose the most likely options (by highlighting yourchoices) for the information missing from the statement below byselectin from the list of options provided.
Based on the patient’s assessment data, the nurse determinesthat the patient is currently at risk for complications, including_______, _______, and _______.
Options
Rationale:
Cognitive Skill: Analyze Cues