Physiological Adaptation Q 44
Kris with a history of chronic infection of the urinary system complains of urinary frequency and burning sensation. To figure out whether the current problem is of renal origin, the nurse should assess whether the client has discomfort or pain in the:
A. Urinary meatus
B. Pain in the labium
C. Suprapubic area
D. Right or left costovertebral angle
Correct Answer: D. Right or left costovertebral angle
Discomfort or pain is a problem that originates in the kidney. It is felt at the costovertebral angle on the affected side. Flank or costovertebral angle (CVA) tenderness is most commonly unilateral over the involved kidney, although bilateral discomfort may be present. Discomfort varies from absent to severe. This finding is usually not subtle and may be elicited with mild or moderately firm palpation.
Option A: Pain or discomfort in the urinary meatus can also be indicative of urethritis or acute urinary tract infection. In both men and women, common causes of urethral pain include sexually transmitted diseases (STDs) such as chlamydia, local irritation from soaps or spermicides, and urinary tract infections (UTIs). In men, prostatitis isn’t an uncommon cause, whereas in women, vaginal dryness due to menopause can be an issue.
Option B: Pain in the labium can be due to a swollen labia or vulva. Chronic yeast infections and bacterial infections can both cause pain that ranges from mild discomfort and itching to severe burning or throbbing. Viral and bacterial infections, such as bacterial vaginosis and the herpes simplex virus, can also cause vulvar pain or discomfort.
Option C: Suprapubic pain has a wide variety of causes, and can include pyelonephritis, perinephric abscess, and nephrolithiasis. Gynecological causes are common with suprapubic pain. Suprapubic pain happens in the lower abdomen near where the hips and many important organs, such as the intestines, bladder, and genitals, are located. Suprapubic pain can have a wide variety of causes, so the doctor may need to do tests of vital functions before diagnosing the underlying cause.