Nurse Elena is handling a 7-year-old child who has cystitis. Which of the following would Nurse Elena expect when assessing the child?
A. Dysuria
B. Costovertebral tenderness
C. Flank pain
D. High fever
Correct Answer: A. Dysuria
Dysuria is a symptom of a lower urinary tract infection (UTI) such as cystitis. Common symptoms include frequency, dysuria, urgency, suprapubic pain, cloudy urine, hematuria, nausea, vomiting, and fever. A history is the most important tool for the diagnosis of acute uncomplicated cystitis, and it should be supported by a focused examination and urinalysis.
Option B: Acute pyelonephritis may be suspected if the patient is ill-appearing and seems uncomfortable, particularly if she has a concomitant fever, tachycardia, or costovertebral angle tenderness.
Option C: Pyelonephritis may have similar symptoms of cystitis but usually will have flank pain, fever, and other systemic symptoms. Acute pyelonephritis is a bacterial infection causing inflammation of the kidneys. Pyelonephritis occurs as a complication of an ascending urinary tract infection that spreads from the bladder to the kidneys.
Option D: Costovertebral tenderness, flank pain, and high fever are signs and symptoms of pyelonephritis, an upper UTI. Acute pyelonephritis will classically present as a triad of fever, flank pain, and nausea or vomiting, but not all symptoms have to be present. Symptoms will usually develop within several hours or over the course of a day.