— 生理適應 · MEDIUM · MCQ —
護理師正在照護一位尿路感染（UTI）病人。哪項評估發現最提示有腎盂腎炎（pyelonephritis，腎臟感染）？
A nurse is caring for a client with a urinary tract infection (UTI). Which assessment finding is most suggestive of pyelonephritis (kidney infection)?
- ACloudy urine with foul odor尿液混濁且有異味
- BFlank pain and fever✓ 正解腰部疼痛和發燒
- CSuprapubic pain恥骨上疼痛
- DDysuria and frequency排尿困難和頻尿
— Explanation · 中文詳解 —
腎盂腎炎是腎臟的感染，通常伴隨全身性症狀，如高燒、畏寒，以及腰部或肋脊角的疼痛（flank pain）。尿道炎（下泌尿道感染）則常見排尿困難（dysuria）、頻尿（frequency）、恥骨上疼痛（suprapubic pain）和尿液異常。選項 B 最能區分腎臟感染與單純的膀胱炎。
Pyelonephritis is an upper urinary tract infection characterized by systemic symptoms such as fever and flank pain, distinguishing it from lower UTIs like cystitis. While cloudy urine, dysuria, and suprapubic pain are common in bladder infections, the presence of flank pain and fever specifically suggests kidney involvement.
✦ 台美臨床差異
美國的 UTI 診斷與治療指南較為統一，抗生素選擇有明確建議；台灣的處置也類似，但部分地區的抗生素抗藥性問題可能影響選擇。