American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the clinical significance of Reynolds' pentad in the context of cholangitis?

1. Indicates mild infection

2. Suggests acute kidney injury

3. Indicates severe infection with potential sepsis

4. Signifies renal stone presence

The correct answer is: Indicates severe infection with potential sepsis

Reynolds' pentad is a clinical syndrome that is significant in the assessment of acute cholangitis, a condition resulting from an infection of the bile duct. It consists of five key features: fever, jaundice, right upper quadrant pain, hypotension, and altered mental status. When a patient presents with Reynolds' pentad, this indicates not just a mild infection, but a severe and potentially life-threatening situation involving the bile duct. The presence of all five signs suggests a high probability of severe infection that could lead to sepsis. In cholangitis, the combination of infection and obstruction (often due to gallstones) can result in systemic inflammatory responses and multi-organ dysfunction if not addressed promptly. Recognizing Reynolds' pentad is crucial for timely intervention, which may include antibiotics and surgical procedures to relieve the obstruction, thereby reducing the risk of complications associated with severe infections and sepsis. The other choices do not accurately reflect the clinical significance of Reynolds' pentad. For example, mild infections do not produce the full spectrum of symptoms that characterize Reynolds' pentad, and suggestions of kidney injury or the presence of renal stones are not directly relevant to the acute infection implications denoted by the pentad itself.