CH 33
What is the most common cancer of the kidney?
renal cell carcinoma
Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?
Increased blood pressure
A client has a tubulointerstitial disorder and is not able to concentrate urine. The nurse will likely assess which manifestations associated with this disorder?
Polyuria Nocturia
Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?
Proteinuria and generalized edema
An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?
Recently had a urinary tract infection
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:
"All glomeruli and all parts of the glomeruli are involved."
A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor?
"Make an appointment with your health care provider immediately."
Which client is likely at the greatest risk of developing a urinary tract infection?
A 79-year-old client with an indwelling catheter
Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?
ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.
A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:
Acute postinfectious glomerulonephritis
A client who developed acute pyelonephritis asks the nurse what caused the infection. What should be included in the nurse's response?
Acute pyelonephritis is caused by bacterial infection. Escherichia coli is the causative agent in about 80% of cases. Outflow obstruction, catheterization, and urinary instrumentation
A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply.
Avoiding bubble baths Wiping from front to back after a bowel movement Careful hand washing
A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen?
Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear.
The nurse is caring for a client with recurring urinary tract infections (UTIs). The client asks, "Other than taking antibiotics, what else can I do?" Which response by the nurse is most accurate?
Drink lots of fluids to help relieve the signs/symptoms of UTIs.
Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)?
Extracorporeal shock wave lithotripsy (ESWL)
A family member asks the nurse, "What should I do if there is blood in my parent's urine and some pain in the lower abdomen?" Which response is the best advice to give this family member?
Get an appointment with the family doctor.
Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis?
Group A Β-hemolytic streptococci
While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?
Heavy smoking
Which factor contributes to the development of polycystic kidney disease?
Hereditary mutations in polycystin I and II
The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections?
Knowledge of aseptic technique when inserting urethral catheters
A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?
Microalbuminuria is a predictor of future nephropathies.
The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?
Plasma proteins
What is the most common cancer of the kidney?
Renal cell carcinoma
A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?
Strain the urine.
What are appropriate interventions in the care of a client diagnosed with renal calculi?
Straining the client's urine Addressing the client's pain Keeping track of intake and output
A client suffering from chronic hypertension is beginning to show the symptoms of glomerular disease. This client's kidney damage is due to what phenomenon?
The higher pressures force protein and cells through the glomerular membrane, resulting in glomerular inflammation.
A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?
There is possible obstruction in the urinary tract.
The nurse caring for an older adult notes a marked decrease in mental acuity over a 24-hour period. What assessment indicates the most likely cause of this change?
Urine cloudy with strong odor
Which is the most important factor in reducing hospital-acquired (nosocomial) urinary tract infections?
Using urinary catheters only when necessary and their prompt removal when no longer needed
The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?
increase in BP
Manifestations of polycystic kidney disease include which of the following?
increase in kidney size bilat
The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?
increased BP
What is the usual cause of acute pyelonephritis?
infection
Which substance would not be found in glomerular filtrate?
protein
The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects which physiologic principle?
salt and water tubular reabsorption
Acute pyelonephritis is a result of:
bacterial infectino
Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.
e. coli
A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?
plasmapheresis
A client has a dilated renal pelvis due to obstruction of urine outflow from the kidney. The pressure of filtrate formation is damaging the renal structures. Which condition is most likely?
Hydronephrosis
A client is diagnosed with renal calcium stone formation. Which endocrine imbalances could contribute to this condition?
Hyperparathyroidism
A student presents to the campus clinic with reports of frequent, burning urination and is diagnosed with an acute lower urinary tract infection (UTI) caused by Escherichia coli. What teaching will the health care provider most likely provide to the student?
"Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe."
The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?
increased BP
Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?
state of hydration
A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?
strain the urine
A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?
uric acid
A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?
calcium
The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?
corticosteroids
