Chapter 36 MS

. The nurse reviews the process to obtain a midstream urine specimen for culture and sensitivity with a female patient. Which patient statements indicate understanding of this process? (Select all that apply.)

"The labia should be kept separated while voiding." "The genitalia should be thoroughly cleaned with the towelettes provided."

The nurse is caring for a patient who is scheduled for a cystoscopy (C&P) with basket extraction of a stone. What is the most important postoperative care for the nurse to provide?

Measuring urine output

The nurse is helping to prepare a patient for a renal biopsy. In which position should the nurse help the patient assume?

Prone

A female patient is embarrassed because of not being able to walk to the bathroom in time before become incontinent of urine. Which type of incontinence should the nurse plan care for this patient?

Urge

The nurse is reviewing the anatomy of the kidney with a patient scheduled for renal surgery. What should the nurse explain as being the structural and functional unit of the kidney?

Nephron

The nurse is collecting data for a patient who has suspected kidney disease. What health problems should the nurse consider as being associated with a high urine specific gravity?

Nephrosis Dehydration Heart failure Diabetes mellitus

The nurse is contributing to the plan of care for an older patient. What should the nurse recognize as normal signs of aging within the renal system?

Number of nephrons decreases Detrusor muscle tone decreases

The nurse is to obtain orthostatic blood pressure measurements for a patient on dialysis for end-stage renal disease. What should the nurse do when measuring this patient's blood pressure?.

Obtain blood pressure while the patient is lying, sitting, and standing.

The nurse needs to obtain a urine specimen from a female patient. What action should the nurse take when obtaining this specimen?

Obtain the first voided urine of the day.

. A patient recovering from radiological studies of the renal system has a nursing diagnosis of Impaired Urinary Elimination. Which outcome indicates that the nursing interventions have been effective?

Patient voids 35 mL/hour of clear urine.

The nurse is making a visit to the home of a patient with functional incontinence. Which observation indicates that teaching about the disorder has been effective?

Patient wearing sweat pants

The nurse is participating in care planning for a patient with urge incontinence. What should the nurse recommend be included in this patient's plan of care?

Void every 2 hours. Practice relaxation breathing. Use urge inhibition techniques Gradually increase length of time between voidings.

The nurse is collecting data for a patient with kidney disease. When reviewing a urinalysis report, which range should the nurse recognize as normal specific gravity of urine?

1.002 to 1.035

A patient is being evaluated for renal dialysis. What creatinine clearance value should the nurse realize this patient must have to live without needing dialysis treatment?

10 mL

The nurse determines that a patient's urine output is normal. How many mL of urine did the patient void within the last 24 hours?

1000 to 2000 mL

The nurse is instructing a patient on the use of Kegel exercises. How many times a day should the nurse recommend that these exercises be performed?

30 to 80

The nurse is catheterzing a patient after voiding to determine the amount of residual urine in the bladder. What should the nurse consider as being the normal amount of urine within the bladder after urination?

50 mL

The nurse is reviewing a urinalysis report. What should the nurse recognize as the normal average pH of urine?

6

The nurse is reviewing normal kidney function with a patient experiencing an acute kidney injury. Which hormones should the nurse include that affect kidney function?

Aldosterone Parathyroid hormone Antidiuretic hormone (ADH) Atrial natriuretic hormone (ANH)

. The nurse is collecting data for a patient with kidney disease. Which information should the nurse identify as being normal urinalysis findings? (Select all that apply.)

Amber color Specific gravity of 1.010 Small quantities of enzymes

The nurse learns that a patient has a urine pH of 7.9. What question should the nurse ask the patient after learning of this laboratory value?

Are you a vegetarian?

The nurse is caring for a patient recovering from a renal biopsy. For which complication should the nurse monitor the patient during the 24 hours after the procedure?

Bleeding

A patient is recovering from a renal arteriogram. What actions should the nurse take when caring for this patient? (Select all that apply.).

Check distal pulses in leg every 30 to 60 minutes A pressure dressing and sandbag used to apply pressure. Implement bed rest for 12 hours and instruct the patient not to bend leg

The nurse is caring for a patient with an acid-base imbalance from kidney disease. How should the nurse explain the role of the kidneys to maintain acid-base balance in the body to the patient?

Conserving or excreting bicarbonate ions

The nurse is collecting data from a patient with kidney disease. Which adventitious lung sound should the nurse recognize as being caused by fluid overload?

Crackles

The nurse contributes to the plan of care for a patient with edema. Which action should the nurse take as the best indicator of this patient's fluid volume status?

Daily weight

The nurse is caring for a patient with an indwelling catheter. What should the nurse include in this patient's routine care?

Encourage fluid intake Maintain a closed system Secure the catheter to the patient's leg. Remove the catheter as soon as possible.

A patient is scheduled for an intravenous pyelogram (IVP). What care should the nurse provide before the patient has this procedure?

Enema evening before the test.

The nurse is caring for a male patient with functional incontinence. What action should the nurse take to help prevent incontinence?

Ensure that the patient has ready access to the urinal

The nurse is caring for a patient with a kidney infection. When providing prescribed medications, the nurse should recall that which structure is the capillary network in each nephrons?

Glomerulus

The nurse is caring for a patient with an elevated uric acid level. Which health problems should the nurse consider as potentially causing this patient's elevation?

Leukemia Malnutrition Kidney disease Use of thiazide diuretics

The nurse is caring for a patient with an indwelling urinary catheter. Which instructions should the nurse provide to help prevent development of a urinary tract infection? (Select all that apply.)

Position the tubing to allow free flow of the urine Use aseptic technique when emptying the drainage bag. Keep the catheter securely taped to prevent catheter movement.

The nurse is reviewing the results of a patient's urinalysis. Which components should the nurse identify as being abnormal in urine? (Select all that apply.)

Protein Red Blood Cells

The nurse is reviewing data for a patient with acute kidney injury. Which diagnostic test results should the nurse recognize that indicate kidney injury? (Select all that apply.)

Serum creatinine 4.2 mg/dl Urine output of 100 ml in 24 hours Fixed urine specific gravity of 1.010

A patient with pneumonia has a blood urea nitrogen (BUN) of 32 mg/dL and creatinine of 0.8 mg/dL. What should the nurse realize is the most probable explanation for this finding?

The patient is dehydrated.

The nurse is collecting data from a patient with stress incontinence. Which finding should the nurse document?

The patient loses small amounts of urine when he or she coughs or sneezes

The nurse is caring for a patient with kidney disease. How should the nurse end a 24-hour urine test at the end of the 24 hours?

The patient voids at the end of 24 hours, adding it to the collection container.

A patient has a glomerular filtration rate of 55%. What should this value indicate to the nurse?

The patient's other tests will be in the normal range

The nurse is reviewing a patient's history and physical report. What term should the nurse recognize is being used to describe waste products building up in the blood?

Uremia

During an assessment, the nurse notes that a patient has crystals deposited on the skin. What should this finding indicate to the nurse?

Uremic frost

A patient's urinalysis results are: white blood cells (WBC) 100+/hpf; red blood cells (RBC) 4/hpf; bacteria, moderate amount; nitrite, positive; specific gravity, 1.025; urine, cloudy. What should the nurse recognize these findings indicate?

Urinary tract infection