EAQ - Chapter 34: Care of Patients with Disorders of the Urinary System

When the nurse is providing care for a patient with acute glomerulonephritis, which laboratory result indicates progression of the disease to nephrotic syndrome? Select all that apply. One, some, or all responses may be correct. 1) Proteinuria 2) Leukocytosis 3) Hypocalcemia 4) Hypernatremia 5) Hyperalbuminemia 6) Hypercholesterolemia

1) Proteinuria 6) Hypercholesterolemia

Which intervention would the nurse implement when providing postoperative care for a patient who experienced a nephrectomy secondary to a renal tumor? Select all that apply. One, some, or all responses may be correct. 1) Recording urinary output 2) Weighing the patient daily 3) Providing proper care of catheters and tubes 4) Ensuring frequent turning and deep breathing 5) Instructing the patient to minimize coughing 6) Providing oral intake immediately after the operation

1) Recording urinary output 2) Weighing the patient daily 3) Providing proper care of catheters and tubes 4) Ensuring frequent turning and deep breathing

For which complication is the patient with a critically low serum calcium level secondary to end-stage renal disease (ESRD) at risk? 1) Seizures 2) Increased edema 3) Cardiac problems 4) Respiratory depression

1) Seizures

Which nonpharmacologic intervention to treat a urinary tract infection (UTI) and control clinical manifestations of frequency, burning, and dysuria would the nurse recommend for a patient diagnosed with a UTI? Select all that apply. One, some, or all responses may be correct. 1) Sitz baths 2) Cranberry juice 3) Vaginal douche twice a day 4) One glass of red wine each night 5) Consumption of 64 to 96 ounces of water daily

1) Sitz baths 2) Cranberry juice 5) Consumption of 64 to 96 ounces of water daily

Which device would the provider use to prevent obstruction of the ureter by edema during recovery and healing for a patient who had a shock wave lithotripsy (SWL) performed? 1) Ureteral stent 2) Urethral catheter 3) Suprapubic catheter 4) Nephrostomy catheter

1) Ureteral stent

Which intervention would the nurse include in the daily assessment of a patient with nephrotic syndrome? Select all that apply. One, some, or all responses may be correct. 1) Weight 2) Allen test 3) Guaiac test 4) Monitoring for edema 5) Pupillary response 6) Peripheral neurovascular checks

1) Weight 4) Monitoring for edema

When preparing a patient for a lithotripsy procedure, which instruction would the nurse provide the patient regarding postprocedural expectations? Select all that apply. One, some, or all responses may be correct. 1) "There will be no pain involved." 2) "You may observe blood in your urine." 3) "The provider inserts a ureteral stent on conclusion of the procedure." 4) "An open surgical procedure will be performed." 5) "Your provider will remove the ureteral stent within 4 to 6 weeks."

2) "You may observe blood in your urine." 3) "The provider inserts a ureteral stent on conclusion of the procedure." 5) "Your provider will remove the ureteral stent within 4 to 6 weeks."

Which rationale supports the nurse's explanation of postponing invasive procedures for 4 to 6 hours after a patient receives a hemodialysis? 1) Hemodialysis is very tiring and takes a long time. 2) Hemodialysis uses heparin during the procedure. 3) Disorientation of the patient occurs immediately after the procedure. 4) A heightened chance of infection occurs immediately after the procedure.

2) Hemodialysis uses heparin during the procedure.

Which postoperative intervention would the nurse include in the plan of care for a patient scheduled for an extracorporeal shock wave lithotripsy (ESWL) secondary to renal calculi? 1) Restricting all fluids to 1500 mL/day 2) Providing educational information on prescribed alpha antagonists 3) Providing patient with dietary instructions on a high-protein, low-carbohydrate diet 4) Performing a straight catheterization after each voiding, and documenting postvoid residual

2) Providing educational information on prescribed alpha antagonists

The nurse would instruct a patient diagnosed with cystitis about adhering to the prescribed treatment to avoid development of which disorder? 1) Gonorrhea 2) Pyelonephritis 3) Bacterial vaginosis 4) Nonspecific urethritis

2) Pyelonephritis

Which test would the nurse anticipate scheduling for a 25-year-old male patient reporting burning pain while urinating, itching, and urinary frequency to the health care provider? 1) Macroscopic urinalysis 2) Urine culture and sensitivity 3) Kidney, ureter, and bladder (KUB) x-ray 4) Serum creatinine and blood urea nitrogen (BUN) levels

2) Urine culture and sensitivity

Which clinical manifestation would the nurse associate with a patient's acute glomerulonephritis? 1) Hearing problems 2) Widespread edema 3) Very pale-yellow urine 4) Fluctuating blood pressures

2) Widespread edema

Which life-long instruction would the nurse provide a patient with a kidney transplant? 1) "Continue to limit your intake of sodium." 2) "Modify your dietary intake to include a protein-restricted diet." 3) "Your daily medications increase your susceptibility to infection." 4) "You must have your DNA checked periodically."

3) "Your daily medications increase your susceptibility to infection."

When providing care for older adult patients in a long-term care facility, which clinical manifestation would the nurse associate with the first sign of a urinary tract infection? 1) Fever 2) Dysuria 3) Confusion 4) Low back pain

3) Confusion

Which clinical manifestation is the earliest sign of a patient's renal impairment? 1) Oliguria 2) Pruritus 3) Polyuria 4) Dark-colored urine

3) Polyuria

A patient scheduled for lithotripsy asks why anesthesia is needed when the procedure is noninvasive, and the nurse explains that the required anesthesia ensures that the patient's position is maintained throughout the procedure. Which type of lithotripsy does the patient have scheduled? 1) ) Laser lithotripsy 2) Electrohydraulic lithotripsy 3) Percutaneous ultrasonic lithotripsy 4) Extracorporeal shock-wave lithotripsy (ESWL)

4) Extracorporeal shock-wave lithotripsy (ESWL

Which event most likely contributed to the development of a patient's bladder cancer? 1) A history of renal calculi 2) Employment in the textile industry 3) Frequent urinary tract infections (UTIs) 4) Two-pack-per-day cigarette use for 25 years

4) Two-pack-per-day cigarette use for 25 years

Which clinical manifestation would the nurse expect to identify in a patient with cystitis? 1) Oliguria 2) Polyuria 3) Bladder distention 4) Urinary frequency

4) Urinary frequency

When teaching skin care to a patient with an ileal conduit, at which frequency would the nurse instruct the patient to empty the collection bag ? 1) Once daily 2) Every hour 3) When the bag is almost full 4) When the bag is one-third full

4) When the bag is one-third full

When a patient with glomerulonephritis requests a snack, which potential food item would the nurse provide? 1) Applesauce 2) Warm broth 3) Orange juice 4) Gelatin

1) Applesauce

Which priority intervention would the nurse implement when a male patient is experiencing extreme pain and kidney stones are suspected? 1) Asking the patient to strain all urine before discarding it in the toilet 2) Having the patient stand up to void in the urinal 3) Administering an analgesic every 8 hours 4) Telling the patient to avoid lying in the supine position

1) Asking the patient to strain all urine before discarding it in the toilet

Which organism most likely caused a female patient's urinary tract infection (UTI)? 1) Escherichia coli 2) Staphylococcus aureus 3) Streptococcus pyogenes 4) Herpes simplex virus 1 (HSV-1)

1) Escherichia coli

Which information would the nurse teach a patient who is prescribed ciprofloxacin, a fluoroquinolone agent, for a suspected urinary tract infection? Select all that apply. One, some, or all responses may be correct. 1) "Be sure to drink 1500 to 2000 mL of fluid each day to prevent crystal formation." 2) "You may take this medication at the same time as your daily iron tablets." 3) "Take the antibiotic within 2 hours of an antacid agent to decrease stomach irritation." 4) "We will notify you if another antibiotic is needed as a result of the urine culture and sensitivity." 5) "The broad-spectrum antibiotic is effective against many gram-positive and gram-negative pathogens."

1) "Be sure to drink 1500 to 2000 mL of fluid each day to prevent crystal formation." 4) "We will notify you if another antibiotic is needed as a result of the urine culture and sensitivity." 5) "The broad-spectrum antibiotic is effective against many gram-positive and gram-negative pathogens."

Which intervention would the nurse implement when providing care for a patient diagnosed with calcium oxalate urinary tract calculi? Select all that apply. One, some, or all responses may be correct. 1) Administering calcium 2) Reducing sodium intake 3) Reducing dietary oxalate 4) Reducing dietary purines 5) Administering alpha-penicillamine and tiopronin

1) Administering calcium 2) Reducing sodium intake 3) Reducing dietary oxalate

After 4 hours, the nurse emptied 50 mL of urine from the collection bag of an indwelling urethral catheter attached to a right nephrostomy tube. Which minimum value reflects adequate urinary output? Record your answer using a whole number. _____ mL

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