Optional Renal, Reproductive and Infectious Diseases (EAQ's)

Peripheral Intravenous Catheter

A catheter that begins and ends in the extremities of the body; used for the administration of intravenous therapy.

A client with radiation therapy for neck cancer reports, "I feel a lump while swallowing and foods get stuck." What does the nurse document in the client's medical history?

Dysphagia

is having difficulty while swallowing. This characterizes pharyngeal and esophageal involvement, which further impedes eating. In this condition, the client may report a feeling of having a "lump" when swallowing and feeling that "foods get stuck."

Dysphagia

is painful or difficult urination

Dysuria

causes pneumonia in a client with acquired immunodeficiency syndrome (AIDS). .

Pneumocystis jiroveci

A nurse is caring for a client who recently had a kidney transplant. Which priority assessment finding requires follow up by the nurse?

Fever is a characteristic of the systemic inflammatory response to the antigen (transplanted kidney) and indicates possible rejection of the transplanted kidney [1] [2].

is reserved for clients who are at risk for the relapse of or have recurrent Clostridium difficile infections.

Fidaxomicin

A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. Which does the nurse conclude is most likely the causative factor?

Retention R: An enlarged prostate constricts the urethra, interfering with urine flow and causing retention. When the bladder fills and approaches capacity, small amounts can be voided, but the bladder never empties completely.

is used to treat traveler's diarrhea caused by Escherichia coli.

Rifaximin

A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic acidosis. What should the nurse conclude is the reason metabolic acidosis develops with kidney failure?

Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate R: Bicarbonate buffering is limited, hydrogen ions accumulate, and acidosis results. The rate of respirations increases in metabolic acidosis to compensate for a low pH.

Is fasting required before an upper GI series?

Yes, usually NPO after midnight.

Herpes simplex virus leads to.

abortions, male urethritis, genital ulcerations, and cervicitis. Trichomonas vaginalis may occur due to vulvovaginitis

A client with mild diarrhea is diagnosed with a Clostridium difficile infection. Which is the first-line drug that would be used to treat this condition?

Metronidazole R: Metronidazole is the first line of treatment prescribed to clients with a Clostridium difficile infection.

Droplet precautions

Must be followed for a patient known or suspected to be infected with pathogens transmitted by large-particle droplets expelled during coughing, sneezing, talking, or laughing. Droplet precautions are for patients who have an illness, which could be spread through contact with secretions from the mouth, nose and lungs when a patient coughs or sneezes. Usually, the droplets can only travel about three feet. Examples of droplet precaution illnesses include whooping cough and influenza. If you are treating a patient in droplet precautions you need to wear a mask, gown and gloves.

causes tuberculosis in a client with AIDS

Mycobacterium tuberculosis

accidental failure to take a medication.

Nonadherence

deliberately failing to take a medication as might be done when skipping doses because of not liking to take pills, choosing to not take a medication because of information seen on television, and not being able to afford medication.

Noncompliance

Conditions such as 1. tuberculosis 2. graft rejection 3. contact dermatitis 4. fungal infections are examples of

cell-mediated immunity.

While xerostomia may contribute to difficulty swallowing, it is not the term used; xerostomia is used to indicate

dry mouth.

During a renal scan, what should be administered after initial imaging to better visualize kidney function and blood flow.

furosemide

PPE for droplet precautions

gloves, gown, mask

Allergic rhinitis and anaphylactic shock are examples of what type of immunity?

humoral immunity: that are mediated by antibodies released by B lymphocytes.

Lasix adverse effects

hypotension, constipation

Dysgeusia

is the loss of taste; clients will report that all food has lost its flavor.

Furosemide (Lasix)

is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen. This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Furosemide is a "water pill" (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.

An overgrowth of Candida albicans causes

mouth pain and difficulty swallowing.

Is fasting required before a renal scan?

no

Odynophagia is

painful swallowing; clients will report severe pain while swallowing.

should be inserted to deliver the radioisotope used in a renal scan.

peripheral intravenous (IV) catheter

humoral immunity

specific immunity produced by B cells that produce antibodies that circulate in body fluids

The urge to void is caused by

stimulation of the stretch receptors as the bladder fills with urine;

Perfusion is

the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue.

Hematuria is expected after surgery. It is

the presence of blood in urine.

A renal scan procedure utilizes only trace doses of radioisotopes, no precautions related to radioisotope exposure are required.

true

in suppression, little or no urine is produced.

true

cell-mediated immunity

type of immunity produced by T cells that attack infected or abnormal body cells

should a client be encouraged to drink fluids after the renal scan to help excrete the isotope

yes

The nurse notes that a client is not adhering to prescribed antibiotic therapy. Which reason should the nurse document?

"I left my pills in the bedroom and I forgot to take them with breakfast. R: Nonadherence is accidental failure to take a medication. Noncompliance is deliberately failing to take a medication as might be done when skipping doses because of not liking to take pills, choosing to not take a medication because of information seen on television, and not being able to afford medication.

The expected serum creatinine range is

0.7 to 1.4 mg /dL (62 to 124 mcmol/L).

Neisseria gonorrhoeae causes

1. gonorrhea 2. salpingitis 3. infertility 4. ectopic pregnancy.

A renal scan is performed to examine the

1.structure 2. function 3. perfusion of the kidneys using the intravenous (IV) administration of a radioisotope.

A registered nurse writes a care plan for a client undergoing a renal scan. Which of the following interventions should the nurse include? Select all that apply.

Administering furosemide after initial imaging Inserting the peripheral intravenous (IV) catheter to give the radioisotope R: A renal scan is performed to examine the structure, function, and perfusion of the kidneys using the intravenous (IV) administration of a radioisotope. During the procedure, furosemide should be administered after initial imaging to better visualize kidney function and blood flow. A peripheral intravenous (IV) catheter should be inserted to deliver the radioisotope. Fasting is not required before the procedure. Because the procedure utilizes only trace doses of radioisotopes, no precautions related to radioisotope exposure are required. The client should be encouraged to drink fluids after the procedure to help excrete the isotope.

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL (260 mcmol/L). What should the nurse do first in response to this laboratory result?

Assess for decreased urine output. R: The expected serum creatinine range is 0.7 to 1.4 mg /dL (62 to 124 mcmol/L). The nurse should obtain additional information that may indicate acute rejection; therefore, the nurse must first assess for decreased urine output and changes in vital signs. Once additional data are collected (e.g., urine output, current blood work reports) and the intravenous (IV) infusions are checked, the nurse should contact the primary healthcare provider, explain the situation, and implement further prescriptions. Eventually the nurse should ensure that proper infusion rates, along with IV medications, are being maintained after the client is first assessed for decreased urine output and for changes in vital signs. Current blood work reports should be obtained after the client is assessed for decreased urine output and changes in vital signs.

Which conditions in clients are examples of cell-mediated immunity? Select all that apply.

Contact Dermatitis Tuberculosis Graft rejection R: Conditions such as tuberculosis, graft rejection, contact dermatitis, and fungal infections are examples of cell-mediated immunity. T lymphocytes and macrophages sensitize T cells and cytokines to provide protection against fungus, viruses (intracellular), chronic infectious agents, and tumor cells. Allergic rhinitis and anaphylactic shock are examples of humoral immunity that are mediated by antibodies released by B lymphocytes.

In teaching a class about sexually transmitted infections, the nurse discusses manifestations associated with each and effects of delaying treatment. During the discussion, gummas, which are tumors that break and ulcerate, and mental and physical disability are described. Which infection is the nurse describing?

Syphilis Gummas are associated with tertiary syphilis. They are tumors of a rubbery consistency that break down and damage the heart and nervous system and skin. The spirochete in late stages can lead to mental and physical disability. Primary syphilis is characterized by chancres. Chlamydia trachomatis is sometimes asymptomatic and often is associated with pelvic inflammatory disease. Redness, itching, and burning are associated with trichomoniasis, as is a frothy, foul-smelling discharge. Gonorrhea may be asymptomatic or associated with a yellow urethral or penile discharge.

A client with acquired immunodeficiency syndrome (AIDS) reports speech, gait, and vision difficulty. The nurse observes the client is confused and lethargic. Which microorganism is most likely responsible for this condition?

Toxoplasma gondii R: Toxoplasmosis encephalitis is an opportunistic infection caused by Toxoplasma gondii. The symptoms of toxoplasmosis encephalitis are speech, gait, and vision difficulty along with confusion and lethargy. An overgrowth of Candida albicans causes mouth pain and difficulty swallowing.

The client in the image has palmar and plantar secondary syphilis, which is caused by

Treponema pallidum.

is preferred for serious Clostridium difficile infections.

Vancomycin