Porth's CH 41 Disorders of Renal Function

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?

Increase washout of urine

Which of the following patients is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old patient with an indwelling catheter

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit pyuria and high counts of urine colony-forming units?

A client who has urinary catheter in place due to confusion

Hospitalized neonates are at the greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

The most damaging effects of urinary obstruction are the result unrelieved obstruction of urine outflow and:

Urinary stasis

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client:

Will not undergo an acute kidney injury by decreasing renal blood flow

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

acute postinfectious glomerulonephritis

A nurse observes that a patient's urine is cola colored and considers which of the following as a possible reason?

he patient's urine contains material from the degradation of red blood cells.

The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate (struvite) stones based on which urinalysis results? Select all that apply

Alkaline urine pH High urine phosphate level High bacterial count

The nurse is reviewing the lab results of a patient with suspected nephrotic syndrome. The nurse anticipates that the results to include:

Protein in the urine

Which of the following statements about the use of angiotensin-converting enzyme inhibitor medications and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen.

Acute pyelonephritis is a result of which of the following?

Bacterial infection

The nurse reviews the lab results for a patient who has advanced autosomal dominant polycystic kidney disease (ADPKD). The patient 's hemoglobin is 8.8 g/dL. The nurse suspects this lab value is related to which of the following causes?

Reduced production of erythropoietin

A pregnant woman in the third trimester reports burning and pain on urination. Which physiologic changes during pregnancy increases the risk for urinary tract infection (UTI)? Select all that apply.

Dilation of the renal calyces, pelvis, and ureters Muscle-relaxing effects of progesterone-like hormones Mechanical obstruction from the enlarged uterus

What is the most common cause of a lower urinary tract infection?

Escherichia coli

Which of the following is a nonsurgical method of treatment for renal calculi (kidney stones)?

Extracorporeal shock wave lithotripsy (ESWL)

Which of the following client clinical manifestations most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

Hematuria

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which of the following?

Increased blood pressure

A patient is to receive a radiocontrast media as part of a diagnostic scan. Which of the following is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate to 125 mL/hour

Which one of the following is the usual cause of acute pyelonephritis?

Infection

A nurse is giving discharge instructions for a patient who was diagnosed with acute pyelonephritis 3 days previously. Which of the following is important for the nurse to discuss when instructing the patient?

It is important that the patient take the prescribed antibiotic for the duration of the prescription.

A client has recently been diagnosed with systemic lupus erythematosus (SLE) glomerulonephritis. Knowing the treatment options, the nurse should anticipate educating the client (who has a positive renal biopsy result) on which medications usually prescribed? Select all that apply.

Prednisone, a corticosteroid Captopril, an ACE inhibitor

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 initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to:

plasma proteins.