URINARY AND RENAL

A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?

4.6 nanograms/milliliter

The staff educator is giving a class for a group of nurses new to the renal unit. The educator is discussing renal biopsies. In what patient would the educator tell the new nurses that renal biopsies are contraindicated?

A 42-year-old patient with morbid obesity

The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first?

A midstream urine for culture.

The nurse is preparing to collect an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters? Select all that apply.

A) Specific gravity of the patients urine B) Testing for the presence of glucose in the patients urine C) Microscopic examination of urine sediment for RBCs D) Microscopic examination of urine sediment for casts

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response?

An elevated PSA can result from several different causes.

The client diagnosed with renal calculi is admitted to the medical unit. Which intervention should the nurse implement first?

Assess the client's pain and rule out complications.

The nurse is caring for a client diagnosed with rule-out nephrotic syndrome. Which intervention should be included in the plan of care

Assess the client's sacrum for dependent edema.

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the primary health care provider (PHCP)?

Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute

A client undergoes a transurethral resection of the prostrate (TURP). In the immediate postoperative period, which characteristic does the nurse expect when observing the urinary drainage?

Bloody

The client from a long-term care facility is admitted to the medical unit with a fever, hot flushed skin, and clumps of white sediment in the indwelling catheter. Which intervention should the nurse implement first?

Change the indwelling catheter.

The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client?

Come to the clinic and provide a urinalysis specimen.

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication?

Decongestants

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?

Decreased force in the stream of urine

A clinic nurse evaluates that a client's levothyroxine (Synthroid) dose is too low when which findings are noted? Select all that apply.

Decreased sweating Apathy and fatigue Paresthesias Slowed mental processes

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?

Detects calculi, cysts, or tumors

The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP?

Elevate the scrotum on a towel roll for support.

The client with possible renal calculi is scheduled for a renal ultrasound. Which intervention should the nurse implement for this procedure?

Explain the test is noninvasive and there is no discomfort.

The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome?

Generalized edema

The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. What Instruction should the nurse give the patient?

Notify the physician about cloudy or foul-smelling urine.

An older adult client reports urinary frequency, urgency, and dysuria. A cystoscopy is performed. After the cystoscopy, which nursing action has the highest priority?

Obtain the client's vital signs.

A patient is scheduled for a diagnostic MRI of the lower urinary system. What pre-procedure education should the nurse include?

Relaxation techniques to apply during the test

The nurse provides care for a client reporting a sudden onset of severe right flank pain. The client is diagnosed with urinary calculi. Which nursing action has the immediate priority?

Relieving pain.

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations should be expected? (Select all that apply.)

a. Vomiting c. Failure to gain weight f. Persistent diaper rash

The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficulty, the nurse asks the client about the presence of which of the following early symptoms?

c. Decreased force in the stream of urine

The nurse is examining a 15-year-old female who is complaining of pain, frequency, and urgency when urinating. After asking the parent to leave the room, which question should the nurse ask the client?

"Are you sexually active?"

The nurse receives a call from a client concerned about eliminating brown colored urine after taking nitrofurantoin for a urinary tract infection. The nurse should make which appropriate response?

"Continue taking the medication; the brown urine occurs and is not harmful."

Which statement indicates the client diagnosed with calcium phosphate renal calculi understands the discharge teaching for ways to prevent future calculi formation?

"I should increase my fluid intake, especially in warm weather."

Which statement indicates discharge teaching has been effective for the client who is postoperative TURP?

"I will call the surgeon if I experience any difficulty urinating."

The nurse is preparing the discharge teaching plan for the male client with a left-sided nephrectomy. Which statement indicates the teaching is effective?

"I will take my temperature and if it is above 101 I will call my doctor."

The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse?

"Potency can return in six (6) to eight (8) weeks."

The client returned from surgery after having a TURP and has a P 110, R 24, BP 90/40, and cool and clammy skin. Which interventions should the nurse implement? Select all that apply.

- Assess the urine in the continuous irrigation drainage bag. - Lower the head of the bed while raising the foot of the bed. - Contact the surgeon to give an update on the client's condition.

The client diagnosed with renal calculi is scheduled for a 24-hour urine specimen collection. Which interventions should the nurse implement? Select all that apply.

- Check for the ordered diet and medication modifications. - Instruct the client to urinate, and discard this urine when starting a collection. - Collect all urine within 24 hours and place it in the appropriate specimen container.

A 5 year old male is admitted with acute glomerulonephritis. On assessment, you note mild edema predominately in the face and tea-colored urine. The patient's blood pressure is 165/110, heart rate 95, oxygen saturation 98% on room air, and temperature 98.9 'F. In your nursing care plan, what nursing interventions will you include in this patient's plan of care? SELECT-ALL-THAT-APPLY:*

- Monitor intake and output hourly. - Assess color of urine after every void. - Weigh patient every daily on a standing scale.

The mother of a child, who was recently diagnosed with nephrotic syndrome, asks how she can identify early signs that her child is experiencing a relapse with the condition. You would tell her to monitor the child for the following: (SATA)

- Protein in the urine using an over-the-counter kit - Swelling in the legs, hands, face, or abdomen

You're caring for a patient with an indwelling catheter. The patient complains of spasm like pain at the catheter insertion site. Which of the following options below are other signs and symptoms the patient could experience or the nurse could observe if a urinary tract infection was present? SELECT-ALL-THAT-APPLY

- increased WBC - FEELING THE NEED TO VOID EVEN WHEN THERES A CATHTER PRESENT - dark couldy urine - cramping

You're providing education to a group of nursing students about nephrotic syndrome. A student describes the signs and symptoms of this condition. Which signs and symptoms verbalized by the student require you to re-educate the student about this topic? Select-all-that-apply:*

- slight protinuria - tea-colorerd urine - hypertension

A kidney biopsy has been scheduled for a patient with a history of acute renal failure. The patient asks the nurse why this test has been scheduled. What is the nurses best response?

A biopsy is sometimes necessary for diagnosing and evaluating the extent of kidney disease.

The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse?

A white blood cell count of 14,000/mm3.

The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first?

Assess the continuous irrigation catheter for patency.

The nurse is caring for a patient who has returned to the postsurgical suite after post-anesthetic recovery from a nephrectomy. The nurses most recent hourly assessment reveals a significant drop in level of consciousness and BP as well as scant urine output over the past hour. What is the nurses best response?

Assess the patient for signs of bleeding and inform the physician.

The client diagnosed with renal calculi is scheduled for lithotripsy. Which postprocedure nursing task is the most appropriate to delegate to the UAP?

Assist the client to the car when being discharged home.

The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI?

Avoid coffee, tea, colas, and alcoholic beverages.

A client has a TURP. Twenty-four hours later, the nurse notices the client's urine is bright red. Which nursing action is most appropriate?

Contact the health care provider.

The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement?

Discuss the importance of limiting vitamin D-enriched foods.

The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list?

Drink 8 to 10 glasses of water per day

Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?

Has the child had a sore throat or a throat infection in the last few weeks?"

The nurse is assessing a patient suspected of having developed acute glomerulonephritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem?

Hematuria

The nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the child's parent should the nurse expect that is associated with this diagnosis?

I noticed his urine was the color of cola lately."

The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?

If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.

The nurse cares for a client 2 hours after the client has a transurethral resection of the prostate (TURP). The nurse assesses the 3-way indwelling urinary catheter and continuous bladder irrigation (CBI) and notes the urinary output is bright red with clots present. Which is the MOST appropriate action for the nurse to take?

Increase the rate of the irrigation fluid

A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action?

Infusing slowly over 60 minutes

The nurse is providing care to a client who has had a transurethral resection of the prostate. The client has a three-way catheter drainage system in place for continuous bladder irrigation. The nurse anticipates that the catheter may be removed when the urine appears as which of the following?

Light yellow and clear

A client is admitted to the emergency department following a fall from a horse, and the primary health care provider (PHCP) prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action?

Notify the PHCP before performing the catheterization.

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply.

Pallor Edema Anorexia Proteinuria

Which nursing diagnosis is priority for the client who has undergone a TURP?

Potential for hemorrhage.

A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine level of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders?

Preprocedure hydration and administration of acetylcysteine

The nurse is preparing a teaching care plan for the client diagnosed with nephrotic syndrome. Which intervention should the nurse include?

Provide teaching for taking diuretics.

The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patients health education, what nutritional guidelines should the nurse provide?

Restrict protein intake as ordered.

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy?

Sore throat

Which intervention is most important for the nurse to implement for the client diagnosed with rule-out renal calculi?

Strain all urine and send any sediment to the laboratory.

The nurse is discharging a client with a health-care facility acquired urinary tract infection. Which information should the nurse include in the discharge teaching?

Take all the antibiotics as prescribed.

The nurse is caring for a patient who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the physician

Temperature 100.2F orally

A client had a TURP. On the third postoperative day, the urinary catheter is removed. Later that day the client reports uncontrolled dribbling after urination. The nurse's response is based upon which statement?

Temporary urinary incontinence is not unusual following catheter removal.

The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis?

The client complains of fatigue, headaches, and increased urination.

Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which interpretation about the client's complaints?

The client is experiencing a pulmonary reaction requiring cessation of the medication.

The nurse is caring for the client recovering from a percutaneous renal biopsy Which data indicate the client is complying with client teaching?

The client is lying flat in the supine position.

The nurse is caring for a pregnant client diagnosed with acute pyelonephritis. Which scientific rationale supports the client being hospitalized for this condition?

The client must be treated aggressively to prevent maternal/fetal complications.

The nurse is preparing a plan of care for the client diagnosed with glomerulonephritis. Which statement is an appropriate long-term goal?

The client will maintain normal renal function.

Which client should the nurse not assign to a UAP working on a surgical floor?

The client with a suprapubic catheter inserted yesterday.

The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving?

The client's bladder spasms are relieved by medication.

The elderly client is diagnosed with glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse?

The glomerular filtration rate is 40 mL/min.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement?

Titrate the NS irrigation to run faster.

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition?

Trauma to the bladder or abdomen

A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?

Ultrasound

The nurse recognizes which of the following symptoms can be seen in a client with benign prostatic hypertrophy? (Select all that apply).

Urinary frequency Urinary urgency Low back pain

A nurse is preparing a patient diagnosed with benign prostatic hypertrophy (BPH) for a lower urinary tract cystoscopic examination. The nurse informs the patient that the most common temporary complication experienced after this procedure is what?

Urinary retention

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation?

Urination is not painful.

The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent reoccurrence?

Venison and sardines.

A patient with a urinary tract infection is taking Bactrim (Sulfamethoxazole/Trimethoprim). As the nurse you know it is important that the patient consumes 2.5 to 3 L of fluid per day to prevent which of the following complications?

cyrstillia

The nurse provides care for an older adult client immediately after a cystoscopy is performed. When assessing the client which finding has the highest priority?

pelvic pain

You're providing care to a 6-year-old male patient who is receiving treatment for nephrotic syndrome. Which assessment finding below requires you to notify the physician immediately?

reddned area on the pts left leg that is swollwn is warm