A&C Urinary/ Renal #4

A nurse is providing dietary teaching to a client who has frequent kidney stones. Which of the following instructions should the nurse include in the teaching?

"Avoid eating tree nuts, such as almonds." The nurse should instruct the client to avoid high-oxalate foods, such as peanuts or tree nuts including almonds, cashews, and hazelnuts, to decrease the risk of stone formation.

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

"I don't eat shellfish because it gives me hives." The client says she experiences hives after eating shellfish, which indicates a sensitivity. The contrast dye typically used for an IVP is an iodine derivative, and the client with a shellfish sensitivity may have cross-sensitivity to iodine and a serious iodine allergy. This nurse should report these finding to the client's provider

A nurse is providing dietary teaching to client who has calcium oxalate kidney stones. Which of the following statements indicates an understanding of the teaching?

"I may eat a banana with my breakfast." Excessive dietary intake of oxalate can increase the risk of calcium oxalate stone. Bananas are not high in oxalate. Therefore, this food choice indicates an understanding of teaching.

A nurse is teachign a client who is scheduled for a cystoscopy. Which of the following information should the nurse include in the teaching?

"You may have pink-tinged urine after this procedure." The client might have blood-tinged, or pink, urine after the procedure. The client should report dark red urine because it is an indication of bleeding.

A nurse is caring for a client who reports recurrent flank pain, nausea, and vomiting for 24hrs. Which of the following actions is the nurse's priority?

Administer pain medication. Using Maslow's hierarchy of needs, the nurse's priority is to meet the client's physiological need for comfort. Therefore, the first action the nurse should take is to administer pain medication to relieve the client's flank pain.

A nurse is caring for a client who has an indwelling urinary catheter and notes blood tinged urine in the catheter bag. The nurse recognizes this finding can be a manifestation of which of the following urinary alterations?

Bladder infection The nurse should recognize that hematuria, or blood-tinged urine, can be a manifestation of a bladder or kidney infection.

A nurse is caring for a client who is 5 hr post op following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

Check the tubing for kinks. When providing client care, the nurse should first use the least restrictive intervention; therefore, the nurse should check the catheter tubing for kinks. The nurse must ensure constant flow of the bladder irrigant into the catheter and outward drainage from the catheter to prevent clotting, which could occlude the catheter lumen.

A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk of renal calculi?

Dehydration Dehydration can cause hypercalcemia which increases the risk for renal stone formation. Inadequate fluid intake can result in urinary stasis and promote the formation of calculi.

A nurse is reviewing the medical record of a client who has a urinary tract infection (UTI). Which of the following findings should the nurse recognize as a risk factor?

Diabetes mellitus Diabetes mellitus is a risk for factor for a UTI due to the increased amount of glucose present in the urine.

A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?

Drink 3 L of fluid every day. The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to dilute the urine and reduce the risk for stone formation

A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take?

Encourage intake of at least 3 L of fluids per day. The nurse should encourage the client to consume at least 3,000 mL of fluids per day to dilute the urine, increase hydrostatic pressure behind the stone, and move the calculi down the urinary tract.

A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor?

Family history Family history is strongly correlated with the formation of urolithiasis. A nurse should assess a client who has kidney stones for familial tendencies toward stone formation.

A nurse is caring for a client who is postoperative following a transurethral resection of the prostate. Which of the following complications is the priority for the nurse to monitor for?

Hemorrhage Using the airway breathing circulation (ABC) approach to client care the nurse determines that the priority complication to monitor for is the client hemorrhaging; therefore, the nurse should monitor the client's urinary output for blood clots and bright red blood tinged urine following surgery.

A nurse is planning care for a client who is 2 hr post op following a transurethral resection of the prostate. The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?

Remind the client he might feel a constant urge to void. The client who is receiving continuous bladder irrigation will experience a continuous urge to void because of pressure on the internal sphincter from the catheter balloon.