Ch. 45 EAQ Info

Which question has the most importance when the nurse admits a patient with a diagnosis of acute glomerulonephritis? "Have you recently had strep throat?" "How much fluid do you drink in a day?" "Do you have susceptibility to allergies?" "Have you had any contact with anyone who has measles?"

"Have you recently had strep throat?"

Which risk factor would the nurse associate with the patient's development of urinary tract calculi?

A large intake of dietary proteins increases uric acid excretion, which is a risk factor for urinary tract calculi formation.

For a patient with renal calculi, what intervention would the nurse want to focus on developing a plan of care?

Acute pain

Which intervention would the nurse include as a priority when developing a plan of care for the patient admitted with acute pyelonephritis?

Administration of the antibiotic is going to help counter the infectious process.

Which disorders are extrarenal causes of nephrotic syndrome?

Amyloidosis, Diabetes mellitus, Hodgkin's lymphoma

Which predisposing factor would the nurse associate with the development of small renal calculi trapped within a patient's ureter?

Calcium oxalate calculi are small and often become trapped in the ureter when the predisposing factor of hyperoxaluria is present.

When providing care for a patient with polycystic kidney disease (PKD), the nurse would assess for the presence of which serious complication of the disease?

Cerebral aneurysm is a serious complication of PKD; the aneurysm can rupture and cause bleeding and even irreversible brain damage.

Which instruction would the nurse verify for patient understanding prior to their discharge home with a renal calculus?

Continue to strain all urine at home for stones.

Which mechanism would the nurse associate with the development of a patient's poststreptococcal glomerulonephritis?

Deposition of immune complexes and complement activation

When preparing information related to food choices for a patient with a history of calcium phosphate renal calculi, which food choices would the nurse recommend the patient select?

Eggs, oranges, chicken, cranberry juice

When preparing discharge instructions, which renal problem would the nurse associate with the patient's scleroderma and subsequent hypertension?

Hypertension occurs with chronic glomerulonephritis, which may be found in patients with scleroderma.

Which interventions would the nurse implement to manage a patient with calcium oxalate urinary tract calculi?

Increase overall fluid intake, Decrease sodium intake, Limit dietary oxalate intake.

dietary recommendation would the nurse provide a patient newly diagnosed with nephrotic syndrome

Most patients with nephrotic syndrome are advised to consume a moderate-protein diet to replace protein lost through the kidneys and to correct hypoalbuminemia and development of edema.

When teaching a patient about preventing acute poststreptococcal glomerulonephritis, which intervention would the nurse present as most important? Instruct the patient to evacuate the colon regularly. Instruct the patient to maintain good personal hygiene. Promote early diagnosis and treatment of sore throats and skin lesions. Encourage the patient to obtain antibiotic therapy to ensure bacteria eradication

Promote early diagnosis and treatment of sore throats and skin lesions

Which diagnostic study would the health care provider prescribe to detect metastases of cancer from renal tumors?

Radionuclide isotope scanning detects metastases when cancer spreads from one part of the body to another.

Which renal disorder would the nurse associate with an abrupt rise of a 22-year-old patient's BP from 110/68 mm Hg, obtained two months earlier for a new job's physical, to the current BP of 154/96 mm Hg, obtained at the health fair?

Renal artery stenosis

Which immune diseases cause glomerulonephritis? Select all that apply. Scleroderma Diabetic nephropathy Goodpasture syndrome Wegener's granulomatosis Systemic lupus erythematosus (SLE)

Scleroderma, Goodpasture syndrome, Systemic lupus erythematosus (SLE)

Which diagnostic assessment reports would the nurse review when preparing to provide care for a patient with acute pyelonephritis?

Urinalysis with urine culture and sensitivity, CT scan of kidneys, Complete blood count (CBC) and differential white blood cell (WBC) count

After notifying the health care provider, which prescribed intervention would the nurse implement when providing care for a patient whose nephrostomy tube is not draining?

Use 5 mL of sterile saline to irrigate the affected tube

precipitating factor is a common cause of pyelonephritis in patients admitted to the medical unit from a long-term care facility

urinary tract catheterization

When providing care for a patient with glomerulonephritis, the nurse would monitor for the presence of which commonly recurring clinical manifestations?

Hypertension and edema, along with headaches and oliguria, are common complications of glomerulonephritis and tend to recur.

Which therapeutic medical intervention would the nurse anticipate scheduling for a patient with renal calculi?

Lithotripsy (also known as extracorporeal shock wave) is a noninvasive therapeutic treatment in which high-energy shock waves are used to crush or pulverize renal calculi in the renal pelvis, ureter, and bladder.

For the patient diagnosed with acute poststreptococcal glomerulonephritis and clinical manifestations of hypertension, edema, and an elevated blood urea nitrogen (BUN), which dietary modifications would the nurse include in a patient's plan of care?

Maintain a low-protein diet because of the renal damage. An elevation in BUN is evidence of an increase in nitrogenous wastes in the patient. A low-sodium diet is necessary to control the patient's edema; this edema is due to decreased glomerular filtration. A fluid-restricted diet will also help control fluid retention because the patient has edema.

For the patient at risk for ureter obstruction from edema while recovering from a lithotripsy procedure, which urinary drainage catheter would the nurse expect to identify and assess?

Use of a ureteral catheter after surgery splints the ureters and prevents obstruction from debris or stone particles.

Which prescribed medication would the nurse associate with the patient who smokes one pack of cigarettes each day and has a history of a cough, bilateral crackles, and hematuria?

Cough, crackles, and hematuria are clinical manifestations of Goodpasture syndrome, found in smokers. Management of Goodpasture syndrome includes the use of Azathioprine.

For a patient with obstructing urinary calculi, which interventions to ensure treatment effectiveness and patient safety would the nurse implement after noting the patient received tamsulosin (Flomax) and opioids to relieve colic pain in the emergency room?

Encouraging the patient to move helps promote the movement of the stone from the upper to the lower urinary tract, resulting in the passage of stones. The nurse should also strain all urine voided by the patient using gauze or a urine strainer to ensure that any spontaneously passed stones are retrieved. To ensure safety, the patient is not left to walk unattended while experiencing acute renal colic, particularly when opioid analgesics are being given.

When performing a physical examination on a patient suspected of having urinary tract calculi, the nurse would associate the presence of which clinical manifestation with the suspected diagnosis?

Sharp pain in the flanks

Which clinical manifestations would the nurse assessing a patient with renal calculi expect to identify?

Vomiting and flank pain