Ch.28- Kidney & Ureter Disorders; Ch.29 Bladder & Urethra

The nurse is planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula?

"A vein and an artery in your arm will be attached surgically."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? "I will not need to worry about being incontinent of urine." "My urine will be eliminated with my feces." "A catheter will drain urine directly from my kidney." "My urine will be eliminated through a stoma."

"My urine will be eliminated through a stoma"

A client who is diagnosed with calcium oxalate stones is instructed to limit calcium intake. The client is instructed to consume ______ mg of calcium per day, or less, as part of dietary treatment.

1,000mg

The nurse coming on shift on the medical unit is taking a report on four clients. What client does the nurse know is at the greatest risk of developing ESKD? A client with diabetes mellitus and poorly controlled hypertension A client with a history of polycystic kidney disease A client who is morbidly obese with a history of vascular disorders A client with severe chronic obstructive pulmonary disease

A client with diabetes mellitus and poorly controlled hypertension

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate])

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?

Azotemia

A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?

Calcium

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?

Change in cognitive functioning

A client is admitted with nephrolithiasis (kidney stones). What symptoms does the nurse expect the client to experience? Select all that apply. Difficulty starting a urine stream Suprapubic pain Elevated temperature Hematuria Constipation

Difficulty starting a urine stream Suprapubic pain Elevated temperature Hematuria

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? Abdominal distention owing to reflex cessation of intestinal peristalsis. Hypovolemic shock caused by hemorrhage. Paralytic ileus caused by manipulation of the colon during surgery. Pneumonia caused by shallow breathing because of severe incisional pain.

Hypovolemic shock caused by hemorrhage

What is a characteristic of the intrarenal category of acute kidney injury (AKI)? Decreased creatinine Increased BUN High specific gravity Decreased urine sodium

Increased BUN

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important? Limiting fluid intake Promoting carbohydrate intake Encouraging coughing and deep breathing Providing pain-relief measures

Limiting fluid intake

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI? Diuresis Recovery Oliguria Initiation

Oliguria

When assessing the impact of medications on the etiology of acute renal failure, the nurse recognizes which of the following as the drug that is not nephrotoxic?

Penicillin

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? Physical and environmental conditions Smoking habits Occupational history History of allergies

Physical and environmental conditions

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? Bactrim Levaquin Pyridium Septra

Pyridium

A patient has been diagnosed with postrenal failure. The nurse reviews the patient's electronic health record and notes a possible cause. Which of the following is the possible cause? Osmotic dieresis. Dysrhythmias Acute pyelonephritis Renal calculi

Renal calculi

A client with chronic kidney disease is completing an exchange during peritoneal dialysis. The nurse observes that the peritoneal fluid is draining slowly and that the client's abdomen is increasing in girth. What is the nurse's most appropriate action?

Reposition the client to facilitate drainage

The laboratory results for a patient with renal failure, accompanied by decreased glomerular filtration, would be evaluated frequently. Which of the following is the most sensitive indicator of renal function? Serum creatinine of 1.5 mg/dL BUN of 20 mg/dLb Creatinine clearance of 90 mL/min Urinary protein level of 150 mg/24h.

Serum creatinine of 1.5 mg/dL

A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event?

Streptococcal infection

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?

Take the antibiotic for 3 days as prescribed.

Which nursing intervention should the nurse caring for the client with pyelonephritis implement?

Teach client to increase fluid intake up to 3 liters per day.

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem?

urinary tract infection

A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic? -The need to undergo a series of three urine cultures after the antibiotics have been completed -The risk of developing antibiotic resistance after the course of antibiotics -The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy -The need to expect a heavy menstrual period following the course of antibiotics

The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?

Urine output of 250 ml/24 hours

Which of the following causes should the nurse suspect in a client diagnosed with an intrarenal AKI?

acute glomerulonephritis

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium? Butter Cooked white rice Citrus fruits Salad oils

citrus fruits

When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?

cola-colored urine

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic?

current medication use

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

increased WBC

A client has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What contributes to the likelihood of developing urinary tract or bladder infections? Select all that apply. indwelling catheter decreased fluid intake frequent catheter hygiene increased ingestion of Vitamin C

indwelling catheter decreased fluid intake

A client has been diagnosed with acute glomerulonephritis. This condition causes: proteinuria polyuria oliguria pyuria

proteinuria

One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include:

restricting sources of potassium

The nurse is caring for a client receiving hemodialysis three times weekly. The client has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this client?

taking B/P on affected arm can damage fistula

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization? procedure for insertion of the catheter placement of the catheter administration of cleansing enemas type and size of the catheter to be used

type and size of catheter to be used

Which clinical finding should a nurse look for in a client with chronic renal failure?

uremia