Exam 3

social worker

A ____ ___ should help the patient obtain assistive devices for the home that are covered by insurance.

5 mL

A catheter ballon size of __mL is appropriate for optimal drainage in adults

3 mL

A catheter ballon size of __mL is used in pediatric patients

Weighing daily

A child who has a history of a 5-lb(2.3 kg) weight gain in 1 week and periorbital swelling edema is admitted with a diagnosis of acute glomerulonephritis. How can the nurse obtain the most accurate information on the status of the child's edema?.

reflex urinary

A diminished or absent awareness of bladder filling and the urge to void are associated with ____ ___ incontinence

Suggest he stand at bedside

A male patient returned from the operating room 6 hours ago with a cast on his right arm. He has not yet voided. Which action would be most beneficial in assisting the patient to void?

Nocturia

A nurse instructs an elderly patient to restrict fluid intake 2 hours before bedtime. Which complication is the nurse trying to reduce?

Increased production of antidiuretic hormone

A patient tells a nurse, "My urine output is lower even after increasing my fluid intake." The nurse suspects that which condition is the cause?

Greater than 16fr

A patient who has undergone urological surgery is prescribed urinary catheterization. Which diameter of catheter does the nurse anticipate will be used for this patient?

dry

Absorbent pads can be used to keep the patient ___.

Nocturia, frequency, distended bladder on plapation

After assessing a patient, a nurse suspects that the patient has overflow urinary incontinence. Which finding supports the nurse's conclusion?

1+

An indentation of 2mm is scored as __.

2+

An indentation of 4mm is scored as __.

4+

An indentation of 8 mm is scored as ___.

30 mL

An older adult patient has undergone a radical retropubic prostatectomy and will need an indwelling catheter. which ballon size is most appropriate for this patient?

60 minutes

At 10:00 am the nurse hangs a 1000-mL bag of 5% dextrose in water (D5W) with 20 mEq of potassium chloride to be administered at 80mL/h. At noon the health care provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion for infusion of the antibiotic?

Serum potassium level

Based on an electrocardiogram (ECG), a client is suspected to have hypokalemia. Which test will be used to confirm hypokalemia?

Dorsal recumbent

How would the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems?

physical therapist

It is the responsibility of a ____ to help the patient with leg strengthening exercises.

urge urinary

Leakage of the urine on the way to the bathroom may occur in patients with ___ ___ incontinence

potassium

Orange juice is an excellent source of ____. Furosemide promotes excretion of _____, which can result in hypokalemia.

prescription

The patient can be catheterized after obtaining a _____ from the health care provider.

abdominal girth

Which client problem would the nurse expect to decrease in response to the administration of serum albumin intravenously to a client with ascites? *An increased serum albumin level increases the osmotic effect and pulls fluid back into the intravascular compartment. This will increase renal flow and urine output, with a resulting decrease in _____ ____.

"Use a moisturizer on the skin daily to help reduce itching"

Which response would be given by a nurse providing discharge teaching to an older adult who was admitted to the hospital to be treated for dehydration when the client asks what to do about itchy, dry skin?

"Mixed incontinence is a combination of stress and functional incontinence"

Which statement by a student nurse regarding urinary incontinence requires correction?

Natriuretic hormones

___ ___ promote tubular secretion of sodium

digoxin

____ toxicity can occur in the presence of hypokalemia.

Vasopression

also known as an antidiuretic hormone. It helps in the reabsorption of water into the capillaries.

ultrasound

an ___ of the urinary bladder helps measure the postvoid residual volume

abdominal roentgenogram

an ____ is commonly prescribed to detect and measure the size of urinary calculi

5-6Fr

catheters with diameters of _____ are used for infants.

8 to 10Fr

children use catheters with diameters of _____.

thyrotropin

decreased levels of ____ cause hypothyroidism, weight gain, and lethargy.

GFR

glomerular filtration rate

70% to 80%

in full-term infants, body water ranges from __ to ___.

uric acid

patients with high ___ ___ levels (gout) may develop uric acid crystals

Three P's

polyuria, polydipsia, polyphagia

squatting

the ____ position facilitates complete bladder emptying in female patients

supine or fowler

the nurse may assist a male patient into the ___ or ____ positions to insert or remove an indwelling catheter

0 to 2

the presence of __ to __ red blood cells is acceptable in the urine

normal absorptive

concentrations of 155mg, 165mg, and 175mg are within the ____ _____ capacity of the kidney. Hence, the urine will be negative for glucose in these situations

"How often are you awakened with the urge to void while you are sleeping?"

A nurse is assessing the severity of a patient's urinary elimination problem. Which question is most appropriate for the nurse to ask?

computed axial tomography (CAT) scan

A nurse is assisting the health care provider in assessing a patient with altered urinary elimination. After assessment, the health care provider suspects that the patient has an obstruction of the ureters. Which diagnostic test does the nurse expect the patient to undergo? * a _______ is commonly used to identify anatomical abnormalities, renal tumors and cysts, calculi, and obstruction of the ureters.

oxybutynin

A nurse is caring for a patient who is receiving treatment for urinary urgency. After few days of taking the prescribed medications, the patient reports a dry mouth, constipation, and blurred vision. Which medication is the most likely cause of the patient's symptoms?

Keeping the drainage bag above the level of the bladder

A nurse is caring for a patient with an indwelling catheter. Which nursing action may increase the risk of a catheter-associated urinary tract infection (CAUTI)? *pooling of the urine increase the risk of a CAUTI

Oxybutynin

A nurse is caring for an elderly patient who is receiving treatment for urinary incontinence. After reviewing the patient's prescription, the nurse knows to observe the patient for cognitive impairment. Which medication is the patient most likely taking? Antimuscarinic agents such as ____ are used to treat different types of urinary incontinence. These drugs may cause cognitive impairment in older adults

-Position the patient in dorsal recumbent or supine position and expose the catheter junctions -Remove the catheter securement device -close the clamp on the tubing, and hang the bag of solution on an intravenous (IV) pole Fill the drip chamber half full by squeezing the chamber, then open the clamp and let the solution flow through the tubing, keeping the end of the tubing sterile

A nurse is performing closed continuous bladder irrigation (CBI) for a patient who has blood clots in the urine, In which order would the nurse perform the beginning actions?

Schedule toileting, absorbent products, clothing modifications

A patient reports having the urge to void, but urine starts leaking before the patient can get the pants down and seated on the toilet. Which treatment strategy would be helpful for this patient?

"I'll teach you pelvic muscle exercises that you can perform regularly to address the problem"

A patient tells a nurse. "I lose small amounts of urine while coughing, laughing, exercising, and walking but not a night while sleeping." Which response by the nurse is most appropriate? It is characteristics of stress incontinence.

185mg/100ml

A patient with diabetes has a urine test positive for glucose. The nurse would expect the patient blood glucose to be minimum of which level?

oliguria

A patient with kidney failure may experience _____

Renal disease

A patient's urinalysis shows the presence of casts. Based on this laboratory data, which condition would the nurse suspect? *the increased presence of granular casts is always an abnormal finding and is usually indicative of ___ ___ or injury.

Starvation, dehydration, diabetes mellitus

A patient's urine specific gravity is 1.05. The urine tests positive for ketone bodies. Which condition is a possible cause?

atropine

Anticholinergics, such as ____, inhibit bladder contractility, thereby increasing the risk of urinary retention

12Fr

Catheters with diameters of ____ are used for young girls.

juxtaglomerular cells

Decreased blood volume triggers the release of renin from the ___ ___.

Elevate the head of the client's bed and obtain vital signs

How would the nurse respond to a client admitted for dehydration who has an intravenous (IV) infusion of normal saline is started at 125mL/h and one hour later begins screaming, "I can't breathe!"?

occupational therapist

Its the ____ to help the patient learn efficient and safe toilet transfers.

Hypocalcemia

Muscle spasma and twitching are often seen in the setting of _____,

polyuria

Patients receiving diuretic therapy and those with uncontrolled diabetes mellitus may exhibit _____

magnesium

Respiratory depression can occur with too rapid intravenous (IV) ______ administration, not potassium administration.

hypokalemia

Serum ___ diminishes the magnitude of the neuronal and muscle cell resting potentials. This can result in observable muscle weakness.

Use the Crede method

The nurse assesses that the patient has a full bladder, and the patient states that she is having difficulty voiding. Which instruction would the nurse provide the patient? with ______, pressure is put on the suprapubic area with each attempted void. The maneuver promotes bladder emptying by relaxing the urethral sphincter.

Change dressings and lines when wet, use absorbent pads, catheterize the patient

The nurse is caring for a patient with urinary incontinence. Which action would the nurse perform to promote comfort for the patient?

Glucose

The nurse is receiving the laboratory report of a patient. The presence of which substance in the urine hints at the possibility of an abnormality?

Starvation, dehydration, and uncontrolled diabetes mellitus

The nurse is reviewing laboratory results for a patient and notices the urine tested positive for ketones. Which underlying factor may lead to the presence of urinary ketone bodies?

Check for kinks in the tubing

The nurse notes that the patient's indwelling catheter bag has been empty for 4 hours. Which action is priority?

Replacing the catheter

The nurse notices pus in the catheter of a patient who had an indwelling catheter inserted 4 days ago. Which nursing measure is appropriate for this patient?

intermittent catheterization

The nurse receives a prescription to obtain a postvoid residual for a patient via catheterization. Which method to obtain this measurement is best? This prevents the rise of infection

perineal hygiene

The nurse should instruct the patient to follow good ____ ___ practices to prevent urinary tract infections

64%

The total body water in a child between the ages of 1 and 12 years is approximately ___.

pelvic muscle

To manage stress urinary incontinence, the nurse should teach the patient ___ ____ exercises.

normal micturition

To promote ____ ____, the nurse may instruct the patient to drink adequate amounts of fluids.

hyperkalemia

Too rapid an administration of potassium can cause ____, which contributes to long refractory period in cardiac cycle, resulting in cardiac dysrhythmias and arrest. Although acidosis can cause ____, ____ will not lead to acidosis. ____ causes muscle flaccidity and weakness, not seizures.

3+

Upon pressure application, which degree of edema would the nurse document for 6-mm deep indentation?

Ultrasound, bladder scan, straight catheterization

What can a nurse use to measure the postvoid residual (PVR) volume in a patient with urinary retention?

helping the patient strengthen the pelvic floor muscles and learn fluid and food modifications

What should the nurse include in the plan of care for a patient with urge urinary incontinence?

Acid-base balance of the body

When ammonia is excreted by healthy kidneys, which mechanism usually is maintained?

stop the transfusion

Which action will a nurse take first when caring for a client reporting chest pain, difficulty breathing, and feeling cold twenty minutes after an infusion of packed red blood cells begins?

Change the IV site

Which action will the nurse take when caring for a client whose intravenous (IV) site is tender with erythema, warmth, and mild edema?

Hypokalemia

Which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema?

Potassium

Which cation regulates intracellular osmolarity?

Muscle weakness

Which clinical finding would the nurse associate with hypokalemia?

cardiac arrest

Which complication would a nurse try to avoid by slowly administering a parenteral preparation of potassium?

serum Potassium level

Which diagnostic test will the nurse use to confirm the diagnosis when hypokalemia is suspected?

sodium

Which electrolyte deficiency triggers the secretion of renin? *Low ____ ion concentration causes blood volume, thereby resulting in decreased perfusion.

failure to secure the catheter adequately

Which factor would the nurse recognize as the cause when a client's intravenous (IV) infusion infiltrates?

Adrenal cortex

Which gland is affected in aldosteronoma?

glucocorticoids

Which hormone aids in regulation intestinal calcium and phosphorous absorption? *by increasing or decreasing protein metabolism

parathyroid hormone (PTH)

Which hormone regulates blood levels of calcium? *____ regulates the blood levels of calcium and phosphorus.

provide normal fluid intake and establish a toilet schedule

Which intervention is most appropriate for a patient with functional urinary incontinence?

a patient with a urinary tract infection

Which patient is most likely to exhibit symptoms such as dysuria, urgency, frequency, and nocturia?

85%

Which percentage of total body water is found in a premature newborn?

Increased blood viscosity

Which physiological alteration would be expected with a high-than-normal re blood (RBC) count?

Monitor intake and output, Inform the patient that there may be difficulty in voiding post procedure, inform the patient that red-tinged urine my be passed post procedure

Which pretest and/or posttest procedure would the nurse follow while managing a patient who is schedule for a cystoscopy?

Assess the client's respiratory status

Which priority action will the nurse take after stopping an intravenous piggyback antibiotic of a client who became restless, flushed and began to wheeze shortly after initiation?

To promote complete bladder emptying

While caring for a female patient with altered urinary elimination, the nurse instructs the patient to assume a squatting position when voiding. Which rationale is the reason behind this recommendation?

To prevent further edema

While providing care for a client with a second-degree left ankle sprain, the nurse raises the injured part above heart level. Which statement describes the rationale behind this nursing action?

Maintaining potassium levels

Why would the nurse advise the client a client who takes furosemide and digoxin for heart failure to drink a glass of orange juice everyday?

Parathyroid hormone

___ ___ secretion increases in response to decreased serum calcium concentration and stimulates the bones to promote osteoclastic activity.

uncontrolled diabetes

___ ____ may cause polyuria but not oliguria

Edema

___ is associated with electrolyte imbalances, including sodium excess (hypernatremia).

ACTH

___ promotes the growth of the adrenal cortex and stimulates the release of corticosteroids

LH (luteinizing hormone)

___ stimulates the production of sex hormones, promotes the growth of reproductive organs and also stimulates reproductive processes

TSH

___ stimulates the release of thyroid hormones and the growth and functioning of they thyroid gland.

Protein-calorie

___-____ malnutrition is characterized by the presence of ketone bodies in the urine, not casts.

intermittent catheterization

____ ____ may be used to manage mild urinary retention

Insulin

____ acts together with growth hormone to build and maintain healthy bone tissue

catheters

____ are used as a last choice because of the potential for infection and body self-image issues

Kegel exercises

____ are used to help with urinary incontinence

diuretics

____ increase urinary output by preventing the resorption of water and certain electrolytes

Thyroxine

____ increases the rate of protein synthesis in all types of tissues.

Kussmail respiration

____ is a breathing pattern characterized by deep and labored breaths in response to metabolic acidosis, especially diabetic ketoacidosis

Phenazopyridine

____ is a urinary analgesic that may be prescribed to patients with painful urination associated with UTIs; patients who take these drugs will void orange urine

long-term catheterization

____ is done in patients with urinary retention. It may also be done for patients with recurrent episodes of UTIs, skin breakdown, and terminal illness.

short-term catheterization

____ is required for obstructive conditions, surgical repair of the bladder and urethra, prevention of urethral obstruction, and bladder irrigation

bethanechol

____ is used to treat urinary retention and may have side effects of nausea, vomiting, diarrhea, and increased salivation

Inflammation

____ of the prostate gland may cause dysuria, not oliguria

Aldosterone

____ promotes sodium reabsorption.

Erythropoietin

____ stimulates bone marrow to make red blood cells

luteinizing hormone (LH)

_____ deficiency causes menstrual abnormalities, decreased libido, and breast atrophy

Urge-inhibition

_____ exercises may also help relieve symptoms associated with urge incontinence, not stress incontinence.

overflow incontinence

_____ is associated with chronic retention of urine, and patients with this type of incontinence may require intermittent catheterization

double voiding technique

_______ is when the patient voids and then attempts to void again.

Viscosity

a measure of fluid's internal resistance to flow, is increased as the number of red blood cells suspended in plasma increases.

0 to 4

a white blood cell count of __ to __ is acceptable and does not indicate an abnormality in the urine.

nitrofuration

antibodies, such as _____, are used to treat urinary tract infection.

prolaction

decreased levels of ____ may cause decreased amounts of milk secretion after birth.

Furosemide

is a potent diuretic used to provide rapid diuresis; it acts in the loop of Henle and causes depletion of electrolytes, such as potassium and sodium. ___ inhibits the reabsorption, not retention, of sodium, ____does not affect protein metabolism and will not elevate blood urea nitrogen. Because ___ increases water excretion relative to solutes, the specific gravity of the fluid more likely will be low.

cystoscopy

is an invasive procedure used to detect bladder tumors and obstruction of the bladder outlet and urethra

urge incontinence

patients with ____ may be instructed to avoid bladder irritants such as caffeine, artificial sweeteners, and alcohol.

excess crystals

the presence of ____ ____ predisposes a patient to the development of renal stones, not casts.

protein

the presence of ____ in the urine is acceptable under 8mg/100mL

prevent infections

to ____ ___, the nurse promotes adequate fluid intake and perineal hygiene and instructs patients to void at regular intervals

stress urinary

to help relieve ___ ___ incontinence, the nurse may provide pelvic muscle training.

skin impairment

wet dressings and linens should be changed to prevent ____ and promote comfort

Reabsorption of water

which action is promoted by vasopressin?

AB

which blood type must a person have to be a universal recipient?

Antidiuretic hormone (ADH)

which hormonal deficiency causes diabetes insipidus in a client?

a need for increased irrigation rate to prevent bleeding

while performing continuous bladder irrigation, a nurse assesses the patient's urine for color, amount, clarity, and the presence of mucus, blood clots, or sediment. What is the nurse looking for?