GU + Renal Disorders (PREPU)

Which drugs cause diuresis by inhibiting re-absorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle? (Select all that apply.)

Furosemide (Lasix) Bumetanide (Bumex)

When preparing the teaching plan for a male client who is prescribed spironolactone, the nurse would alert the client to the possibility of which of the following?

Gynecomastia

A client who is allergic to sulfonamide would use what diuretic cautiously?

Hydrochlorothiazide

When describing the fluid in the ascending loop of Henle, what would be most accurate?

Hypotonic

A nurse is educating a patient undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the patient as part of the patient teaching plan?

Increase fluid intake to at least 2000 ml/d.

Hydrochlorothiazide works by what mechanism of action?

Increasing the excretion of sodium and chloride in the distal tubule

Which structure connects the afferent arteriole to the distal convoluted tubule?

Juxtaglomerular apparatus

The nurse understands that the action of most diuretics typically results in which effects? (Select all that apply.)

Loss of water Loss of chloride

Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect?

Metabolic alkalosis

What would a nurse expect to be prescribed for a patient experiencing bladder spasms?

Oxybutynin

Which drug would the nurse identify as turning a client's urine reddish brown?

Phenazopyridine

Sodium ions are actively reabsorbed in which location?

Proximal convoluted tubule

What are key roles of the kidneys? (Select all that apply.)

Regulating body fluid volume Maintaining blood pressure Balancing acids/bases

Countercurrent focuses on what mechanism to regulate fluid and electrolyte balance

Regulating sodium absorption

Which nursing diagnosis is highest priority for a patient with history of urinary urgency who is taking oxybutynin (Ditropan)?

Risk for impaired urinary elimination

A nurse is preparing to administer a diuretic that antagonizes the action of aldosterone. Which drug would the nurse be most likely to administer?

Spironolactone

A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply.

Take the drug with food or milk to improve absorption. Continue therapy for at least 1 week. Notify the PHCP in case of fever, chills, or cough.

What best describes the structure of the kidneys?

The renal pelvises drain urine into the ureters.

Aldosterone acts on the renal tubules to retain sodium and water. (T or F)

True

Aldosterone levels would be affected if which gland was dysfunctional?

adrenal

Arterial blood enters the glomerulus by the ________________ _____________, and blood that does not become part of the glomerular filtrate leaves the glomerulus through the ______________ _____________. The ____________ connect the kidneys to the bladde

afferent arteriole; efferent arteriole; ureters

An allergy to sulfonamides would contraindicate the use of what diuretic? Select all that apply.

hydrochlorothiazide furosemide chlorothiazide

After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify what as a possible adverse effect?

hypocalcemia

Thiazide diuretics can cause

hypokalemia hyperuricemia (increased uric acid levels), hypercalcemia hyperglycemia (with long-term use)

Erythropoietin is produced by a small group of cells called the _____________________ ______________

juxtaglomerular apparatus

The countercurrent mechanism occurs in the:

loop of Henle

When describing where bumetanide acts, what would the nurse include?

loop of henle

A client is prescribed methenamine to treat urinary tract symptoms. Which nursing assessment finding would suggest the reason for this medication?

low grade fever

only the _____________ ______________ can concentrate or dilute urine

medullary nephrons

Which would the nurse expect to find in a client receiving acetazolamide?

metabolic acidosis

A client cannot recall the name of the medication prescribed to help manage the pain associated with a urinary tract infection (UTI). What medication was likely prescribed?

phenazopyridine hydrochloride

An adult client with multiple chronic health problems has been prescribed furosemide in the management of hypertension. When reviewing this client's current medication administration record, what drug should signal the nurse to a potentially increased risk of hypokalemia?

prednisone (Corticosteroids increase the risk of hypokalemia in clients who are taking furosemide)

The majority of reabsorption process takes place in what anatomical location?

proximal tubule

The ________ __________ come directly off the aorta

renal arteries

A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?

renal pelvis

Which hormone is secreted by the juxtaglomerular apparatus?

renin

Which is released in response to a decrease in blood flow to the nephron?

renin

Question 9 See full question When considering the possible gastrointestinal side effects, what instruction should the nurse provide a client being prescribed a urinary tract antispasmodic?

take this medication with food

What is the focus of the renal system's renin-angiotensin- aldosterone system?

the regulation of blood pressure

Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure?

water

A patient with a history of cystitis asks the nurse why this disorder is so common in women. Which response by the nurse would be most appropriate?

"A woman's urethra is shorter and exposed to an area of normal bacteria."

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion?

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

A nurse is describing the reasons why more women than men are affected by cystitis. Which would the nurse identify as a major reason?

"The urethra exits into an area rich in gram-negative bacteria."

A client who is taking phenazopyridine for urinary analgesia along with nitrofurantoin calls the clinic to report that her sclera appears yellowish. What is the nurse's best response to this clien

"This is an expected side effect of this medication and is not alarming."

What information should the nurse discuss with the client considering pregnancy regarding the use of a diuretic during pregnancy?

"Typically, women on diuretics prior to becoming pregnant can remain on the medication during their pregnancy."

A group of students are reviewing the function of the kidneys and demonstrate understanding when they identify that the kidneys receive what portion of the cardiac output?

1/4

The amount of fluid excreted as urine each day averages approximately less than how many liters?

2 L

A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame?

2 hours

What percentage of the total number of nephrons is estimated to be necessary to maintain healthy renal function?

25%

Which drugs are sulfonamides, with nonbacteriostatic action, that inhibit the enzyme carbonic anhydrase? (Select all that apply.)

Acetazolamide (Diamox) Methazolamide (Naptazane) [Carbonic anhydrase inhibitors]

A nurse is planning care for a client who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug?

Altered Urinary Elimination related to overactive bladder

A client is receiving triamterene. The nurse instructs the client to avoid what foods? (Select all that apply.)

Bananas Prunes Broccoli

When describing the action of spironolactone, the nurse would explain that this drug acts by:

Blocking aldosterone in the distal tubule

How does the renal system maintain the volume and composition of body fluids within normal ranges? Select all that apply

Clearing nitrogen waste by-products Maintaining acid-base levels Stabilizing electrolyte levels Excreting drug metabolites

A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment?

Do not take this medication for more than two days

A client is receiving a diuretic and tells the nurse that he has decreased his fluid intake so that he does not have to make so many trips to the bathroom. The nurse realizes the client is at risk for:

Fluid rebound