Honan, Chapter 26: Nursing Assessment: Renal and Urinary Tract Function

The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?

Bleeding

A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing:

ureteral stones.

The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration?

phenazopyridine hydrochloride

A kidney biopsy has been scheduled for a patient with a history of acute renal failure. The patient asks the nurse why this test has been scheduled. What is the nurse's best response?

"A biopsy is sometimes necessary for diagnosing and evaluating the extent of kidney disease."

A client asks the nurse why a creatinine clearance test is accurate. The nurse is most correct to reply which of the following?

"Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client?

"Do you take multiple vitamin preparations?"

While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question?

"Do you urinate while sleeping?"

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions?

"I can resume my usual activities without restriction."

The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse?

"I took my blood pressure medication with my morning coffee an hour ago."

A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is:

"The glomerular filtration rate decreases as we age."

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client?

"You don't need to do any fasting before this noninvasive test."

A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?

150

Approximately what percentage of blood passing through the glomeruli is filtered into the nephron?

20%

The nurse received report on a hospitalized patient who was being evaluated for renal disease. The nurse was told that the patient had oliguria. Select the output record that would be consistent with that diagnosis.

350 mL/24 hr

Renal function results may be within normal limits until the GFR is reduced to less than which percentage of normal?

50

A routine serum glucose analysis indicated the presence of renal glycosuria. The nurse knew that the serum glucose level was:

>180 mg/dL.

A nurse is caring for a 73-year-old male patient with a urethral obstruction related to prostatic enlargement. The nurse is aware this may result in what?

A urinary tract infection (UTI)

Which hormone causes the kidneys to reabsorb sodium?

Aldosterone

A patient had a renal angiography and is being brought back to the hospital room. What nursing interventions should the nurse carry out after the procedure to detect complications? Select all that apply.

Assess peripheral pulses. Compare color and temperature between the involved and uninvolved extremities. Examine the puncture site for swelling and hematoma formation.

The nurse at the diabetes clinic is instructing a client who is struggling with compliance to the diabetic diet. When discussing disease progression, which manifestation of the disease process on the urinary system is most notable?

Clients have chronic renal failure.

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish?

Computed tomography with contrast

When describing the functions of the kidney to a client, which of the following would the nurse include?

Control of water balance

A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection?

Creatinine

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change?

Creatinine clearance

A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for?

Creatinine clearance level

An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:

Encourage high fluid intake.

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to:

Encourage high fluid intake.

Three areas of the ureters have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where?

In the ureteropelvic junction

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?

Increased serum creatinine

The nurse observes that the client's urine is orange. Which additional assessment would be important for this client?

Intake of medication such as phenazopyridine hydrochloride

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?

Kidney stones

The nurse received report on a hospitalized patient who was being evaluated for renal disease. The nurse was told that the patient had oliguria. Select the output record that would be consistent with that diagnosis.A nurse who works in a clinic is aware of the importance of thorough and thoughtful urologic assessments, despite the fact that these assessments have the potential to make patients uncomfortable. When interviewing patients about their urologic health, the nurse should:

Maintain a composed but empathic demeanor.

Which of the following describes awakening at night to urinate?

Nocturia

A client undergoes renal angiography. The nurse prepares the client for the test and provides postprocedure care. Which intervention should the nurse provide to the client after renal angiography?

Palpate the pulses in the legs and feet

Retention of which electrolyte is the most life-threatening effect of renal failure?

Potassium

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?

Pruritus

The nephrons are the functional units of the kidney, responsible for the initial formation of urine. The nurse knows that damage to the area of the kidney where the nephrons are located will affect urine formation. Identify that area.

Renal cortex

A patient's vasa recta have detected a precipitous drop in the patient's blood pressure. In response to feedback from the vasa recta, the patient's kidneys will:

Secrete renin

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is:

Specific gravity 1.035

A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact?

The left kidney usually is slightly higher than the right one.

An increase in the osmolality of a patient's blood has prompted the release of antidiuretic hormone (ADH) from the patient's posterior pituitary gland. What effect will result from the release of this hormone?

The patient's kidneys will resorb more water than usual.

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?

Ureters

The most frequent reason for admission to skilled care facilities includes which of the following?

Urinary incontinence

Which of the following is used to identify vesicoureteral reflux?

Voiding cystourethrography

When the bladder contains 400 to 500 mL of urine, this is referred to as

functional capacity.

A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine?

glucose

The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to

drink liberal amounts of fluids.

Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys?

excreting protein