Medical Surgical: Renal and Urinary

A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make?

Avoid taking blood pressures on the clients left arm. The nurse should avoid taking blood pressure measurements on the clients left arm, which can decrease blood flow and cause clotting.

A nurse is reinforcing teaching about urinary track infections with a client. Which of the following manifestations should the nurse include?

Back pain Back pain and flank pain are manifestations of a UTI. Other manifestations include frequency, urgency, and cloudy, foul smelling urine.

A nurse is collecting data from a client who has one week post operative following a living donor kidney transplant. Which of the following findings should indicate to the nurse that the client is experiencing acute kidney rejection?

Blood pressure 160/90

A nurse is reinforcing dietary teaching with a client who has late stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet?

Calcium A client who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium absorption. The client should supplement her diet with dietary calcium.

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the dialysate output is less than the input, and the clients abdomen is distended. Which of the following actions should the nurse take?

Change the clients position The client is retaining the dialysate solution after the dwelltime. The nurse should ensure that the clamp is open and the tubing is not kinked, and re-position the client to facilitate the drainage of the solution from the peritoneal cavity.

A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first?

Check the clients electrolyte values. The nurse should check the clients most recent potassium value because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias; therefore this is the priority action.

A nurse is collecting data from a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider?

Cloudy, yellow drainage Cloudy drainage is an early manifestation of peritonitis and the nurse should report this finding to the provider. Other manifestations include fever and abdominal tenderness.

A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the clients Urinary catheter, which of the following findings should the nurse report to the provider?

Decreased urine output A decrease in urine output after a TURP indicates obstruction to urine flow by a clot or residual prostatic tissue and should be reported to the provider.

A nurse is reinforcing teaching with a client prior to a cystoscopy. Which of the following statements should the nurse make?

Expect to have pink tinged urine after this procedure. A cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Following the procedure, pink tinged urine is expected.

A nurse is collecting data from a client who has an injury to the lower abdomen following a motor vehicle crash. The nurse should identify that which of the following findings is a manifestation of bladder trauma?

Hematuria

A nurse is reinforcing teaching with a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statements indicates an understanding of the information?

I will feel the urge to urinate following this procedure. After a TURP, the client will feel the urge to urinate. The nurse should reassure him that he will receive analgesics to help relieve this discomfort.

A nurse is reinforcing teaching with a client who has a history of urinary tract infections. Which of the following statements should indicate to the nurse the need for additional instruction?

I will use a vaginal douche daily. The client should avoid vaginal dishes, bubble baths, and any substances that can increase the risk for UTIs. The client should use mild soap and water to wash the perineal area.

A nurse is reinforcing teaching with a client who has chronic kidney disease. Which of the following instructions should the nurse include?

Limit fluid intake

A nurse is reinforcing teaching about collecting a 24 hour urine specimen for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse include?

Place signs in the bathroom as a reminder about the test in progress.

A nurse is caring for a client who has a diagnosis of renal calculi and reports sever flank pain. Which of the following is the priority nursing action?

Relieve the clients pain.

A nurse is collecting data from a client who is postoperative following extracorporeal shockwave lithotripsy (ESWL). The nurse should identify that which of the following findings is the priority?

Report of palpitations ESWL is the application of sound, laser, or dry shockwave energies to break a kidney stone into small pieces. The shock waves are initiated during the R wave of the ECG to prevent dysrhythmias.

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following adverse effects?

Respiratory distress Respiratory distress can occur during peritoneal dialysis due to fluid overload.

A nurse is reinforcing teaching about the prostate-specific antigen test with a client. Which of the following statements should the nurse make?

You don't need to fast prior to the PSA test.

A nurse is reinforcing teaching with a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching?

You should complete the entire cycle of antibiotic therapy. The client should complete the full prescription of antibiotic therapy to decrease the chance of regrowth of the causative organism.

A nurse is reinforcing teaching with a client prior to a renal biopsy. Which of the following statements should the nurse make?

You will need to be on bedrest following the procedure. A renal biopsy involves a tissue biopsy through needle insertion into the lower lobe of the kidney. The client should maintain bedrest in a supine position with a back Road for support for 2 to 24 hours following the procedure to reduce the risk for bleeding. The nurse can elevate the head of the bed.