N102 GU Urolithiasis Practice Quiz EAQ

A client is admitted to the hospital with severe flank pain, nausea, and hematuria caused by a ureteral calculus. What should be the nurse's initial intervention? Strain all urine output. Increase oral fluid intake. Obtain a urine specimen for culture. Administer the prescribed analgesic.

Administer the prescribed analgesic.

A client is diagnosed with calcium oxalate renal calculi. Which foods should the nurse teach the client to avoid? Select all that apply. a. Milk b. Tea c. Liver d. Spinach e. Rhubarb

B, D, E b. Tea d. Spinach e. Rhubarb Tea, rhubarb, and spinach are high in calcium oxalate. Limiting oxalate-rich foods limits oxalate absorption and the formation of calcium oxalate calculi. Milk is an acceptable calcium-rich protein and is avoided in calcium stones but not with oxalate stones. Liver is a purine-rich food that may be eaten.

A pathology report states that a client's urinary calculus is composed of uric acid. Which food item should the nurse instruct the client to avoid? Milk Liver Cheese Vegetables

Liver

A client is admitted with renal calculi. Which clinical manifestations does a nurse expect the client to report? Select all that apply. a. Blood in the urine b. Irritability and twitching c. Dry, itchy skin and pyuria d. Frequency and urgency of urination e. Pain radiating from the kidney to a shoulder

A, D a. Blood in the urine d. Frequency and urgency of urination

A client is admitted to the hospital with ureteral calculus. Which urinary clinical findings will the nurse expect upon assessment? Foul odor and dark urine Urgency and mild aching pain Frequency with small amounts of urine Hematuria with sharp pain when voiding

Hematuria with sharp pain when voiding Hematuria and pain may result from damage to the ureteral lining as the calculus moves down the urinary tract; the urine may become cloudy or pink tinged. Although severe pain may be present, urgency is not associated with renal calculi; urgency may be associated with an enlarged prostate, cystitis, or other genitourinary problems. The odor of urine is not foul with this condition; the color of urine is not dark with this condition, although it may be cloudy, pink, or red from hematuria. Frequency may occur when the calculus reaches the bladder.

A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening the client's urinary output is much less than the intake. When it is confirmed that the bladder is not distended, what should the nurse suspect developed? Oliguria Hydroureter Renal shutdown Urethral obstruction

Hydroureter Calculi may obstruct the flow of urine to the bladder, allowing the urine to distend the ureter, causing hydroureter. There is insufficient information to come to the conclusion of oliguria, even though output is less than intake; oliguria is present when the output is less than 400 mL in a 24-hour period. Calculi do not cause renal shutdown directly; they may obstruct the urinary tract and cause damage indirectly as a result of pressure from urine buildup. If the urethra is obstructed, the bladder will be distended.

The nurse is caring for a client with ureteral colic. To prevent the development of renal calculi in the future, which strategy should be included in the client's plan of care? Instructing the client to drink at least 3L of fluid daily Interventions to decrease the serum creatinine level A urinary output goal of 2000 mL per 24 hours Excluding milk products from the diet

Instructing the client to drink at least 3L of fluid daily

The nurse is caring for a client who recently was diagnosed with urinary phosphate calculi. What should the nurse plan to teach this client to include in the diet? Pears Hamburgers Baked salmon Cheddar cheese

Pears

A client is transferred to the postanesthesia care unit after undergoing a pyelolithotomy. The client's urinary output is 50 mL/hr. What should the nurse do? a. Record the output as an expected finding. b. Encourage the client to drink oral fluids. c. Milk the client's nephrostomy tube. d. Notify the primary healthcare provider.

a. Record the output as an expected finding.

A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? Select all that apply. A. Limiting fluid intake at night B. Monitoring intake and output C. Straining the urine at each voiding D. Recording the client's blood pressure E. Administering the prescribed analgesic

b, c, e, B. Monitoring intake and output C. Straining the urine at each voiding E. Administering the prescribed analgesic

A client who had a lithotripsy for a renal calculus is to be discharged from the hospital. Which information should the nurse include in the home care instructions? a. "Increase your intake of dairy products for 5 days." b. "Drink at least 3 L of fluid daily for 4 weeks." c. "Take no medications after this treatment." d. "Report blood in the urine immediately."

b. "Drink at least 3 L of fluid daily for 4 weeks." Increasing fluid intake aids in the passage of fragments of the calculus that remain after the lithotripsy. Calcium is the major component of the most common type of calculus; the intake of dairy products, which are high in calcium, should be limited. The client will take antibiotics after the treatment and should complete the entire regimen. Hematuria (blood in the urine) after lithotripsy is an expected response and does not need to be reported.

The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an elevated serum purine. How should the nurse interpret these findings about the stone's composition? a. It contains cystine. b. It contains uric acid. c. It contains calcium oxalate. d. It contains magnesium ammonium phosphate

b. It contains uric acid.

A client with renal colic is scheduled for extracorporeal shock-wave lithotripsy. The night before the procedure, the client puts the call light on frequently and has many demands. Which will be an appropriate statement for the nurse to make? a. "I know how you feel; I had this same procedure last year." b. "We'll take good care of you, so you have nothing to worry about." c. "You are facing a new experience tomorrow; tell me what concerns you have." d. "Your behavior tells me that you are scared of what you are facing tomorrow."

c. "You are facing a new experience tomorrow; tell me what concerns you have."

A nurse prepares a client with kidney dysfunction for a cystoscopy. Which nursing intervention would be beneficial? a. Asking the client to have an adequate evening meal b. Instructing the client to take oral fluids to increase urine output c. Performing a bowel preparation with enema the morning before the procedure d. Asking the client to be NPO (nil per os) after midnight on the night before the procedure

d. Asking the client to be NPO (nil per os) after midnight on the night before the procedure

A client with a left ureteral calculus is scheduled for a transurethral ureterolithotomy. During the preoperative assessment, how does the nurse expect the client to report pain? a. It is a boring-type pain that is located in the left flank. b. It is dull and constant and located in the costovertebral angle. c. It is located at the level of the kidneys and occurs with each urination. d. It is spasmodic and located in the left side and radiating to the suprapubic area.

d. It is spasmodic and located in the left side and radiating to the suprapubic area. Pain with ureteral stones is caused by spasm (renal colic) and is excruciating and intermittent; it follows the path of the ureter to the bladder down to the groin. Pain is spasmodic and excruciating, not boring, dull, or constant. Pain intensifies as the calculus lodges in the ureter and spasms occur in an attempt to dislodge it. Pain at the costovertebral angle can indicate urinary tract infection. The pain is episodic and not located at the level of the kidneys.