Nursing Assessment: Renal and Urinary Tract Function

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."

The term used to describe total urine output less than 0.5 mL/kg/hour is

oliguria

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

Which of the following hormones is secreted by the juxtaglomerular apparatus?

Renin

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?

Angiography

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio?

10:1

Which substance stimulates the bone marrow to produce red blood cells?

Erythropoietin

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

functional capacity.

The nurse is caring for a client scheduled for urodynamic testing. Following the procedure, which information does the nurse provide to the client?

"Contact the primary provider if you experience fever, chills, or lower back pain."

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?"

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."

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."

When fluid intake is normal, the specific gravity of urine should be:

1.010 to 1.025

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.

Following a cystoscopy, the client has a nursing diagnosis of acute pain related to the trauma of the procedure to the urinary tract. An appropriate nursing intervention is to:

Assist with warm sitz baths.

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 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?

Check the patient's urine for hematuria.

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.

A creatinine clearance test has been ordered. The nurse prepares to:

Collect the client's urine for 24 hours.

The nurse has been closely monitoring the blood work of a patient who recently experienced nephrotoxic effects from an over-the-counter medication. In the course of providing care, the nurse has been teaching the patient about the various roles that the kidney plays in the maintenance of homeostasis. Which of the following functions is performed by the kidneys?

Control of acid-base balance

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

A 68-year-old woman has experienced multiple urinary tract infections over the past several months, and her care provider suspects a structural problem with her bladder or urethra. To directly visualize these structures, what diagnostic test may be ordered?

Cystoscopy

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition?

Decreased fluid intake

The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings?

Glucose and protein

To assess circulating oxygen concentration, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which diagnostic test?

Hemoglobin

An older client is experiencing an increasingly troublesome need to urinate several times through the night. The client's prostate is within normal limits, and the physician prescribes limiting fluid intake after the evening meal. What is another important intervention to keep the client safe?

Increase fluid intake throughout the day.

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?

Infection

The nurse has paged a hospital patient's primary care provider because the patient's urine output over the past 12 hours is approximately 140 mL. The nurse would recognize that this patient is experiencing what health problem?

Oliguria

Which term best describes a total urine output less than 500 mL in 24 hours?

Oliguria

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected?

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

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

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

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.

Which of the following is used to identify vesicoureteral reflux?

Voiding cystourethrography

A nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 35 mL. Urine output that's less than 50 ml in 24 hours is known as:

anuria.

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

A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. This test will reveal details about:

renal circulation.

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 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure?

After discarding the 8:00 am specimen

Serum sodium plays a major role in maintaining fluid and electrolyte balance. Choose all the correct statements that apply.

Aldosterone causes renal reabsorption of sodium. Angiotensin II controls the release of aldosterone. Renin, an enzyme released by the kidneys, activates the RAS system to ensure adequate filtration.

The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find?

Costovertebral angle tenderness

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated?

The specific gravity will be high.

Which is an effect of aging on upper and lower urinary tract function?

Susceptibility to develop hypernatremia

A patient is having an MAG3 renogram and is informed that radioactive material will be injected to determine kidney function. What should the nurse instruct the patient to do during the procedure?

Lie still on the table for approximately 35 minutes.

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

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.

A client is undergoing a renal angiogram after a traumatic accident. What post-procedural assessments would the nurse perform on the client? Select all that apply.

Monitor hypersensitivity response. Palpates the pulses in the legs and feet. Monitor site condition.

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

Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure?

Hyperkalemia

A gerontological nurse is aware that older adults experience numerous age-related physiological changes that place them at risk of fluid and electrolyte imbalances. Age-related changes to kidney function and the thirst mechanism create a particular risk of what problem?

Hypernatremia

Diagnostic testing of a patient with a history of chronic renal failure has been ordered. The care provider has ordered a test of the patient's creatinine clearance in an effort to gauge the progression of his disease. The nurse understands that this test reflects what aspect of the kidney structure and function?

The volume of blood that the kidneys are able to filter in a given time