nursing care 1 exam 6
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?
Urinary calculi
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.
micturition
urination or voiding
oliguria
urine output less than 0.5mL/kg/hr
residual urine
urine that remains in the bladder after voiding
frequency
voiding more frequently than every 3 hours
urinary frequency
voiding more often than every 3 hours
glomerular filtration rate (GFR)
amount of plasma filtered through the glomeruli per unit of time
urethrovesical reflux
an obstruction to free-flowing urine leading to the reflux of urine from the urethra into the bladder
bacteriuria
bacteria in the urine
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."
The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?
A low-purine diet
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 working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?
Change the wafer and pouch.
An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?
Detects calculi, cysts, or tumors
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D
Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease?
Incontinence
Patients with urolithiasis need to be encouraged to:
Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.
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 is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?
Ketoralac (Toradol)
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action?
Maintain skin and stomal integrity.
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?
Monitor the client for an allergy to iodine contrast material
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
Which medication may be ordered to relieve discomfort associated with a urinary tract infection?
Phenazopyridine
Which term refers to inflammation of the renal pelvis?
Pyelonephritis
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Pyridium
Sympathomimetics have which of the following effects on the body?
Relaxation of bladder wall
Which of the following hormones is secreted by the juxtaglomerular apparatus?
Renin
A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?
The pouch faceplate doesn't fit the stoma.
The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:
WBC 50
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?
When the urine output is less than 30 mL/h
suprapubic catheter
a urinary catheter that is inserted through a suprapubic incision into the bladder
renal clearance
ability of the kidneys to clear solutes from the plasma
nocturia
awakening at night to urinate
ureterovesical or vesicoureteral reflux
backward flow of urine from the bladder into one or both ureters
neurogenic bladder
bladder dysfunction that results from a disorder or dysfunction of the nervous system and leads to urinary incontinence
hematuria
red blood cells in the urine
An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should
confirm all of the medications and supplements normally taken.
urosepsis
spread of infection from the urinary tract to the bloodstream that results in a systemic infection
anuria
decreased urine output of less than 50 mL in 24 hours
urea nitrogen
end product of protein metabolism
creatinine
endogenous waste product of muscle energy metabolism
renal glycosuria
excretion of glucose in the urine
specific gravity
expression of the degree of concentration of the urine
nephron
structural and functional unit of the kidneys responsible for urine formation
cystectomy
surgical removal of the urinary bladder
hilum
the rounded outer convex of each kidney. penetrated with blood vessels, nerves, and the ureter
ureterosigmoidostomy
transplantation of the ureters into the sigmoid colon, allowing urine to flow through the colon and out the rectum
ileal conduit
transplantation of the ureters to an isolated section of the terminal ileum, with one end of the ureters brought to the abdominal wall
antidiuretic hormone (ADH)
hormone secreted by the posterior pituitary gland; causes the kidneys to reabsorb more water; also called vasopressin
aldosterone
hormone synthesized and released by the adrenal cortex; causes the kidneys to reabsorb sodium
diuresis
increased urine volume
interstitial cystitis
inflammation of the bladder wall that eventually causes disintegration of the lining and loss of bladder elasticity
prostatitis
inflammation of the prostate gland
pyelonephritis
inflammation of the renal pelvis
urethritis
inflammation of the urethra
cystitis
inflammation of the urinary bladder
urinary incontinence
involuntary or uncontrolled loss of urine from the bladder
overflow incontinence
involuntary urine loss associated with overdistention of the bladder
dysuria
painful or difficult urination
proteinuria
protein in the urine
glomerulus
tuft of capillaries forming part of the nephron through which filtration occurs
An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?
Application of an ostomy pouch
A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?
Diabetes mellitus
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:
Encourage high fluid intake.
pyuria
white blood cells in the urine