Patho Exam 2 Ch 25

Surgical stone removal is indicated for which of the following instances?

Obstruction of urine flow.

A 34 year-old man has been taking up to 2400 mg of ibuprofen per day following a motor vehicle several months ago and consequent chronic pain. He has recently been diagnosed with chronic analgesic nephritis as a result of his high analgesic intake. The man is surprised at the diagnosis stating, "I thought that taking too many drugs hurt your liver if anything, not your kidneys." What is the most appropriate response to the man's statement?

"Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs."

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit pyuria and high counts of urine colony-forming units?

A client who has urinary catheter in place due to confusion.

A client has been diagnosed with systemic lupus erythematosus. The client now presents with sudden hematuria, variable proteinuria, and a decreased glomerular filtration rate. Which of the following is a probable diagnosis?

Acute nephritic syndrome.

A patient is being evaluated for kidney stones. The nurse anticipates the patient will manifest:

Acute onset of colicky or dull and achy intermittent flank pain.

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

Acute postinfectious glomerulonephritis.

A patient is concerned that medication may damage his kidneys. Which factor(s) place the patient at most risk for developing a drug-related nephropathy? Select all that apply.

Age/elderly, prescription methicillin and other synthetic antibiotics, diuretics, procedures involving radiocontrast media, and nonsteroidal anti-inflammatory drugs (NSAIDs).

A four year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the healthcare team's initial differential diagnosis most likely be?

Alport syndrome.

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which of the following disorders?

Autosomal recessive polycystic kidney disease (ARPD).

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. The nurse responds:

Corticosteroids.

Acute pyelonephritis is a result of which of the following?

Bacterial infection.

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development.

A nurse is caring for a patient with systemic lupus erthematosis (SLE). The patient asks why a urinalysis is necessary. The best answer is that urinalysis would determine whether which of the following factors was present in the urine?

Blood or protein.

A patient who has had an intestinal bypass has developed a kidney stone. Which of the following types of kidney stone does the nurse recognize that this patient will most likely be treated for?

Calcium.

Which laboratory findings should you expect to see in a patient diagnosed with nephritic syndrome?

Elevated urine protein and hypoalbuminemia.

Which of the following pain descriptions would lead the nurse to suspect the client is experiencing ureteral colic?

Excruciating pain in the flank and upper outer quadrant of abdomen that radiates to bladder area.

Which of the following is a nonsurgical method of treatment for renal calculi (kidney stones)?

Extracorporeal shock wave lithotripsy (ESWL).

A patient has passed a kidney stone composed of uric acid (urate). Which of the following pathological conditions is a contributing factor for the development of this type of kidney stone?

Gout.

A nurse is caring for a patient who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this patient?

Hydration.

A nurse is administering medications to a patient with a kidney stone. Which medication does the nurse administer that will lower urinary calcium by increasing tubular reabsorption to decrease the amount of calcium in the urine?

Hydrochlorothiazide (HCTZ).

The nurse is assessing a patient who has a unilateral obstruction to the urinary tract. The nurse anticipates the patient may develop:

Increase in blood pressure.

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protect action is the nurse telling the client to utilize?

Increase washout of urine.

The nurse is planning care for a patient with a urinary tract obstruction. The nurse includes assessment for which of the following possible complications?

Increased blood pressure.

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which of the following?

Increased blood pressure.

A patient is to receive a radiocontrast media as part of a diagnostic scan. Which of the following is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate to 125 mL/hour.

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension.

A patient diagnosed with Goodpasture's syndrome would require which of the therapies to remove proteins and autoantibodies from the system?

Plasmapheresis.

Which of the following would the nurse see as being liable to cause the most serious long-term problems?

Polycystic kidney disease.

The nurse is reviewing the lab results of a patient with suspected nephrotic syndrome. The nurse anticipates that the results to include:

Protein in the urine.

Which of the following substances would not be found in glomerular filtrate?

Protein.

The nurse reviews the lab results for a patient who has advanced autosomal dominant polycystic kidney disease (ADPKD). The patient's hemoglobin is 8.8 g/dL. The nurse suspects this lab values is related to which of the following causes?

Reduced production of erythopoietin.

The nurse is assessing a patient with diabetic nephropathy whose blood pressure is 124/80. The patient smokes two packs of cigarettes a day and consumes a diet high in saturated fats and sodium. The nurse's plan of care should focus on which of the following to decrease the patient's risk for progression of the diabetic nephropathy?

Smoking cessation program.

Which of the following are appropriate interventions in the care of a patient diagnosed with renal calculi? Select all that apply.

Staining the client's urine, addressing the client's pain, and keeping track of intake and output.

A nurse is caring for a patient who has been diagnosed with kidney colic and has not yet passed the stone. Which of the following interventions should the nurse be sure to include when planning the care for this patient?

Strain the urine.

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is a possible obstruction in the urinary tract.

Because the associated nephropathy is an important cause of end-stage renal failure in children and adolescents, a toddler who has had an uncomplicated bout of urinary tract infection (UTI) should be evaluated for:

Vesicoureteral reflux.