PU Renal 55 (2-)

Painless hematuria

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

Encouraging intake of at least 2 L of fluid daily

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

urge

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?

Acute pain

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

acute pain

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Maintain skin and stoma integrity

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?

Risk for infection

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

Urinary retention

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?

Bladder retraining

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?

obstructive disorders.

Bladder stones and urethral stricture are

WBC 50

The nurse recognizes that test results that most likely indicate a urinary tract infection include:

Anticholinergic agents

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?

Stones are shattered into smaller particles that are passed from the urinary tract. ESWL is a high-energy blast of pressure.

What is true about extracorporeal shock wave lithotripsy (ESWL)? Select all that apply.

The client keeps the drainage bag below the bladder at all times.

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?

"This medication will relieve your pain."

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?

most common place for stones

The most common site of renal calculi formation is the kidney. Calculi may travel down the urinary tract with or without causing damage and lodge anywhere along the tract or may stay within the kidney. The ureter, bladder, and urethra are less common sites of renal calculi formation.

Clinical manifestations of peritonitis

include abdominal pain and distention, absence of bowel sounds, nausea and vomiting, fever, changes in vital signs.

Ketonuria

indicates a diabetic state. Because the client with pyelonephritis typically has signs of infection, the WBC count is more likely to be high rather than low

Cystectomy

is a surgical removal of the bladder and is performed for large tumors that have penetrated the muscle wall.

Urethroplasty

is a surgical repair of the urethra.

Cystitis

is an infectious disorder.

Pyelonephritis

is diagnosed by the presence of pyuria, leukocytosis, hematuria, and bacteriuria. The client exhibits fever, chills, and flank pain. .

Myoglobinuria

is seen with any disease process that destroys muscle.

An incontinent urinary diversion

requires an external ostomy bag to collect the urine.

Perform meticulous perineal care daily with soap and water

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

Increase fluids to 3 to 4 L/24 hours to dilute the urine.

The nurse advises the patient with chronic pyelonephritis that he should:

Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. Drink liberal amounts of fluid to flush out bacteria. Void every 2-3 hours to prevent overdistention of the bladder

The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply.

Pyuria

Which condition or laboratory result supports a diagnosis of pyelonephritis?

Urinary incontinence isn't a disease.

Which statement describing urinary incontinence in an older adult client is true?

location of discomfort

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

urinary retention and urinary incontinence

are voiding dysfunctions, temporary or permanent alterations in the ability to urinate normally.

kidney

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

Away from skin folds

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located?

pyuria

Which condition or laboratory result supports a diagnosis of pyelonephritis?

Eat plenty of cheese and eggs.

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor?

Ileal conduit

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select?

an incontinent urinary diversion.

The nurse is caring for a client who has a type of urinary diversion that requires an external ostomy bag to collect the urine. This client has:

Peritonitis

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

Location of discomfort

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

see and reach it.

The nurse plans to have the stoma located away from skin folds and creases, bony prominences, the belt line, and the umbilicus. The stoma should be located in an area where the client can

Risk for impaired skin integrity Disturbed body image Deficient knowledge: management of urinary diversion

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.

Anticholinergic agents inhibit

bladder contraction and are considered first line medications for urge incontinence.

Ureterolithiasis typically causes

such acute, severe pain that the client can't rest and becomes increasingly anxious. Therefore, the nursing diagnosis of Acute pain takes highest priority. Diagnoses of Risk for infection and Impaired urinary elimination are appropriate when the client's pain is controlled. A diagnosis of Imbalanced nutrition: Less than body requirements isn't pertinent at this time.

Place client on a timed voiding schedule.

A client has developed urinary incontinence after having a urinary catheter in place for a few weeks. What is the initial nursing intervention the nurse should use to start the client with bladder training?

Observe for leakage of urine or stool from the anastomosis. Maintain renal function. Assess for signs and symptoms of peritonitis

A client has just undergone a urinary diversion procedure. What management issues related specifically to urinary diversion would be included in this client's care plan? Select all that apply.

A continent urinary diversion

is the creation of a reservoir within the body for urine collection. The reservoir is catheterized to drain urine.

Increases bladder neck resistance Decreases involuntary bladder contractions

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands that this drug is an effective treatment for which reason? Select all that apply.

The nursing assistant places the drainage bag on the client's abdomen for transport.

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?

Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care.

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.