Ch. 33 Disorders of Renal Function

Which substance would not be found in glomerular filtrate?

Protein

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

Increased blood pressure

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

Increased blood pressure

What is the usual cause of acute pyelonephritis?

Infection

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

Proteinuria and generalized edema

An adult client has been diagnosed with polycystic kidney disease. Which statement by the client demonstrates an accurate understanding of this diagnosis?

"I suppose I should be tested to see if my children might inherit this."

An adult female client has been diagnosed with cystitis. Which symptoms reported by the client does the nurse recognize are significant for cystitis? Select all that apply.

1. Burning and pain with urination 2. Frequency of urination 3. Lower abdominal and back discomfort

Which pathophysiologic changes are associated with nephrotic syndrome? Select all that apply.

1. Glomerular damage 2. Hypoproteinemia 3. Compensatory synthesis of proteins by the liver

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

Autosomal recessive

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute postinfectious glomerulonephritis

A nurse is caring for a client with diabetic glomerulosclerosis. The presence of which substance in the urine would be used in diagnosing this condition?

Albumin

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

Autosomal recessive polycystic kidney disease (ARPKD)

Acute pyelonephritis is a result of:

Bacterial infection

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

Calcium

Which client would the nurse consider having the highest risk for developing a urinary tract infection?

Client with obstructed urinary outflow from a kidney stone

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

Corticosteroids

What is the most common cause of a lower urinary tract infection?

Escherichia coli

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

Extracorporeal shock wave lithotripsy (ESWL)

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?

Heavy smoking

The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections?

Knowledge of aseptic technique when inserting urethral catheters

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 nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies.

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

Plasma proteins

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?

Plasmapheresis

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause?

Reduced production of erythropoietin

What is the most common cancer of the kidney?

Renal cell carcinoma

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?

Smoking cessation program

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason?

The client's urine contains material from the degradation of red blood cells.

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 possible obstruction in the urinary tract.

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

The nurse recognizes the most common cause of acute postinfectious glomeru

a streptococcal infection 7 to 12 days prior to onset.

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.

The nurse is reviewing the laboratory results for a client. Which laboratory findings would the nurse correlate with nephrotic syndrome?

elevated urine protein level (>3.5 g/day) and hypoalbuminemia

A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs?

hygiene practices to reduce exposing the urethral meatus to Escherichia coli

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI?

increased nitrites

A client has recently undergone diagnostic testing for possible Berger disease. The nurse caring for this client would anticipate the primary clinical manifestations to include which findings? Select all that apply.

1. Gross hematuria 2. Recent upper respiratory infection 3. Fever, chills, and general body aches

Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems?

Polycystic kidney disease

Which can be said about acute, drug-induced interstitial nephritis? Select all that apply.

-It may be related to a sensitivity to sulfonamide drugs. -It manifests as a fever, hematuria, mild proteinuria, and possibly a rash. -It may result in acute renal failure.

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?

Acute pyelonephritis

The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

Increase in blood pressure

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

Increase washout of urine