Chapter 34

Which life-long instruction would the nurse provide a patient with a kidney transplant?

"Your daily medications increase your susceptibility to infection"

Which postoperative intervention would the nurse implement for a patient scheduled for creation of an internal arteriovenous fistula and temporary placement of an external arteriovenous shunt secondary to end-stage renal disease?

- Regularly checking the positioning of the external shunt -Avoiding taking blood pressure on the extremity with the shunt -Avoiding infusing intravenous fluids in the arm with the shunt

The patient presents to the emergency department 16 days after a strep throat infection and is diagnosed with acute glomerulonephritis. The nurse anticipates providing instructions on which category of medication(s)?

-A diuretic -A corticosteroid -An antihypertensive medication

Which interventions would the nurse implement when providing care for a patient suspected of having struvite urinary calculi?

-Administering antibiotic agent -Administering acetohydroxamic acid

Which intervention would the nurse implement when providing care for a patient diagnosed with calcium oxalate urinary tract calculi?

-Administering calcium -Reducing sodium intake -Reducing dietary oxalate

Which complication would the nurse anticipate when a patient with chronic kidney disease develops uremic syndrome as a result of increased blood urea levels?

-Anemia -Heart Failure -Pulmonary edema

Which food items would the nurse instruct a patient to avoid while receiving hemodialysis three times per week?

-Bananas -Pickled tuna -Barbecued red meat

Which information will the nurse teach a patient who is prescribed ciprofloxacin, a fluoroquinolone agent, for a suspected urinary tract infection?

-Be sure to drink 1500 to 2000 mL of fluid each day to prevent crystal formation -We will notify you if another antibiotic is needed as a result of the urine culture and sensitivity -The broad-spectrum antibiotic is effective against many gram-positive and gram-negative pathogens

Which method to reduce the risk for infection would the nurse include in the discharge teaching for a patient with a diagnosis of cystitis?

-Drink a glass of water after swimming and before and after intercourse to flush the urethra -Consider drinking cranberry juice to make the urine more acidic and discourage bacterial growth.

After the nurse provides educational information for a patient experiencing recurrent urinary tract infection, which patient statement indicate effective learning?

-Each day, I will drink eight or more full glasses of water -I will report any vaginal discharge to my provider promptly -It's unfortunate that I have to cancel my upcoming bike riding trip -I will go buy simple white cotton underwear and wash them with mild detergent

Which potential complications of hemodialysis would the nurse monitor for potential development when providing care for a patient with chronic kidney disease?

-Fluid imbalance -Cardiac dysrhythmias

Which food items would the nurse suggest when providing care for a patient with edema and oliguria secondary to acute glomerulonephritis?

-Fresh fruit -Spaghetti with garlic olive oil

Which clinical manifestations would the nurse anticipate identifying when examining a patient with glomerulonephritis?

-Hypertension -Generalized body edema -Hematuria and smoky urine

Which factors would the nurse identify when teaching a group of patients about the risk factors contributing to development of urinary tract calculi?

-Low fluid intake -Sedentary occupation -Excessive intake of peanuts

When providing educational information for a patient with recurrent calcium oxalate renal stones, which food choices would the nurse suggest?

-Milk -Yogurt -Apples

A nurse is giving dietary advice to a patient who is on continuous ambulatory peritoneal dialysis for chronic renal failure. Which dietary instructions are appropriate for this patient?

-No-potassium restriction -High-quality protein foods

Which prescribed medication would the nurse prepare to teach a patient who presents to the clinic complaining of urinary urgency, frequency, dysuria, and low back pain and the nurse suspects cystitis?

-Phenazopyridine Trimethoprim-sulfamethoxazole

Which instructions would the nurse include when teaching a patient strategies to manage nephrotic syndrome?

-Record weight daily -Restrict dietary salt intake -Clean edematous skin carefully

Which nonpharmacologic intervention to treat a urinary tract infection (UTI) and control clinical manifestations of frequency, burning, and dysuria would the nurse recommend for a patient diagnosed with a UTI?

-Sitz baths -Cranberry juice -Consumption of 64 to 96 ounces of water

Which disorders would the nurse suspect when a patient with chronic kidney disease reports severe itching all over the body?

-Very dry skin -Excess blood urea levels

Which instructions would the nurse include when providing dietary teaching for a patient receiving continuous ambulatory peritoneal dialysis ( CAPD) for chronic kidney disease?

-You do not need to restrict dietary potassium -Ensure intake of high-quality protein foods

When a patient with glomerulonephritis requests a snack, which potential food item would the nurse provide?

Applesauce

Which priority intervention would the nurse implement when a male patient is experiencing extreme pain and kidney stones are suspected?

Asking the patient to strain all urine before discarding it in the toilet

Which priority intervention would the nurse implement when a patient arrives at the emergency department with penetrating renal trauma secondary to a motor vehicle accident?

Assessing the cardiovascular system and monitoring for signs of shock

Which intervention would the nurse implement for a patient retaining fluid and diagnosed with inadequate renal function?

Auscultating the patient's lungs every 2 hours

When providing care for an older adult patients in a long-term care facility, which clinical manifestation would the nurse associate with the first sign of urinary tract infection?

Confusion

Which organism most likely caused a female patient's urinary tract infection(UTI)

Escherichia coli

A patient scheduled for lithotripsy asks why anesthesia is needed when the procedure is noninvasive, and the nurse explains that the required anesthesia ensures that the patient's position is maintained throughout the procedure. Which type of lithotripsy does the patient have scheduled?

Extracorporeal shock-wave lithotripsy (ESWL)

Which rationale supports the nurse's explanation of postponing invasive procedures for 4 to 6 hours after a patient receives hemodialysis?

Hemodialysis uses heparin during the procedure.

The LPN/LVN should understand that invasive procedures are postponed for 4 to 6 hours after hemodialysis for which reason?

Heparin is used during the procedure

The nurse is caring for a patient with a nephrostomy tube. The nurse anticipates finding which condition listed in the patient's past medical history?

Hydronephrosis

Treatment of benign prostatic hyperplasia(BPH) prevents which potentially serious complication?

Hydronephrosis

Which finding in a patient's history would the nurse relate to the patient's development of acute glomerulonephritis?

I had strep throat about 2 or 3 weeks ago

Which patient statement indicates understanding of a scheduled ureteral stent placement for passage of renal calculi?

I will have the stents removed in about 6 weeks at an outpatient center.

Which is the priority nursing intervention when changing the appliance for a patient with an ileal conduit?

Keeping the skin free from urine

Which clinical manifestation is the earliest sign of a patient's renal impairament?

Polyuria

Which potential occurrence would the nurse relate to a patient hospitalized with acute glomerulonephritis?

Prior bacterial infection

Which patient need would be the focus of the plan of care after a nephrectomy?

Promoting unimpeded urine flow

Which postoperative intervention would the nurse include in the plan of care for a patient scheduled for an extracorporeal shock wave lithotripsy (ESWL) secondary to renal calculi?

Providing educational information on prescribed alpha antagonists

The nurse would instruct a patient diagnosed with cystitis about adhering to the prescribed treatment to avoid development of which disorder?

Pyelonephritis

Which disorder would the nurse associate with a patient presenting to the emergency department reporting right side pain radiating down to the genital and inner thigh area, nausea, and vomiting?

Renal calculi

For which complication is the patient with critically low serum calcium level secondary to end-stage renal disease (ESRD) at risk?

Seizures

Which snack selection would the nurse instruct the patient to avoid when providing dietary teaching related to calcium oxalate renal calculi?

Strawberries

Which patient statement indicates understanding of preoperative instructions regarding elimination after a procedure to create a continent ileal reservoir?

The pouch has a nipple valve through which I will catheterize myself every 4 hours

Which event most likely contributed to the development of a patient's bladder cancer?

Two-pack-per-day cigarette use for 25 years

Which device would the provider use to prevent obstruction of the ureter by edema during recovery and healing for a patient who had a shock wave lithotripsy (SWL) performed?

Ureteral stent

Which clinical manifestation would the nurse expect to identify in a patient with cystitis?

Urinary frequency

When teaching skin care to a patient with an ileal conduit, at which frequency would the nurse instruct the patient to empty the collection bag?

When the bag is one-third full

Which question would the nurse ask first when an 18-year-old patient presents to the emergency department reporting chills and middle back pain, and the nurse notes 3+ generalized edema, periorbital puffiness, temperature of 103 F (39.44), and a blood pressure of 156/98 mm Hg?

When was the last time you had strep throat?

Which clinical manifestation would the nurse associate with a patient's acute glomerulonephritis?

Widespread edema

A patient with acute glomerulonephritis is most likely to have which symptom?

Widespread enema

Which clinical manifestation would the nurse associate with a patient's uremia secondary to end-stage renal disease (ESRD)

Yellow-gray skin color

Which response would the nurse use when a patient with renal calculi asks about the level of pain experienced during an extracorporeal shock wave lithotripsy (ESWL)?

You will receive sedation for the procedure and pain medication afterward