Genoitourinary

A nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which of the following questions to the mother would elicit information about the cause of this disease?

Did your child recently complain of a sore throat?

A nurse is admitting a client with chronic renal failure (CRF) to the nursing unit. The nurse monitors the client for which most frequent cardiovascular sign that occurs in CRF?

Hypertension

A patient has nephrotic syndrome. Which of these statements made by the patient indicates that she understands the dietary modifications?

"I will need to increase protein and decrease sodium intake."

A nurse collects a urine specimen from a urinalysis from a client recently diagnosed with polycystic disease of the kidneys. The nurse documents that the urine is dilute and that the specific gravity of the urine is low. Based on this documentation, which of the following specific gravity results were present?

1.000

The physician ordered 1000 ml of D5W to infuse over 16 hours with a drop factor of 20 get/ml. Calculate the correct IV flow rate in drops per minute. Round off to the nearest whole number.

21

The nurse needs to obtain a sterile urine specimen for culture and sensitivity from a client with an indwelling urinary catheter. Choose all of the following that would apply to this situation. 1. Disconnect the catheter from the drainage tubing and let the urine drip into the sterile bottle. 2. Use a needle and syringe to withdraw urine from the tubing port. 3. Inject the specimen from the syringe into the sterile bottle. 4. Place a towel under the bag, and open the drainage valve at the bottom of the drainage bag. 5. Remove the old Foley, then using a straight catheter, recatheterize the patient.

2,3

A physician orders orphenadrine (Norflex) 60 mg IV q12. If orphenadrine (Norflex) is available in a 30 mg/mL vial, how many milliliters will the nurse need to prepare and administer to the client in a 24 hour period?

4 ml/day

They physician ordered D5 NS to run at 125 mL/ hour with a drop factor of 20 gtt/ mL. Calculate the IV flow rate in gtt/ minute. Round off to the nearest whole number.

42

Which of the following clients is at greatest risk for developing acute renal failure?

A client with diabetes and who is dehydrated.

A client has just undergone a renal biopsy. In planning care for this client, the nurse would avoid which intervention?

Ambulate in the room and hall for short distances.

__________ is a term for severe generalized edema:

Anasarca

A nurse has an order to collect a 24- hour urine specimen from a client. The nurse should avoid which of the following errors in technique while completing this procedure?

Ask the client to void at the start time, save the specimen, and document the start time.

A nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which of the following, if noted in the first few hours following the procedure, indicates the need to notify the registered nurse?

Bloody urine with clots.

A patient age 69 is admitted to the hospital with gross hematuria and history of a 20-lb weight loss during the last 3 months. The physician suspects renal cancer. In obtaining a nursing history from this patient, the nurse recognizes which of the following as a significant risk factor for renal cancer?

Cigarette smoking.

A female client has an order for a clean-catch urine culture. After providing a sterile specimen cup to the client, the nurse would give which instruction so that the specimen is collected properly?

Cleanse the labia using cleansing towels, begin to void into toilet , and then collect the specimen.

In preparing your client for an intravenous pyelogram (IVP), it is important to implement which of the following?

Determine any history of allergies specially to iodine or shellfish.

The patient has end-stage renal disease (ESRD) and is admitted with a blood urea nitrogen (BUN) level of 93 mg/dL. An excessive elevation of BUN could result in:

Disorientation.

The course of ARF is divided into phases, what are the phases?

Diuresis Recovery Oliguria

In the clients suspected of having benign prostatic hypertrophy (BPH), the most frequent signs observed are:

Dysuria, nocturia

A nurse is reviewing the client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following?

Elevated blood urea nitrogen (BUN) and creatinine level.

Pediatric patients, especially girls, are susceptible to urinary tract infections because:

Females have a short and proximal urethra in relation to the vagina.

A nurse is providing instructions to the client regarding the complications of peritoneal dialysis. The nurse instructs the client that which manifestation is most likely associated with the onset of peritonitis?

Fever

A nurse is caring for a client who has been diagnosed as having a kidney mass. The client asks the nurse the reason for a renal biopsy, when other tests such as computerized tomography (CT) and ultrasound are available. In formulating a response, the nurse incorporates the knowledge that a renal biopsy:

Gives specific cytological information, malignancy determination about the lesion.

A client with new- onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which of the following on return from the dialysis treatment (Disequilibrium syndrome)?

Headache, decreasing level of consciousness and seizures.

A client with new- onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which of the following on return from the dialysis treatment?

Headache, decreasing level of consciousness, and seizures.

A nurse is performing an admission assessment on a client with a diagnosis of bladder cancer. Which of the following would the nurse most likely expect to note on data collection of this client?

Hematuria.

The method that employs shock waves to shatter/ pulverize kidney stones is:

Lithotripsy

A 56 year old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. An important aspect in nursing interventions of the patient with an ileal conduit is?

Maintenance of skin integrity.

The nurse notes the amount and color of the urine the patient with urolithiasis (presence of stones). While using standard precautions, the nurse's next action would be to:

Make sure to strain all urine

PH 7.46; HCO3 30; PaCO2 45

Metabolic alkalosis, partial uncompensated

A nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent?

Presence of bruit and thrill over the fistula.

PH 7.36; HCO3 23; PaCO2 39

Normal ABG

A nurse is providing information to the mother of a child with nephrotic syndrome regarding the edematous appearance of the child. Which of the following statements should the nurse make to the mother?

The fluid retention should be controlled by medication and diet.

A nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy.the nurse notifies the registered nurse and plans to take what action?

Obtain a culture and sensitivity of the drainage per orders.

A nurse has an order to obtain a sample for urinalysis from a client with an indwelling urinary catheter. The nurse would avoid which of the following, which could contaminate the specimen?

Obtaining the specimen from the urinary drainage bag.

The patient, age 30, has a history of renal calculi and is admitted to the hospital with gross hematuria and severe colicky left flank pain that radiates to his left testicle. An intravenous pyelogram confirmas the presence of a 4-mm renal calculus in the proximal left ureter. Physician orders include morphine 1mg q4h pen, strain all urine, and encourage fluids to 4,000 mL/day. In planning care for this patient, the nurse gives the highest priority to which nursing diagnosis?

Pain related to irritation of a stone.

An adult client has had serum electrolytes drawn. The nurse receiving the results by telephone from the laboratory would be most concerned with which of the following results?

Potassium 5.4 mEq/L

One method of monitoring for signs and symptoms of fluid overload when administering diuretics is:

Record daily morning weights (same time, scale, clothes).

Mr. S. Tony came to the ED with family, complaining of low- grade fever, sudden onset of sharp, severe pain originating in the lumbar area and radiating around the side and down toward the testicle, hematuria with urinary frequency and alternating retention. Morphine for pain was ordered and the patient was further assessed to behaving what, basing from the initial signs and symptoms?

Renal calculi.

PH 7.28; HCO3 28; PaCO2 46

Respiratory acidosis, partial compensated

PH 7.27; HCO3 24; PaCO2 53

Respiratory acidosis, partial uncompensated

PH 7.52; HCO3 23; PaCO2 29

Respiratory alkalosis, partial uncompensated

When preparing to teach a patient about continuous bladder irrigation, the nurse notes that the most frequently used irritant is:

Sterile isotonic saline.

Mr. Shunter receives hemodialysis treatments through an arteriovenous (AV) shunt in the left arm. Which of the following interventions is appropriate?

Take the blood pressure on the right arm.

Urinary frequency, urgency, nocturia, retention, and incontinence are common with aging. These occur because of:

The effects of medications such as diuretics 1,000 to 2,000 mL fluids per 24 hours.

A client with chronic renal failure asks the nurse why he is anemic. Which of the following responses by the nurse is best?

There is a decreased production by the kidneys of the hormone erythropoietin.

A patient, age 78, has been admitted to the hospital with dehydration and electrolyte imbalance. She is confused and incontinent of urine on admission. Which appropriate nursing intervention does the nurse include in developing a plan of care?

Use protective undergarments.

Which of the following instructions is given to clients with chronic pyelonephritis?

You may need antibiotic treatment for several weeks for the treatment of the infection.

It is 2 days after a difficult patient's urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. The most likely explanation for his behavior is that he:

is having problems accepting the urinary diversion.

The physician orders a urinalysis and urine culture. To obtain the urine specimen, the nurse would first instruct the patient about:

obtaining a clean-catch specimen.