Med Surg II Care of the patient with a Urinary Disorder

Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower UTI. Which instruction should the nurse reinforce to the client?

A reddish-orange discoloration of the urine may occur.

A sulfonamide is prescribed for a client with a UTI. During review of the client's record, the nurse notes that the client is taking warfarin sodium daily. Which prescription would the nurse anticipate for this client?

A decrease in the warfarin sodium dosage

When scheduling the administration of furosemide - Lasix - it would be in the patient's best interest to schedule the medication to be given what time?

0900

___ causes the cells of the distal convoluted tubules to increase their rate of water reabsorption

ADH

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which S/S of this disorder?

Aching pain, pallor, and edema of the left arm

The streptococci infection disease process triggers an immune response that results in inflammation of glomeruli that allows excretion of red blood cells and protein in the urine.

Acute glomerulonephritis

A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which do these data indicate?

Aluminum intoxication

Which factor will most likely promote patient compliance with the prescribed treatment plan?

An active role in the planning

has severe generalized edema.

Anasarca

develops as excessive amounts of nitrogenous compounds build up in the blood.

Azotemia

used to determine the kidney's ability to rid the blood of nonprotein nitrogenous waste and urea, which result from protein breakdown.

Blood urea nitrogen

Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

Blood urea nitrogen level of 25mg/dL

The nurse is caring for the client with epididymitis. Which treatment modalities would be implemented?

Bed rest Sitz bath Antibiotics Scrotal elevation

The_______ is the most common site of cancer in the urinary tract.

Bladder

After a renal biopsy, the client complains of pain at the biopsy site, which radiates to the front of the abdomen. Which would this indicate?

Bleeding

The nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The nurse would check the client for which sign of toxicity?

Bradycardia

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome?

Bradycardia and confusion

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply.

Check the level of the drainage bag Reposition the client to side Place the client in good body alignment Check the peritoneal dialysis system for kinks

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?

Hyperglycemia

The nurse is monitoring an older client suspected of having a urinary tract infection for signs of infection. Which S/S is likely to present first?

Confusion

A client has epididymitis as a complication of a UTI. Tuhe nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teach if?

Continue to take antibiotics until all symptoms are gone. Full rounds should be taken

is an inflammation of the wall of the urinary bladder.

Cystitis

The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client needs to be questioned about the use of which class of medications?

Decongestants

The nurse s reviewing the client's record and notes that the primary health care provider has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function?

Decreased hemoglobin Elevated serum creatinine level Decreased RBC Elevated BUN

A client is scheduled for intravenous pyelography. Which priority nursing action would the nurse take?

Determine if there is a history of allergies

The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which health problem noted on the client's record would the nurse identify as a risk factor for this diagnosis?

Diabetes Mellitus

blood chemistry levels begin to return to normal and urinary output increases to 1 to 2 L/24 hour.

Diuretic phase

enhance urinary output by increasing the filtration of sodium, chloride, and water at various sites in the kidney

Diuretics

The nurse performs a bladder scan immediately after a patient voids ands obtains 30 mL of residual urine. What action by the nurse should be taken next?

Document the procedure with outcome data.

A male client has a tentative diagnosis of urethritis. The nurse would assess the client for which manifestations of the disorder?

Dysuria and penile discharge

Which goal would have priority in planning care of the aging patient with urinary incontinence?

Episodes of incontinence decrease

The nursing care plan includes teaching a patient Kegel exercises. What would be the best instruction when teaching this patient this type of exercise?

Exercise the muscles around your urinary meatus several times a day

of water and blood products occurs in the glomerulus of Bowman's capsule

Filtration

What is the primary function of the kidney?

Filtration of water and blood products

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Hematocrit of 33%

is used for patients with acute or irreversible renal failure and fluid and electrolyte imbalances.

Hemodialsis

What statement by a patient indicates the need for further teaching before renal angiography?

I'm glad I don't have to stay in bed after the test

bladder capacity may be exceeded and the urine may overflow, causing

Incontinence

evaluates structures of the urinary tract system, filling of the renal pelvis with urine, and transport of urine via the ureters to the bladder.

Intraveous Pyelography/urography

that tighten the muscles of the perineal floor.

Kegel exercise

The adrenal glands sit near the top of each

Kidney

The nurse is reinforcing discharge instructions to a client receiving sulfadiazine. Which would be included in the list of instructions?

Maintain a high fluid intake

When calculating actual urinary output during continuous bladder irrigations, the nurse would:

Measure the total output and deduct the amount of irrigation solution used

the glomeruli become damaged due to inflammation, so that small proteins, such as albumins, immunoglobulins, and antithrombin, can pass through the kidneys into the urine.

Nephrotic syndrome

means the loss of voluntary voiding control, resulting in urinary retention or incontinence.

Neurogenic bladder

BUN and serum creatinine levels rise while the urinary output decreases to less than 400 mL / 24 hours.

Oliguric phase

act on the distal convoluted tubule to inhibit sodium reabsorption and potassium secretion

Potassium-sparing diuretics

as inflammation and / or infection of the prostate gland.

Prostatitis

The nurse is caring for a patient who has just had a renal angiography performed. What is the priority assessment?

Puncture site

is an inflammation of the structures of the kidney-- the renal pelvis, renal tubules, and interstitial tissue.

Pyelonephritis

The nurse is reviewing the urinalysis report on an assigned patient. The nurse recognizes which findings to be normal?

RBC - 15 to 20 WBC - 1 to 3

of water, glucose, and necessary ions back into the blood occurs in the proximal convoluted tubules, Henle's loop, and the distal convoluted tubules.

Reabsorption

The kidney function return to normal or nearly normal function occurs in

Recovery phase

is characterized by the kidneys' inability to remove wastes, concentrate urine, and conserve or eliminate electrolytes.

Renal Failure

are round, fluid sacs on the kidneys.

Renal cysts

Oxybutynin chloride is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this mediation?

Restlessness

Which activity would be most harmful for the incontinent patient?

Restricting fluid intake

A patient with chronic kidney injury is starting peritoneal dialysis. Which statement to the patient best describes the purpose of this treatment?

Since your kidneys no longer work efficiently peritoneal dialysis will filter toxins from your blood in place of your kidneys

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse would instruct the client to report which symptom if it developed during the course of this medication therapy?

Sore throat

Results from the pressure on the bladder sphincter by events such as sneezing or heavy lifting.

Stress incontinence

The health care provider has talked to a patient and his wife about the treatment plan for his bladder cancer. Later, the patient tells the nurse he does not understand what the health care provider is going to do. What is the most appropriate initial response by the nurse?

Tell me what you know about the treatment

act at the distal convoluted tubule to impair sodium and chloride reabsorption, leading to excretion of electrolytes and water.

Thiazide diuretics

Phenazopyridine hydrochloride has been prescribed for a patient. What information should be provided to the patient about this medication?

This medication will result in experiencing reduced bladder discomfort The urine will have an orange hue as a result of this medication

The nurse is reviewing the orders for a patient and finds that a culture and sensitivity test has been ordered. What instruction does the nurse provide to the patient regarding this diagnostic test?

This test is ordered in order to determine the type of bacteria causing your infection and the antibiotic that will treat the infection

allowing a microwave antenna to be positioned within the prostate; there it heats and destroys hyperplastic prostate tissue.

Transurethral microwave thermotherapy

is caused by the multiplication of microorganisms in any urinary system structure.

UTI

is a narrowing of the lumen of the urethra that interferes with urine flow.

Urethral strictures

inflammation of the urethra, is classified by the presence or absence of gonorrhea.

Urethritis

The nurse is collecting data from a client who has had benign prostatic hyperplasia in the past. To determine whether the client is currently experiencing exacerbation of PBH, the nurse would ask the client about the presence of which early symptom?

Urge incontinence

Several types of procedures are used to divert the flow of urine when required for treatment of bladder cancer.

Urinary Diversion

Bethanechol chloride is prescribed for a client with urinary retention. WHich health problem would be contraindication to the administration of this medication?

Urinary strictures

The nurse is caring for a patient during the postoperative period after an arteriovenous shunt has been placed What is the most important action to be taken?

Use strict surgical asepsis for dressing changes

A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions?

Use warm sitz baths and analgesics to increase comfort.

urinary output of less than 100mL/day

anuria

decrease strength or energy.

asthenia

In discussing dietary needs with a patient with ESKD, the nurse indicates that potassium-rich foods should be limited in the diet. Which selections should be limited?

baked potatoes, bananas, apricots

enlargement of the prostate gland.

benign prostatic hypertrophy hyperplasia

erythrocytes in the urine

hematuria

the ureters are implanted into a loop of the ileum that is isolated and brought to the surface of the abdominal wall.

ileal conduit

is a chronic pelvic pain disorder with recurring discomfort or pain in the urinary bladder and surrounding region.

interstital cystitis

sugar in the urine

glycosuria

This condition is seen with diabetes mellitus, starvation, or any other metabolic condition in which fats are rapidly catabolized.

ketone bodies

act primarily in the ascending loop of Henle to inhibit tubular reabsorption of sodium and chloride.

loop or high-ceiling diuretics

is a disorder characterized by marked proteinuria, hyperlipidemia, hypoalbuminemia, and edema.

nephrotic syndrome

Excessive urination at night

nocturia

Repeated inability to fully empty the bladder results in a full bladder leaks out unexpectedly.

overflow incontinence

The kidneys lie behind the

peritoneum ret-roperitoneal

is an organ-specific glycoprotein produced by normal prostatic tissue.

prostate-specific antigen

pain in the prostate gland.

prostatodynia, prostatalgia

As ___ break down, nitrogenous waste --- urea, ammonia, and creatinine is produced

proteins

is a tightly bound network of capillaries called glomeruli

renal corpuscle

the amount of urine left in the bladder after urination.

residual urine

This occur because of weakened musculature in the bladder

retention

of certain ions, nitrogenous waste products, and drugs occurs primarily in the distal convoluted tubule.

sectretion

the density of a urine sample is compared with that of water.

specific gravity

is the terminal portion of the urinary system and is shorter in women

urethra

describes normal and abnormal constituents in the urine and possible factors that influence test results.

urinalysis

Obstruction at any point within the urinary tract can adversely affect function and alter structure.

urinary obstruction

is the inability to void even with an urge to void.

urinary rention