Med Surge from Mom 3

B Normal venous blood pH ranges from 7.31 to 7.41. Normal arterial blood pH ranges from 7.35 to 7.45.

Normal venous blood pH ranges from: A 6.8 to 7.2 B 7.31 to 7.41 C 7.35 to 7.45 D 7.0 to 8.0

D Continence

Normal voluntary control of the bladder is called: A Incontinence B Intersitital cystitis C Urinatia D Continence

B Metabolic acidosis results from excessive absorption or retention of acid or excessive excretion of bicarbonate. A base is needed. Sodium bicarbonate is a base and is used to treat documented metabolic acidosis. Potassium, serum sodium determinations, and a bronchodilator would be inappropriate orders for this client.

A client is diagnosed with metabolic acidosis, which would the nurse expect the health care provider to order? A Potassium B Sodium bicarbonate C Serum sodium level D Bronchodilator

C. Autonomic dysreflexia is a potentially life-threatening complication of spinal cord injury, occurring from obstruction of the urinary system or bowel. Incontinence and diarrhea don't result in obstruction of the urinary system or bowel, respectively. An URI could obstruct the respiratory system, but not the urinary or bowel system

A 27-year old client, who became paraplegic after a swimming accident, is experiencing autonomic dysreflexia. Which condition is the most common cause of autonomic dysrelexia? a. Upper respiratory infection b. Incontinence c. Bladder distention d. Diarrhea

C. "First, I will pee a small amount of urine in the toilet and then collect the rest in the cup." When collecting a urinalysis it is important to avoid contaminating the sample. So, the patient will collect the urine during mid-stream. The patient will void a small amount in the toilet and then void the rest into the cup (until it is halfway full). The cup should be placed a few inches away from the urethra and prior to voiding the patient should use an antiseptic wipe to cleanse the labia from front to back. It is best to collect the sample when the bladder has been full for 2-3 hours, therefore the urine in concentrated not diluted.

A 36 year old female, who is 29 weeks pregnant, reports she is experiencing burning when voiding. The physician orders a urinalysis. Which statement by the patient demonstrates she understands how to collect the specimen?* · A. "I'll hold the cup firmly against the urethra while collecting the sample." · B. "I will cleanse back to front with the antiseptic wipe before peeing in the cup." · C. "First, I will pee a small amount of urine in the toilet and then collect the rest in the cup." · D. "I will be sure to drink a lot of fluids to keep the urine diluted before peeing into the cup."

A TURP is the most widely used procedure for prostate gland removal. Because it requires no incision, TURP is especially suitable for men with relatively minor prostatic enlargements and for those who are poor surgical risks. Suprapubic prostatectomy, retropubic prostatectomy, and transurethral laser incision of the prostate are less common procedures; they all require an incision.

A 55-year old client with benign prostatic hyperplasia doesn't respond to medical treatment and is admitted to the facility for prostate gland removal. Before providing preoperative and postoperative instructions to the client, Nurse Gerry asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for prostate gland removal? A Transurethral resection of the prostate (TURP) B Suprapubic prostatectomy C Retropubic prostatectomy D Transurethral laser incision of the prostate

. Infections is the major complication to watch for in clients on cyclosporine therapy because it's an immunosuppressive drug. Depression may occur post-transplantation but not because of cyclosporine. Hemorrhage is a complication associated with anticoagulant therapy. Peptic ulcer disease is a complication of steroid therapy

A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy? a. Depression b. Hemorrhage c. Infection d. Peptic ulcer disease

C. The calculus should be analyzed for composition to determine appropriate interventions such as dietary restrictions. Calculi don't result in infections. The size and number of calculi aren't relevant, and they don't contain antibodies

A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for which of the following factors? a. Antibodies b. Type of infection c. Composition of calculus d. Size and number of calculi

C Electrolyte imbalances associated with Addison's disease include hypoglycemia, hyponatremia, and hyperkalemia. Salted bouillon and fruit juices provide glucose and sodium to replenish these deficits. Diet soda does not contain sugar. Water could cause further sodium dilution. Coffee's diuretic effect would aggravate the fluid deficit. Milk contains potassium and sodium.

A client with Addison's disease is admitted to the medical unit. The nurse diagnoses the client with Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As the client's oral intake increases, which of the following fluids would be most appropriate? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes

A Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.

A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? A This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. B The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. C The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse. D The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex.

C After renal angiography involving a femoral puncture site, the nurse should check the client's pedal pulses frequently to detect reduced circulation to the feet caused by vascular injury. The nurse also should monitor vital signs for evidence of internal hemorrhage and should observe the puncture site frequently for fresh bleeding. The client should be kept on bed rest for several hours so the puncture site can seal completely. Keeping the client's knee bent is unnecessary. By the time the client returns to the short-procedure unit, manual pressure over the puncture site is no longer needed because a pressure dressing is in place. The nurse shouldn't remove this dressing for several hours — and only if instructed to do so.

A male client in the short-procedure unit is recovering from renal angiography in which a femoral puncture site was useD. When providing postprocedure care, the nurse should: A keep the client's knee on the affected side bent for 6 hours. B apply pressure to the puncture site for 30 minutes. C check the client's pedal pulses frequently. D remove the dressing on the puncture site after vital signs stabilize

d. manually instill 50 ml of saline and try to remove the clots.

A patient undergoing a TURP returns from surgery with a three-way urinary catheter with continuous bladder irrigation in place. The nurse observes that the urine output has decreased and the urine is clear red with multiple clots. The patient is complaining of painful bladder spasms. The most appropriate action by the nurse is to a. administer the ordered IV morphine sulfate, 4 mg. b. increase the flow rate of the continuous bladder irrigation. c. give the ordered the belladonna and opium suppository. d. manually instill 50 ml of saline and try to remove the clots

B. EPO (erythropoietin) helps create red blood cells in the bone marrow. The kidneys produce EPO and when the kidneys are damaged in CKD they can decrease in the production of EPO. Therefore, the patient is at risk for anemia

A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for?* · A. Hypercalcemia · B. Anemia · C. Blood clots · D. Hyperkalemia

C. The patient's description of the pain is known as ureteral colic. The kidney stone may be in the ureter. On the other hand, another type of pain that can be reported is renal colic. This is a dull, deep aching in the flank/costovertebral area and the kidney stone may be in the renal pelvis

A patient with a kidney stone explains that the pain he is experiencing is intense, sharp, and wavelike that radiates to the scrotum. In addition, he explains it feels like he has to void but a small amount of urine is passed. Based on the patient's signs and symptoms, where may the kidney stone be located?* · A. Renal Calyx · B. Renal Papilla · C. Ureter · D. Urethra

D. Orange colored urine is a normal side effect of Pyridium which acts as a pain reliever to decreasing frequent urination and pain associated with a UTI.

A patient, who is having spasms and burning while urinating due to a UTI, is prescribed "Pyridium" (Phenazopyridine). Which option below is a normal side effect of this drug?* · A. Hematuria · B. Crystalluria · C. Urethra mucous · D. Orange colored urine

A The internal vasoconstrictive compensatory reactions within the body are responsible for the symptoms exhibited. The body naturally attempts to conserve fluid internally specifically for the brain & heart.Rationale 2: A diuretic would cause further fluid loss, & is contraindicated. Rationale 3: Rapidly infused intravenous fluids would not cause a decrease in urine output. Rationale 4: The manifestations reported are not indicative of cardiac failure in this pt.

A pt, experiencing multisystem fluid volume deficit, has the symptoms of tachycardia, pale, cool skin, & decreased urine output. The nurse realizes these findings are most likely a direct result of which of the following? A. the body's natural compensatory mechanisms B. pharmacological effects of a diuretic C. effects of rapidly infused intravenous fluids D. cardiac failure

A When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the nurse is aware that the functions of the three lumens include: A Continuous inflow and outflow of irrigation solution B Intermittent inflow and continuous outflow of irrigation solution C Continuous inflow and intermittent outflow of irrigation solution D Intermittent flow of irrigation solution and prevention of hemorrhage

• C. Simultaneous Respiratory and Metabolic Acidosis • Whenever the PCO2 and HCO3 are abnormal in opposite directions, ie, one above normal while the other is reduced, a mixed respiratory and metabolic acid-base disorder exists. When the PCO2 is elevated and the [HCO3-] reduced, respiratory acidosis and metabolic acidosis coexist.

A young woman is found comatose, having taken an unknown number of sleeping pills an unknown time before. An arterial blood sample yields the following values: pH 6.90, HCO3- 13 meq/liter, and PaCO2 68 mmHg. This patient's acid-base status is most accurately described as: · A. Metabolic Acidosis · B. Respiratory Acidosis · C. Simultaneous Respiratory and Metabolic Acidosis · D. Respiratory Acidosis with Complete Renal Compensation

A Aldosterone is secreted in response to fluid loss. Aldosterone causes sodium reabsorption and potassium elimination, further exacerbating hypokalemia

Aldosterone secretion in response to fluid loss will result in which one of the following electrolyte imbalances? A hypokalemia B hyperkalemia C hyponatremia D hypernatremia

A Low potassium can cause an imbalance at the cellular level that leads to dysrhythmias and cardiac arrest. Hyperglycemia is caused by elevated blood sugar. Hypertension is unrelated to potassium levels. Increased energy is unrelated to potassium levels.

An expected physiologic response to a low potassium level is: A. Cardiac dysrhythmias. B. Hyperglycemia. C. Hypertension. D. Increased energy.

• C. Metabolic Acidosis, Fully Compensated Baby Angela has metabolic acidosis due to decreased HCO3 and slightly acidic pH. Her pH value is within the normal range which made the result fully compensated

Baby Angela was rushed to the Emergency Room following her mother's complaint that the infant has been irritable, difficult to breastfeed, and has had diarrhea for the past 3 days. The infant's respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. The results from the ABG results show pH 7.39, PaCO2 27 mmHg, and HCO3 19 mEq/L. What does this mean? • A. Respiratory Alkalosis, Fully Compensated • B. Metabolic Acidosis, Uncompensated • C. Metabolic Acidosis, Fully Compensated • D. Respiratory Acidosis, Uncompensated

B Hypotonic fluid volume excess (FVE) involves an increase in water volume without an increase in sodium concentration. Increased sodium intake is part of the management of this condition

Dietary recommendations for a patient with a hypotonic fluid excess should include: A decreased sodium intake B increased sodium intake C increased fluid intake D intake of potassium-rich foods

C During the oliguric phase of ARF, urine output decreases markedly, possibly leading to fluid overload. Limiting oral and I.V. fluid intake can prevent fluid overload and its complications, such as heart failure and pulmonary edema. Encouraging coughing and deep breathing is important for clients with various respiratory disorders. Promoting carbohydrate intake may be helpful in ARF but doesn't take precedence over fluid limitation. Controlling pain isn't important because ARF rarely causes pain.

For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important? A Encouraging coughing and deep breathing B Promoting carbohydrate intake C Limiting fluid intake D Providing pain-relief measures

B Hemorrhage is a potential complication. Urine retention isn't a problem soon after surgery because a catheter is in place. Pneumonia may occur if the patient doesn't cough and deep breathe. Thrombosis may occur later if the patient doesn't ambulate

Immediately post-op after a prostatectomy, which complications requires priority assessment of your patient? A Pneumonia B Hemorrhage C Urine retention D Deep vein thrombosis

C Salicylate overdose causes a high anion gap metabolic acidosis in both children and adults. Adults commonly develop a mixed acid-base disorder as a respiratory alkalosis due to direct respiratory center stimulation occurs as well. This second disorder is uncommon in children

Liza's mother is seen in the emergency department at a community hospital. She admits that her mother is taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. Also, the mother complains of an inability to urinate. The nurse on duty took her vital signs and noted the following: Temp = 97.8 °F; apical pulse = 95; respiration = 32 and deep. Which primary acid-base imbalance is the client at risk for if medical attention is not provided? • A. Respiratory Acidosis • B. Respiratory Alkalosis • C. Metabolic Acidosis • D. Metabolic Alkalosis

A In a client with hypocalcemia, a positive Trousseau's sign refers to carpopedal spasm that develops usually within 2 to 5 minutes after applying and inflating a blood pressure cuff to about 20 mm Hg higher than systolic pressure on the upper arm. This spasm occurs as the blood supply to the ulnar nerve is obstructed. Chvostek's sign refers to twitching of the facial nerve when tapping below the earlobe. Paresthesia refers to the numbness or tingling. Tetany is a clinical manifestation of hypocalcemia denoted by tingling in the tips of the fingers around the mouth, and muscle spasms in the extremities and face.

Marie Joy's lab test revealed that her serum calcium is 2.5 mEq/L. Which assessment data does the nurse document when a client diagnosed with hypocalcemia develops a carpopedal spasm after the blood-pressure cuff is inflated? A Positive Trousseau's sign B Positive Chvostek's sign C Tetany D Paresthesia

C Keeping the linens dry and wrinkle-free aids in preventing moisture and pressure from interfering with adequate blood supply to the tissues, helping to maintain skin integrity. Using a foot board is appropriate for maintaining normal body function position. Monitoring intake and output aids in assessing and maintaining bladder function.. Coughing and deep breathing help promote gas exchange.

Mrs. dela Riva is in her first trimester of pregnancy. She has been lying all day because her OB-GYN requested her to have a complete bed rest. Which nursing intervention is appropriate when addressing the client's need to maintain skin integrity? A Monitoring intake and output accurately B Instructing the client to cough and deep-breathe every 2 hours C Keeping the linens dry and wrinkle free D Using a foot board to maintain correct anatomic position

B Urinary incontinence isn't a normal part of aging nor is it a disease. It may be caused by confusion, dehydration, fecal impaction, restricted mobility, or other causes. Certain medications, including diuretics, hypnotics, sedatives, anticholinergics, and antihypertensives, may trigger urinary incontinence. Most clients with urinary incontinence can be treated; some can be cured.

Nurse Gil is aware that the following statements describing urinary incontinence in the elderly is true? A Urinary incontinence is a normal part of aging B Urinary incontinence isn't a disease C Urinary incontinence in the elderly can't be treated D Urinary incontinence is a disease

C Infection can occur with renal calculi from urine stasis caused by obstruction. Options A and D aren't appropriate for this diagnosis, and retention of urine usually occurs, rather than incontinence.

Nurse Harry is aware that the following is an appropriate nursing diagnosis for a client with renal calculi? A Ineffective tissue perfusion B Functional urinary incontinence C Risk for infection D Decreased cardiac output

C The client should report the presence of foul-smelling or cloudy urine. Unless contraindicated, the client should be instructed to drink large quantities of fluid each day to flush the kidneys. Sand-like debris is normal due to residual stone products. Hematuria is common after lithotripsy

Nurse Harry is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to: A limit oral fluid intake for 1 to 2 weeks. B report the presence of fine, sand-like particles through the nephrostomy tube. C notify the physician about cloudy or foul-smelling urine. D report bright pink urine within 24 hours after the procedure.

D Symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. Rashes on the palms of the hands and soles of the feet are symptoms of the secondary stage of syphilis. Cauliflower-like warts on the penis are a sign of human papillomavirus. Painful red papules on the shaft of the penis may be a sign of the first stage of genital herpes

Nurse Lily is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? A Rashes on the palms of the hands and soles of the feet B Cauliflower-like warts on the penis C Painful red papules on the shaft of the penis D Foul-smelling discharge from the penis

A Administration of phosphate binders (amphogel and basagel) will reduce the serum phosphate levels.

Nursing intervention for the patient with hyperphosphatemia include encouraging intake of: A amphogel B Fleets phospho-soda C milk D vitamin D

B In a patient with hypermagnesemia, administration of calcium gluconate will antagonize the cardiac effects of magnesium. Although calcium gluconate will raise serum calcium levels, that is not the purpose of administration. Calcium gluconate does not lower calcium or magnesium levels.

Nursing interventions for a patient with hypermagnesemia include administering calcium gluconate to: A increase calcium levels B antagonize the cardiac effects of magnesium C lower calcium levels D lower magnesium levels

C Hyponatremia involves a decreased concentration of sodium in relation to fluid volume, so restricting fluid intake is indicated.

Nursing interventions for a patient with hyponatremia include: A administering hypotonic IV fluids B encouraging water intake C restricting fluid intake D restricting sodium intake

A Kidneys, ureters, bladder

The KUB in a KUB X-ray stands for A Kidneys, ureters, bladder B Kidneys, urethra, bladder C Kinesis, urinary tract, BMP D Kinesis, ureters, BMP

A. The client with prostatitis has a prostate gland that is swollen and tender but that is also warm to the touch, firm, and indurated. Systemic symptoms include fever with chills, perineal and low back pain, and signs of urinary tract infection (which often accompany the disorder).

The client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse would look at the results of the prostate examination, which should reveal that the prostate gland is: a. Tender, indurated, and warm to the touch b. Soft and swollen c. Tender and edematous with ecchymosis d. Reddened, swollen, and boggy.

B. Frequent dressing changes around the Penrose drain is required to protect the skin against breakdown from urinary drainage. If urinary drainage is excessive, an ostomy pouch may be placed over the drain to protect the skin. A Penrose drain is not irrigated. Weighing the dressings is not necessary. Placing the client on the affected side will prevent a free flow of urine through the drain

The client returns to the nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in place. Which of the following would the nurse include on the client's postoperative care? a. Sterile irrigation of the Penrose drain b. Frequent dressing changes around the Penrose drain c. Weighing the dressings d. Maintaining the client's position on the affected sid

D The vibration or thrill felt during palpation ensures that the fistula has the desired turbulent blood flow. Pinching the fistula could cause damage. Aspirating blood is a needless invasive procedure.

What is the best way to check for patency of the arteriovenous fistula for hemodialysis? A Pinch the fistula and note the speed of filling on release B Use a needle and syringe to aspirate blood from the fistula C Check for capillary refill of the nail beds on that extremity D Palpate the fistula throughout its length to assess for a thrill

C Insensible losses may occur without the person's awareness. Insensible losses occur daily through the skin and the lungs. Sensible losses are those of which the person is aware, such as through urination, wound drainage, and gastrointestinal tract losses.

The nurse is reading a health care provider's (HCP's) progress notes in the client's record and reads that the HCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse makes a notation that insensible fluid loss occurs through which type of excretion? A. Urinary output B. Wound drainage C. Integumentary output D. The gastrointestinal tract

A, B, D The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). A serum sodium level of 150 mEq/L (150 mmol/L) indicates hypernatremia. On the basis of this finding, the nurse would instruct the client to avoid foods high in sodium. Peas, nuts, and cauliflower are good food sources of phosphorus and are not high in sodium (unless they are canned or salted). Peas are also a good source of magnesium. Processed foods such as cheese and processed oat cereals are high in sodium content.

The nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the health care provider (HCP) and the HCP prescribes dietary instructions based on the sodium level. Which acceptable food items does the nurse instruct the client to consume? Select all that apply. A. Peas B. Nuts C. Cheese D. Cauliflower E. Processed oat cereals

F Complications include CAUTI, bladder spasms, periurethral abscess, chronic pyelonephritis, urosepsis, trauma, fistula or stricture formation, and stone formation....not gall stones

What are some common complications of catheterization? A Bladder spasms, chronic pyelonephritis, trauma B Bladder spasms, fistula or stricture formation, periurethral abscess, gall stones C CAUTI, Urosepsis, chronic pyelonephritis D All of the above E A&B F A&C

A Narcotic analgesics are usually needed to relieve the severe pain of renal calculi. Muscle relaxants are typically used to treat skeletal muscle spasms. NSAIDS and salicylates are used for their anti-inflammatory and antipyretic properties and to treat less severe pain

Which drug is indicated for pain related to acute renal calculi? A Narcotic analgesics B Nonsteroidal anti-inflammatory drugs (NSAIDS) C Muscle relaxants D Salicylates

D Sodium is the electrolyte whose level is the primary determinant of the extracellular fluid concentration. Sodium a cation (e.g., positively charged ion), is the major electrolyte in extracellular fluid. Chloride, an anion (e.g., negatively charged ion), is also present in extracellular fluid, but to a lesser extent. Potassium (a cation) and phosphate (an anion) are the major electrolytes in the intracellular fluid.

Which electrolyte would the nurse identify as the major electrolyte responsible for determining the concentration of the extracellular fluid? A Potassium B Phosphate C Chloride D Sodium

C Mild to moderate HTN may result from sodium or water retention and inappropriate renin release from the kidneys. Oliguria and fatigue also may be seen. Other signs are proteinuria and azotemia.

Which finding leads you to suspect acute glomerulonephritis in your 32 y.o. patient? A Dysuria, frequency, and urgency B Back pain, nausea, and vomiting C Hypertension, oliguria, and fatigue D Fever, chills, and right upper quadrant pain radiating to the back

D Pyridium is taken to relieve dysuria because is provides an analgesic and anesthetic effect on the urinary tract mucosa. The patient can stop taking it after the dysuria is relieved. The urine may temporarily turn red or orange due to the dye in the drug. The drug isn't taken before voiding, and is usually taken 3 times a day for 2 days.

Which instructions do you include in the teaching care plan for a patient with cystitis receiving phenazopyridine (Pyridium). A If the urine turns orange-red, call the doctor B Take phenazopyridine just before urination to relieve pain C Once painful urinatino is relieved, discontinue prescribed antibiotics D After painful urination is relieved, stop taking Phenazopyridine

A nocturia, frequency, dysuria, incontinence B and D are both partially made up and C is the manifestation of obstructive BPH

Which of the following are manifestations of irritative BPH? A nocturia, frequency, dysuria, incontinence B nyoptic, dysuria, incomplete elimination, frequency C Intermittent stream, dribbling, decrease force D fulcritive colitis, nastursium, incontinence, dribbling

A In the aging urinary system, there is a 50% decrease in glomeruli function. More than this would be considered abnormal

Which of the following are not normal effects of the aging urinary system: A 80% decrease in glomeruli function B Hormone levels change C Female - loss of elasticity and muscle support D Male - prostate enlarges

E Decrease force and dribbling. The third manifestation is intermittent stream, not continual stream

Which of the following indicate obstructive manifestations of BPH? A Decrease force B Dribbling C Continual stream D All of the above E A&B F A &C

D. All the patients above are at risk for losing too much fluid volume.

Which patient is at most risk for fluid volume deficient?* • A. A patient who has been vomiting and having diarrhea for 2 days. • B. A patient with continuous nasogastric suction. • C. A patient with an abdominal wound vac at intermittent suction. D. All of the above are correct

B and D. Calcium acetate (also known as PhosLo) is a phosphate binder, which will help keep the patient's phosphate level from becoming too high. It helps excrete the phosphate taken in the food by excreting it out of the stool. Therefore, it should be taken with meals or immediately after. Option C is wrong because the patient should AVOID these types of foods high in phosphate. You are providing education to a patient with CKD about calcium acetate

Which statement by the patient demonstrates they understood your teaching about this medication? Select-all-that-apply:* · A. "This medication will help keep my calcium level normal." · B. "I will take this medication with meals or immediately after." · C. "It is important I consume high amounts of oatmeal, poultry, fish, and dairy products while taking this medication." · D. "This medication will help prevent my phosphate level from increasing."

A The immunosuppressive activity of cyclosporine places the patient at risk for infection, and steroids can mask the signs of infection. The patient may not be able to resume normal fluid intake or return to work for an extended period of time and the patient may need cyclosporine therapy for life.

You're developing a care plan with the nursing diagnosis risk for infection for your patient that received a kidney transplant. A goal for this patient is to: A Remain afebrile and have negative cultures B Resume normal fluid intake within 2 to 3 days C Resume the patient's normal job within 2 to 3 weeks D Try to discontinue cyclosporine (Neoral) as quickly as possible

D Bleeding at the urethral meatus is evidence that the urethra is injured. Because catheterization can cause further harm, consult with the doctor.

You're preparing for urinary catheterization of a trauma patient and you observe bleeding at the urethral meatus. Which action has priority? A Irrigate and clean the meatus before catheterization B Check the discharge for occult blood before catheterization C Heavily lubricate the catheter before insertion D Delay catheterization and notify the doctor

B. The most common type of kidney stone composite is calcium and oxalate

You're providing an in-service to a group of nurses about the different types of kidney stones. You explain to the attendees that the most common type of kidney stone is made up of:* · A. Cholesterol · B. Calcium and oxalate · C. Calcium and phosphate · D. Uric acid

B and C. Extracoporeal shock wave lithotripsy (ESWL) is NONINVASIVE (no incisions...no dressings or nephrostomy tubes are placed). Shockwaves are created to penetrate though the skin and body tissue. Shockwaves will hit the stone and break it down into grain of sand like particles which will be passed out by the patient. Option A is wrong because the patient should be kept mobile (as tolerated) to assist the passage of the kidney stone fragment

Your patient arrives back to their room after having extracoporeal shock wave lithotripsy (ESWL) for treatment of a kidney stone. What will be included in the patient's plan of care? SELECT-ALL-THAT-APPLY:* · A. Keep the patient in bed · B. Encourage fluid intake of 3-4 liters per day · C. Maintain nephrostomy tube · D. Strain urine · E. Keep dressing dry and intact

B Disequilibrium syndrome is caused by a rapid reduction in urea, sodium, and other solutes from the blood. This can lead to cerebral edema and increased intracranial pressure (ICP). Signs and symptoms include headache, nausea, restlessness, vomiting, confusion, twitching, and seizures.

Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect? A Infection B Disequilibrium syndrome C Air embolus D Acute hemolysis

D Pressure on the fistula or the extremity can decrease blood flow and precipitate clotting, so avoid taking blood pressure on the affected arm

Your patient had surgery to form an arteriovenous fistula for hemodialysis. Which information is important for providing care for the patient? A The patient shouldn't feel pain during initiation of dialysis B The patient feels best immediately after the dialysis treatment C Using a stethoscope for auscultating the fistula is contraindicated D Taking a blood pressure reading on the affected arm can cause clotting of the fistula

D Patients with renal calculi commonly have blood in the urine caused by the stone's passage through the urinary tract. The urine appears dark, tests positive for blood, and is typically scant

Your patient has complaints of severe right-sided flank pain, nausea, vomiting and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33 breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal calculi? A Pain radiating to the right upper quadrant B History of mild flu symptoms last week C Dark-colored coffee-ground emesis D Dark, scanty urine output

• C. Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type of EKG findings.

• After obtaining an EKG on a patient you notice that ST depression is present along with an inverted T wave and prominent U wave. What lab value would be the cause of this finding?* o A. Magnesium level of 2.2 o B. Potassium level of 5.6 o C. Potassium level of 2.2 o D. Phoshorus level of 2.0