Module 13: Patho

A nurse is describing the following conditions: detrusor hyperreflexia, vescicosphincter dyssynergia, and detrusor areflexia/acontractile. Which type of urinary disorder is the nurse discussing?

Neurogenic bladder -Examples of neurogenic bladder include detrusor hyperreflexia, vescicosphincter dyssynergia, and detrusor areflexia/acontractile.

A patient has bladder cancer. Which assessment finding is most typical for this patient?

Painless hematuria -Gross painless hematuria is the archetypal clinical manifestation of bladder cancer

What type of diet will the nurse encourage for a patient with nephrotic syndrome?

Salt restricted -Nephrotic syndrome is commonly treated by adhering to a normal-protein (i.e., 1 g/kg body weight/day, some may need supplements), low-fat, salt-restricted diet.

A patient had both kidneys obstructed but is now unobstructed and urinating large amounts of urine. What term should the nurse use to describe this process?

Postobstructive diuresis -Hypoperfusion results in a decrease of urine formation. Relief of bilateral, partial urinary tract obstruction or complete obstruction of one kidney is usually followed by a brief period of diuresis (commonly called postobstructive diuresis)

A patient has renal cell carcinoma that is confined to the kidney capsule. What stage is the patients cancer?

Stage I -If the tumor is confined to the kidney capsule it is Stage I.

A patient has a loss of urine when laughing or sneezing. Which type of incontinence does the nurse suspect the patient is experiencing?

Stress -Stress incontinence is the loss of urine when there is increased abdominal pressure (sneezing, laughing, bending, etc)

A patient has an obstruction of urine flow in the lower urinary tract. After the patient voids what equipment should the nurse have ready?

Urinary catheterization kit -The post-void urine is measured by catheterization within 5 to 15 minutes of urination or through a bladder ultrasound machine that measures bladder height and width to provide an approximation of urine within the vesicle

A patient has pyelonephritis from chronic backup of urine into the ureters and kidneys. Which predisposing factor does this patient have for pyelonephritis?

Vesicoureteral reflux -Vesicoureteral reflux is chronic backing up of urine into the ureters and kidneys

A patient has acute kidney injury. Which principle should the nurse use to guide nursing care?

Carefully monitor fluid and electrolyte balance -Fluid and electrolyte balance must be carefully monitored.

Which patient is most prone to cystitis?

Diabetic woman with an indwelling catheter -At risk are individuals with indwelling catheters; and persons with diabetes mellitus, neurogenic bladder, or urinary tract obstruction. Cystitis is more common in women because of the shorter urethra and the closeness of the urethra to the anus (increasing the possibility of bacterial contamination)

Which of the following data can help the nurse determine the severity of a patient's urinary tract obstruction

Duration of the blockage -The severity of an obstructive uropathy is determined by (1) the location of the obstructive lesion, (2) the involvement of one or both upper urinary tracts, (3) the severity (completeness) of the blockage, (4) the duration of the blockage, and (5) the nature of the obstructive lesion

Which of the following concepts should the nurse include when describing the pathophysiology for chronic renal disease?

Glomerulosclerosis, tubulointerstitial inflammation, and proteinuria -Characteristic features of chronic renal disease pathophysiology include glomerular hypertension, glomerulosclerosis, proteinuria, tubulointerstitial inflammation, and fibrosis

A patient with glomerulonephritis has nephritic type sediment. What will the nurse observe in the urine?

Hematuria with red cell casts -Urine with nephritic sediment is characterized by the presence of blood with red cell casts, white cell casts, and varying degrees of protein, which usually is not severe

A patient has a dilated ureter from an obstructed upper urinary tract. Which term will the nurse use to describe this condition

Hydroureter -Dilation of the ureter is referred to as hydroureter (accumulation of urine in the ureter)

A nurse is asked why hyperlipidemia occurs in nephrotic syndrome. What is the nurse's best response?

Loss of albumin stimulates lipoprotein synthesis by the liver and hyperlipidemia