PN test 3

Women have more uti because of what reasons?(aging )

(aging)declining estrogen

Control blood glucose and blood pressure, restricted protein diet 1. early stages of diabetic nephropathy 2. later stages diabetic nephropathy

1

Diagnosis of glomerulonephritis select all that apply 1. UA 2. ultrasound 3. MRI, 4. xray 5. biopsy 6. CT

1,3,4,5

select all that apply: etiology of chronic kidney disease 1. diabetic nephropathy 2. nephrosclerosis 3. glomerulonephritis 4. autoimmune disease

1.2.3.4

this stage of diabetic nephropathy involves dialysis and kidney transplant 1. early 2. later

2

which action is essential for the nurse to take for renal calculi nursing care 1. limit fluids 2. strain all urine 3. maintain bed rest 4. restrict dairy products

2

when they have end stage CKD they lose how many nephrons? 1. 40% 2. 50% 3. 90% 4. 75%

3

the lpn/lvn reinforces the education for the client with recurrent uti which directions does the lpn include? 1. cleanse from the vaginal orifice to the urethra 2. douche daily with alkaline solutions 3. drink at least 6 glasses of water daily 4. urinate as soon as possible after intercourse

4

what is urine ph

4.6 to 8.2

lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider? 1 Passage of pink-tinged urine 2 Pink drainage on the dressing 3 Intake of 1750 mL in 24 hours 4 Urine output of 20 to 30 mL/hr

4; rationale Output should be at least 30 mL/hr or more; a decreased output may indicate obstruction or impaired kidney function. Blood, tinting the urine pink, is expected. Drainage may be pink; bright red drainage should be reported. The intake of 1750 mL in 24 hours is adequate; however, a higher intake usually is preferred (e.g., 2000 to 3000 mL).

s/s of polycystic kidney disease select all that apply a. dull heaviness in flank, back b. hematuria c. hypotension d. hypertension e. vomiting f. uti

a,b,d,f

what are some ways that they test for renal calculi

abdominal xray, ivp (intravenous pyelogram), renal ultrasound, urinalysis

what do you do when the patient comes back from surgery for renal biopsy

check vital signs, observe for bleeding, pressure dressing

non surgical therapeutic interventions for bladder cancer

chemo, bacille carlmete guerin vaccine, phyodynamic therapy,

this is kock pouch indiana pouch mainz pouch florida pouch

continent urinary diversion

this is inflammation of the bladder wall

cystitis

urinary diversion has 2 types continent and incontinent name incontinent version

ileal conduit

A client undergoing peritoneal dialysis reports severe abdominal pain. Which action should the nurse take? 1. Notify the health-care provider (HCP). 2. Instruct the client to only dialyze twice daily. 3. Administer an opioid analgesic. 4. Review the client's potassium level.

1

A client with chronic kidney disease is scheduled to begin peritoneal dialysis. When discussing the procedure, what does the nurse explain is the purpose of the dialysis? 1 Help do some of the work usually done by the kidneys 2 Prevent the client from developing complicating heart problems 3 Remove bad chemicals from the body so the disease will not get worse 4 Speed the client's recovery because the kidneys are not responding to other therapy

1

A nurse is evaluating a client's response to fluid replacement therapy. Which clinical finding indicates adequate tissue perfusion to vital organs? 1 Urinary output of 30 mL in an hour 2 Central venous pressure reading of 2 mm Hg 3 Baseline pulse rate of 120 that decreases to 110 beats/min within a 15-minute period 4 Baseline blood pressure of 50/30 that increases to 70/40 mm Hg within a 30-minute period

1

After a transurethral vaporization of the prostate, the client returns to the unit with an indwelling urinary catheter and a continuous bladder irrigation. The client puts the call light on to report the need to urinate. What should the nurse do first? 1 Assess that the tubing attached to the collection bag is patent 2 Obtain the client's vital signs 3 Explain that the balloon inflated in the bladder causes this feeling 4 Review the client's intake and output

1

During discharge teaching, a client with an ileal conduit asks how frequently the urine pouch should be emptied. What is the best reply by the nurse? "To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours." 1 "To prevent skin irritation, it should be emptied every hour if any urine has collected in the bag." 2 "To reduce the risk of infection, the system should be opened as little as possible; two times a day is adequate." 3 "To reduce the cost of drainage pouches, it should be emptied once the system is switched to a bedside collection bag." 4

1

The nurse is caring for a client four days after the client had a cystectomy and formation of a continent diversion. After observing mucous threads in the client's urine, what should the nurse do? 1 Recognize that this is an expected response 2 Report this to the health care provider immediately 3 Obtain a specimen for culture and sensitivity 4 Increase the client's fluid intake for the next 12 hours

1

The nurse is providing teaching to a group of nurses about clients with an arteriovenous (AV) graft. Which of the following should the nurse include in the teaching? 1. Avoid blood draws on the affected side. 2. Take the blood pressure on the affected side. 3. Wear constrictive clothing covering the site. 4. Listen for a thrill to assess good blood flow.

1

despite receiving 2900 mL intake for two days, the client's urine output has progressively diminished. The nurse identifies that the urinary output is less than 40 mL/hr over the past three hours. What action should the nurse take? 1 Assess breath sounds and obtain vital signs 2 Decrease the intravenous (IV) flow rate and increase oral fluids 3 Insert an indwelling catheter to facilitate emptying of the bladder 4 Check for dependent edema by assessing the lower extremities

1

A client is admitted to the hospital with a diagnosis of chronic kidney disease. Which should the nurse expect the client to exhibit? Select all that apply. 1 Polyuria 2 Paresthesias 3 Hypertension 4 Metabolic alkalosis 5 Widening pulse pressure

1,2,3

which of these is a symptom of uti? select all that apply 1. dysuria 2. urgency 3. frequency, 4. clear urine 5. ammonia smelling urine

1,2,3,

(select all that apply) which of the following are post procedure care for a renal biopsy? 1. monitor vital signs 2. observe for bleeding 3. monitor biopsy site 4. monitor urine output 5. maintain NPO

1,2,3,4

the client who has chronic kidney disease asks the lpn to clarify dietary information about potassium. the LPN identifies which foods as high in potassium. 1. broccoli 2. grapefruit 3. peaches 4. pickles 5. spinach

1,2,3,5

what things can you do as a nurse for your patient with glomerulonephritis? select all that apply 1. vital signs 2. symptom support 3. rest. 4. extra fluids to flush system 5. fluid restriction 6. sodium restriction 7. extra protein for healing 8. protein restriction 9. education

1,2,3,5,6,8,9

the lpn recognizes that which are signs and symptoms of uti for the ederly? select all that apply 1. altered sensorium 2. incontinence 3. low back pain 4. low grade fever 5. nocturia.

1,2,4

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which responses? Select all that apply. 1 Weight loss 2 Negative nitrogen balance 3 Increased urine specific gravity 4 Excessive loss of potassium ions 5 Pronounced retention of sodium ions

1,4

s/s glomerulonephritis select all that apply 1. oliguria 2. anuria, 3. hypotension 4. hypertension 5. electrolyte imbalances 6. edema 7. flank pain 8.stomach pain

1,4,5,6,7

what is spec gravity?

1.002 to 1.028

which of these is a priority during data collection for a patient with a vascular access(select all that apply) 1. listen for a bruit at the access 2. palpate the thrill at the access 3. flush access with heparin 4. observe bruising at site 5. note tenderness at site

1.2.

renal filtrate kidneys form in ____ mL/min

100-125 ml

how much urine in 24 hours?

1000 to 2000 ml

A client weighed 210 pounds on admission to the hospital. After two days of diuretic therapy, the client weighs 205.5 pounds. How many liters of fluid has the client excreted? Record your answer using a whole number. __________ liters

2

A pathology report states that a client's urinary calculus is composed of uric acid. Which should the nurse instruct the client to avoid? 1 Milk 2 Liver 3 Cheese 4 Vegetables

2

Client who has been on hemodialysis for several weeks asks the nurse what substances are being removed by the dialysis. The nurse informs the client that one of the substances passing through the membrane is what? 1 Blood 2 Sodium 3 Glucose 4 Bacteria

2

The nurse expects to find ketones in the urine of which client? 1. A client with kidney stones 2. A client with diabetes 3. A client with a liver disorder 4. A client with cancer

2

The nurse is caring for a client receiving hemodialysis. Which stat order written the morning of dialysis should the nurse question? 1. Levothyroxine (Synthroid) 2. Lisinopril (Prinivil) 3. Famotidine (Pepcid) 4. Ceftriaxone (Rocephin)

2

The nurse is discussing peritoneal dialysis with a client. Which statement made by the client requires correction? 1. "I can do peritoneal dialysis at home." 2. "I will have an arteriovenous (AV) graft in my arm." 3. "I repeat the treatment three to four times each day." 4. "I must use sterile technique when performing an exchange."

2

The nurse reviews a client's medication history, which includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse recalls that cholinergic medications are prescribed primarily for what type of urinary condition? 1 Kidney stones 2 Flaccid bladder 3 Spastic bladder 4 Urinary tract infections

2

What is an acute, life-threatening complication for which a nurse should assess a client in the early postoperative period after a radical nephrectomy? 1 Sepsis 2 Hemorrhage 3 Renal failure 4 Paralytic ileus

2

the LPN cares for the client after surgery. the lpn notes the urine output has decreased from 600 ml on the last shift to no urine for the first 4 hours of the shift. the client is experiencing ACUTE kidney injury. the lpn recognizes its from which? 1. hemorrhage before surgery 2. hypotension during surgery 3. nephrolithiasis 4. UTI

2

When performing a peritoneal dialysis procedure, what should the nurse do? 1 Place the client in a side-lying position 2 Warm dialysate solution slightly before instillation 3 Infuse the dialysate solution slowly over several hours 4 Withhold the routine medications until after the procedure

2 The infusion should be warmed to body temperature to lessen abdominal discomfort and promote dilation of peritoneal vessels. The side-lying position may restrict fluid inflow and prevent maximum urea clearance; the client should be placed in the semi-Fowler position. The infusion of dialysate solution should take approximately 5 to 10 minutes. Routine medications should not interfere with the infusion of dialysate solution.

Which of the following describe the function of the kidneys? Select all that apply. 1. Eliminating urine 2. Regulation of blood pressure 3. Regulation of acid-base balance 4. Production of erythropoietin 5. Activation of vitamin B12

2,3,4

A client is diagnosed with calcium oxalate renal calculi. Which nutrients should the nurse teach the client to avoid? Select all that apply. 1 Milk 2 Nuts 3 Liver 4 Spinach 5 Rhubarb

2,4,5

A client comes to the emergency department because of minimal urinary output despite drinking adequate fluid. The client's blood pressure is 190/94. For what additional clinical manifestation associated with this data, should the nurse assess the client? 1 Thirst 2 Urinary retention 3 Weight gain 4 Urinary hesitancy

3

A client who has repeated episodes of cystitis is scheduled for a cystoscopy to determine the possibility of urinary tract abnormalities. The client asks the nurse to describe the procedure. What is the nurse's most appropriate response? 1 "This procedure is a computerized scan that outlines the bladder and surrounding tissue." 2 "This procedure is an X-ray film of the abdomen, kidneys, ureters, and bladder after administration of dye." 3 "This procedure is the visualization of the inside of the bladder with an instrument connected to a source of light." 4 "This procedure is the visualization of the urinary tract through ureteral catheterization and the use of radiopaque material."

3

The nurse is caring for a client who has a 3500 mL/day urine output. Which of the following likely affected the volume of urine output? 1. Sweating 2. Dehydration 3. Intravenous (IV) fluids 4. Fluid restriction

3

The nurse is caring for a client with a diagnosis of acute kidney failure associated with drug toxicity. When the client complains of thirst, what should the nurse offer? 1 Ice chips 2 Warm milk 3 Hard candy 4 Carbonated soda

3

Which of the following is the best indicator of fluid balance in the body? 1. Intake and output 2. Presence of edema 3. Weight 4. Lung sounds

3

client with a urinary retention catheter reports discomfort in the bladder and urethra. What should the nurse do first? 1 Milk the tubing gently. 2 Notify the health care provider. 3 Check the patency of the catheter. 4 Irrigate the catheter with prescribed solutions.

3

he nurse is providing care to a client who is being treated for bacterial cystitis. Before discharge, it is most important for the client to do what? 1 Understand the need to drink 4 L of water per day, an essential measure to prevent dehydration 2 Be able to identify dietary restrictions and plan menus 3 Achieve relief of symptoms and to maintain kidney function 4 Recognize signs of bleeding, a complication associated with this type of procedure

3

The nurse is caring for a client who underwent a placement of an arteriovenous (AV) graft yesterday. Which of the following would warrant notification of the health-care provider (HCP)? 1. Capillary refill less than 3 seconds 2. Report of mild discomfort 3. Minimal drainage at the site 4. Inability to feel the thrill

4

The nurse is providing teaching to a client with a urinary tract infection (UTI) who is receiving phenazopyridine (Pyridium). Which of the following statements made by the client indicates an understanding of the teaching? 1. "I have mild kidney disease, so it is okay if I take this." 2. "This medication will treat my UTI." 3. "I can't take antacids while taking this medication." 4. "My urine may be a red-orange color."

4

What does the nurse determine is the most likely cause of renal calculi in clients with paraplegia? 1 High fluid intake 2 Increased intake of calcium 3 Inadequate kidney function 4 Accelerated bone demineralization

4

What is normal urine output in a 24-hour period? 1. 50 to 200 mL 2. 300 to 500 mL 3. 600 to 800 mL 4. 1000 to 2000 mL

4

Which clinical manifestation should a nurse expect a client with diabetes insipidus to exhibit? 1 Increased blood glucose 2 Decreased serum sodium 3 Increased specific gravity 4 Decreased urine osmolarity

4

client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the health care provider? 1 Prepare for urinary catheterization. 2 Teach the client how to perform perineal care. 3 Start a 24-hour urine collection. 4 Obtain a urine specimen for culture and sensitivity.

4

the lpn reinforces the dietary education for a client with chronic kidney disease. the lpn recognizes the teaching is effective when the client chooses which food for lunch? 1. barbecued beef 2. grilled salmon 3. potato skins 4. rice

4

the lpn reinforces the discharge education for the client who has had an ileostomy which statement made by the client indicates the teaching is successful? 1. i must call the provider when my stoma is beefy red 2. i need to cut a hole in the skin barrier 1/2 inch larger than the stoma 3. i will not be able to drink my daily red wine 4. i must drink at least 2 liters of water a day

4

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result? 1 Notify the health care provider. 2 Check the intravenous (IV) infusion. 3 Obtain current blood test results. 4 Assess for decreased urine output.

4 the expected serum creatinine range is 0.5 to 1.2 mg/dL. The nurse should obtain additional information that may indicate acute rejection; therefore, the nurse must first assess for decreased urine output and changes in vital signs. Once additional data are collected (e.g., urine output, current blood work reports) and the IV infusions are checked, the nurse should contact the health care provider, explain the situation, and implement further prescriptions. Eventually the nurse should ensure that proper infusion rates, along with IV medications, are being maintained after the client is first assessed for decreased urine output and for changes in vital signs. Current blood work reports should be obtained after the client is assessed for decreased urine output and changes in vital signs.

when having the renal biopsy what do you do for the patient before doing the biopsy?

NPO, mild sedative

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. Which factor will influence the client's ability to deep breathe and cough postoperatively? Location of the surgical incision (a) Increased anxiety about the prognosis (b) Inflammatory process associated with surgery(c) Pulmonary congestion from preoperative medications(d)

a

what are some causes for acute urine retention

anesthesia, medications, local trauma to urinary structures

if a pt is getting hemodialysis permanently what route do they get it? a, central vein b. v fistula or v graft

b

why are kidney disease patients given kayexalate ?

because when they have chronic kidney disease they have a high level of potassium and kayexalate takes the potassium out of the body by stool; the patient has a large amount of stool .

this is a temporary storage of urine and its elimination

bladder

if a pt is getting hemodialysis which is temporary what is the location? a. a v fistula b. a v graft c. central vein

c

surgical options for bladder cancer

cystoscopy and pyelogram with fulgration, laser, robotic laparoscopic radical cystectomy,

when a patient has chronic kidney disease they lose _______ percent of nephrons a. 25% b. 30% c. 50 % d. 75%

d

most common cause of chronic kidney disease

diabetic nephropathy

s/s of uti

dysuria, urgency, frequency, cloudy urine, foul smelling urine, hematuria, burning

painless and slight hematuria

early signs of cancer of the bladder

what are some causes for chronic urinary retention

enlarged prostate, meds, strictures, tumors

true or false: you cant get kidney stones from dehydration

false

ways to avoid renal calculi

foods, hydration, exercise

describe kidney function

formation of urine, excretion or conservation of water electrolyte balance, acid base balance, activation of vitamin d, productino of eryhtropoeitin, production of renin

this is an incontinence from impairment of physical and mental function

functional incontinence

frequency, urgency, dysuria, flank and back pain, kidney disease

hydronephrosis

this is an obstruction in the urinary tract that the kidney enlarges and urine collects

hydronephrosis

what things will you do as a nurse for your renal trauma patient

intake and output, vital signs, iv fluids, pain control

what are the 3 types of pyelograms?

intravenous, retrograde, antegrade

hematuria and dull pain in flank area, mass

late signs of kidney cancer

pelvic pain. lower back pain, dysuria, inability to void

late stages of bladder cancer

bladder cancer is more common for men or women?

men

is chronic kidney disease reversible?

no

this is studer pouch hemi kock pouch ileal with neobladder

orthotopic bladder substitution

this is involuntary loss of urine associated with bladder overdistention

overflow incontinence

this is infection of the kidney

pyelonephritis

some therapeutic interventions for kidney cancer

radical nephrectromy, nephron sparing surgery, radiation therapy, immunotherapy, chemotherapy

flank pain, renal colic, dysuria, costovertebral, tenderness, hematuria, frequency, urgency, enuresis, GI upset

renal calculi

these are non invasive sound waves that examine anatomy of urinary tract that show kidney enlargement, kidney stones chronic infections and tumors

renal ultrasound

smoking obesity, hypertension, long term kidney dialysis, radiation exposure, asbestos, industrial pollution

risk factors for cancer of kidney

check _________ ____________ prior to contrast media or nephrotoxic meds

serum creatinine

these are some therapeutic interventions for renal calculi

small stones passed, iv fluids, pain control, thiazide diuretics, allopurinol, lithotripsy

what can you do for nursing care for the renal calculi?

strain all urine, monitor symptoms, intake and output, pain control, hydration, teaching

this is involuntary urine loss from increasing abdominal pressure

stress incontinence

these are some urological obstructions

strictures (lumen narrowing ), renal calculi

this is an indwelling inserted through an incision in the lower abdomen into the bladder

suprapubic catheter

what things do you see with a renal angiography?

the dye visualizes renal arteries, check allergies, check creatitine

why do women get uti more often than men?

the soaps, the shorter urethra

peritoneal dialysis

this type of dialysis is done by the pt; the membrane is semipermeable which excess wastes and fluids move from blood they have a catheter also

this is continuous unpredictable loss of urine

total incontinence

these are some therapeutic interventions for hydronephrosis

treat the cause, urinary catheter, stents, nephrostomy tube (monitor that tubes intake and output and dont clamp it)

(true or false) you hydrate before and after intravenous pyelogram

true

true or false men have a greater chance of getting renal calculi than women

true

true or false renal calculi can be hereditary

true

what is the KUB test for

tumors, swollen kidneys, kidney stones

how is cancer of the bladder diagnosed?

ua, telomerase, urine for cytology, culture, cystoscopy and trans-urethral biopsy, intravenous pyelogram

carries urine from bladder to exterior

urethra

this is an inflammation of the urethra

urethritis

this is involuntary urine loss with a strong desire to void

urge incontinence

what is NOT a reason to give someone an indwelling catheter

urinary incontinence

patho for renal calculi

urinary salts settle, calcium oxalate

ureters carry _________ from ______ to ____________

urine, kidneys, bladder

what are some complications from kidney stones (renal calculi)

uti hydronephrosis

ivp, cystoscopy, pyelogram, ultrasound, MRI, renal biopsy

ways to diagnose kidney cancer