Renal

A patient newly diagnosed with polycystic kidney disease asks the nurse:" What is this disease and is it curable?" The best response by the nurse is:

"Treatment is supportive to maintain kidney function."

We want how many mL/hr with renal transplant?

-30 mL/hr -less than this could be a sign of rejeciton

Which nursing diagnosis is appropriate for a client with renal calculi?

-Risk for infection -by urinary stasis r/t obstruction

Which of the following medications may be ordered to relieve discomfort associated with a UTI?

Phenazopyridine (Pyridium) Rationale: Pyridium is a urinary analgesic ordered to relieve discomfort associated with UTIs. Furadantin, Cipro, and Levaquin are antibiotics.

A 7-year-old, completed a course of Zithromax for bilateral otitis media.2 days ago. Today, her mother brought her to the urgent care clinic with the complaint " itch and burn down there" while pointing to her perineal area. What would the nurse expect to find when examining the child?

Reddened labia, and a thick, whitish vaginal discharge, an indication of a superinfection

A nurse is planning care for a client with acute glomerulonephritis. The nurse delegates to the nursing assistant to do which of the following in the care of this client?

Remove the water pitcher

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following?

-By ascending infection (transurethral)

healthy stoma is __________

-Characteristics of a healthy stoma include a pink and moist appearance. It is insensitive to pain because it has no nerve endings.

All of the following are risk factors toward the development of kidney stones except

-Hypoparathyroidism is not a risk factor for the development of kidney stones. -Immobilization, gout, and hyperparathyroidism are risk factors.

Acute dialysis is indicated in which situation?

-Impending pulmonary edema -Acute dialysis is indicated when there is a high and increasing level of serum potassium, fluid overload, or impending pulmonary edema, or increasing acidosis.

The nurse advises the patient with chronic pyelonephritis that he should:

-Increase fluids to 3 to 4 L/24 hours to dilute the urine. -decreases burning on urination and prevents dehydration

Which of the following occurs late in chronic glomerulonephritis?

-Peripheral neuropathy with diminished deep tendon reflexes and neurosensory changes

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

-Peritonitis -Clinical manifestations of peritonitis include abdominal pain and distention, absence of bowel sounds, nausea and vomiting, fever, changes in vital signs.

Which laboratory value supports a diagnosis of pyelonephritis?

-Pyelonephritis is diagnosed by the presence of pyuria, leukocytosis, hematuria, and bacteriuria. The client exhibits fever, chills, and flank pain. -elevated WBC r/t infection

Which of the following nursing actions is most important in caring for the client following lithotripsy?

-Strain the urine carefully for stone fragments

Initiation period (first phase)

-The initiation period begins with the initial insult and ends when cellular injury and oliguria develops.

Oliguric period (second phase)

-The oliguric period is accompanied by an increase in the serum concentration of wastes such as urea, creatinine, organic acids, and the electrolytes potassium, phosphorous, and magnesium

Recovery period (fourth phase)

-The recovery period signals the improvement of renal function and energy level and may take 6 to 12 months.

Anuria

-Urine output less than 50 ml in 24 hours

Hematuria

-blood in urine

Which phase of acute renal failure signals that glomerular filtration has started to recover? (third phase)

-diuretic -The diuretic phase is marked by a gradual increase in urine output, which signals that glomerular filtration has started to recover.

Uremia

-excess of urea and other nitrogenous wastes in the blood

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

-helps the nurse determine the location of discomfort and signs of fluid retention (such as peripheral edema or shortness of breath)

Which of the following is a characteristic of the intrarenal category of acute renal failure?

-increased BUN, -increased creatinine - a low specific gravity of urine -increased urine sodium.

polyuria

-increased volume of urine voided

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important?

-limit fluid intake -because urine output decreases, there is a rx for fluid overload -heart failure and pulmonary edema can result from overload

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?

-very few s/s are associated with renal cancer

What is the difference in an ileostomy and ileal conduit?

An ileal conduit is performed for urinary output with or without bladder removal

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?

Anticholinergic agents

Which medication is the treatment of choice for cystitis?

Bactrim

After three days of persistent pain, an adult patient undergoes extracorporeal shock wave lithotripsy which successfully shatters the stone. After the lithotripsy, the nurse encourages fluids to 4000 ml/day and knows that the interventions for the patient have been effective based on which finding?

Free flow of urine is present.

What is the earliest sign of kidney cancer?

Hematuria

An early symptom of acute postreptococcal glomerulonephritis (ASPGN) is:

Hematuria *POST means low, which signals stones and bleed r/t stones

Which of the following antibiotics is an example of a Cephalosporin?

Velocef

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:

WBC 50

For a client who has had uric acid renal calculi on 2 occasions, which medication would the nurse anticipate as treatment?

Zyloprim (Allopurinol)

Observing characteristics of urine can help determine _______

abnormalities

pyuria

-puss in urine

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

-Application of an ostomy pouch -involves skin protection and stoma care

What subjective data would the nurse expect a patient newly diagnosed with bladder cancer to report?

suprapubic or flank pain

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

-"Make sure to eat enough fiber to prevent constipation."

An investment banker, with chronic renal failure, informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?

-"This type of dialysis will provide more independence."

A nurse is caring for a client who's ordered continuous ambulatory peritoneal dialysis (CAPD). Which finding should lead the nurse to question the client's suitability for CAPD?

-A history of diverticulitis contraindicates CAPD because CAPD has been associated with the rupture of diverticulum.

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

-low-purine diet is used for uric acid stones to reduce the excretion of uric acid in the urine-Clients with a history of calcium oxalate stone formation need a diet that is adequate in calcium and low in oxalate. -Only clients who have type II absorptive hypercalciuria, need to limit calcium intake. -Usually, clients are told to increase their fluid intake significantly, consume a moderate protein intake, and limit sodium.

oliguria

-no urine output

What would a nurse expect to find as a result of glomerulonephritis?

-proteinuria -The disruption of membrane permeability causes red blood cells (RBCs) and protein molecules to filter from the glomeruli into Bowman's capsule and eventually become lost in the urine.

High purine foods to avoid

-shellfish, anchovies, asparagus, mushrooms, and organ meats

When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?

-tea/cola colored -hematuria, edema, azotemia, and proteinuria. -patients can experience no s/s until it has progressed

Azotemia

-the concentration of urea and other nitrogenous wastes in the blood

An adult patient is scheduled for an intravenous pyelogram (IVP) to determine the location of a renal calculus. Which of the following measures would be most important for the nurse to include in pretest preparation?

Checking his history for an allergy to iodine

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, reducing swelling and facilitating passage of the stone?

Ketoralac (Toradol) Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketorolac (Toradol), are effective in treating renal stone pain because they provide specific pain relief. They also inhibit the synthesis of prostaglandin E, reducing swelling and facilitating passage of the stone.

An 18 year old healthy, female client who has recently become sexually active, visits her family physician with complaints of urinary frequency, urgency and burning. Based upon her history, which lab test would the nurse anticipate to be ordered and which medication(s) prescribed?

Lab: Clean catch urine specimen and prescriptions for Bactrim and Pyridium

When caring for a patient with an uncomplicated, mild urinary tract infection (UTI), the nurse knows that recent studies have shown which of the following drugs to be a good choice for short-course (eg, 3 day) therapy?

Levofloxacin (Levaquin)

During the acute phase of glomerulonephritis, the nurse plans which intervention to meet the expected outcome that the patient will have no permanent kidney damage?

Maintenance of bed rest *we restrict fluids and protein, but not salt

A patient with suspected pyelonephritis is admitted to the hospital with the following medical orders. Which one should be implemented first? Start IV of D5 ½ normal saline at 125 mL/hr. Complete Blood Count with differential. Clean catch urine for culture and sensitivity. Kefzol 1 gram IVPB ever 8 hours. Bedrest with bathroom privileges. Strict I & O.

Obtain urine C&S first then send to lab so we can know which antibiotic will help fight the infection

The nurse is employed in an urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

anticholinergic drugs Pharmacologic agents that can improve bladder retention, emptying, and control include anticholinergic drugs. In this classification are medications such as Detrol, Ditropan, and Urecholine. Diuretics eliminate fluid from the body but do not affect the muscles of urinary elimination. Anticonvulsant and cholinergic medications also do not directly help with control.

When a nurse is teaching a client about antibiotic therapy, s/he must explain:

it is necessary to drink enough liquids so that their urine is almost colorless

Why do patients need to take each dose of an antibiotic until the round is complete?

weaker strains of bacteria will be killed and the stronger ones will survive and a superinfection results

The nurse is caring for a patient with a medical history of untreated CKD that has progressed to ESKD. Which of the following serum values and associated signs and symptoms will the nurse expect the patient to exhibit? Select all that apply.

• Calcium 7.5 mg/dL; hypotension and irritability • Potassium 6.4 mEq/L; dysrhythmias and abdominal distention • Phosphate 5.0 mg/dL; tachycardia and nausea and emesis

A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply.

• Empty the collection bag at least every 8 hours to reduce bacterial growth. • Suspend the drainage bag off the floor. • Wash the perineal area with soap and water at least twice daily.