Unit 7 Med Surg Ch.36

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Normal urinary output is how many mL/24hr?

1,000-2,000

An older male patient expresses frustration at need to urinate often, dribbling of urine, and feelings of inability to empty his bladder. Which suggestion by the nurses most helpful into the patient?

Encourage an appointment with a urologist

The nurse is caring for a patient with an indwelling catheter. Which of the following would be included in routine nursing care?

Encourage fluid intake, secure the catheter to the patient's leg, maintain a closed system, remove the catheter as soon as possible

The nurse is caring for a male patient who has functional incontinence. What actions should the nurse take to prevent incontinence?

Ensure that the patient has ready access to the urinal

Which of the following hormones affects kidney function?

Estrogen, ADH, parathyroid hormone, atrial natriuretic hormone

The nurses collecting data on a patient who experienced a sport injury to the lower back area. Which finding will cause the nurse greatest concern?

Flank edema and bloody urine

A patient is scheduled for an intravenous pyelogram. The nurse would evaluate the patient as understanding preprocedure teaching if the patient reported that which of these would be restricted as part of the preparation for an IVP?

Fluid intake

Which structure is the capillary network in each nephron?

Glomerulus

The nurse is reviewing laboratory results for a patient. Which question does the nurse ask the patient if the creatinine level is elevated?

How much do you exercise?

The nurse is caring for a patient who has a urinary catheter inserted. Which of the following instructions should the nurse provide to help prevent development of a urinary tract infection?

Keep the catheter securely taped to prevent catheter movement. Use a septic technique when emptying the drainage bag. Position the tubing to allow free flow of the urine.

The nurse is caring for a patient who has an elevated uric acid level. Which of the following could cause this elevated uric acid level?

Kidney disease, leukemia, malnutrition, use of thiazide diuretics

The nurse is providing care for a patient who is on fluid restrictions due to renal failure. The patient's intake and output should be carefully measured. Which substance does the nurse exclude from the intake total?

Mashed potatoes and creamed corn

The nurse is caring for a patient who is scheduled for a Cystoscopy with basket extraction of a stone. What is the most important post operative care after this surgery for the nurse to provide?

Measuring urine output

The formation of urine is a critical physiological function. The nurse is aware that multiple processes are involved. Which process does the nurse recognize as not part of the formation of urine?

Micturition

What is the structural and functional unit of the kidney?

Nephron

The nurse is to obtain an orthostatic blood pressure measurement for a patient on dialysis for end stage renal disease. Which of these with the nurse do to obtain this measurement?

Obtain blood pressure while patient is lying, sitting, and standing.

The nurse contributes to the plan of care for a patient who has had radiological studies of the renal system and has a nursing diagnosis of impaired urinary elimination. Which outcome indicates that the nursing interventions have been effective?

Patient voids 35 ml/hour of clear urine

The nurse is making a visit to the home of a patient with functional incontinence. Which observation indicates that teaching about the disorder has been effective?

Patient wearing sweatpants

The nurse is helping to prepare a patient for a renal biopsy. What position should the nurse help the patient assume?

Prone

The nurse is reviewing the results of a patient's urinanalysis's which components does the nurse identify as being abnormal in urine?

Protein and RBC's

Which of these is an abnormal component of urine?

Protein and red blood cells

A patient shares a long standing problem of urinary incontinence with the nurse. Which intervention does the nurse recognize as taking priority?

Providing caring support to the patient

The nurse understands that a major function of the kidneys is to remove potentially toxic waste products from the blood. Which function is inaccurate?

Regulate blood pressure through the conservation of fluids

The nurses reviewing data for a patient with acute kidney injury. Which of the following diagnostic test results would the nurse recognized as being indicative of kidney injury?

Serum creatinine:4.2, fixed urine specific gravity:1.010, urine output:100mL/24hr

The nurses providing care for a patient with a diagnosis of kidney disease. The patient's last laboratory result indicates metabolic acidosis. Which kidney activity does the nurse recognized for the condition?

The kidneys are unable to excrete hydrogen ions

Which of these, if stated by a patient, indicates to the nurse correct understanding of how to obtain a mid stream urine specimen for culture and sensitivity for a female patient?

The labia should be kept separated while voiding. The genetalia should be thoroughly cleaned with the towelettes provided.

The nurse is providing care for a patient scheduled for diagnostic studies of the gastrointestinal system using contrast medium. Which finding in the patient's medical history warrants the nurse contacting the HCP?

The patient has a history of renal dysfunction

A patient with pneumonia has a BUN of 32 And creatinine of 0.8. What should the nurse realize is the most probable explanation for this finding?

The patient is dehydrated

The nurse is caring for a patient who is admitted with pneumonia. The nurse notes a BUN of 32 and creatinine of 0.8. What is the most probable explanation for this finding?

The patient is dehydrated

The nurses providing care for a patient with thoracic spinal cord injury. For which reason does the nurse understand that the presence of a suprapubic catheter?

The patient is unable to detect the need to urinate

The nurse is collecting data for a patient who has stress incontinence. Which of these findings would the nurse document?

The patient loses small amounts of urine when he or she coughs or sneezes

The nurse is caring for a patient who has kidney disease. How does the nurse end a 24 hour urine test at the end of the 24 hours?

The patient voids at the end of 24 hours, adding it to the collection container

The nurse is reviewing a patient's urinalysis results WBC:100, RBC:4, Bacteria:moderate amount, Nitrite:positive, Specific gravity:1.025, Urine:cloudy. What would the nurse recognized these findings indicate?

UTI

The nurses reviewing the patient's history and physical report. What is the term used to describe a waste products building up in the blood?

Uremia

A patient's urinalysis results are WBC:100, RBC:4, Bacteria:moderate amount, Nitrite:positive, Specific gravity:1.025, Urine:cloudy. What should the nurse recognize these findings indicate?

Urinary tract infection

The nurse is reinforcing teaching to a client who is preparing to perform intermittent self catheterization at home. Which information by the nurse is inappropriate?

Where a urinary incontinence pad if away from home

The nurse is collecting data for a patient with kidney disease. When reviewing a urinalysis report, what would the nurse recognize as normal specific gravity of urine?

1.002 to 1.035

A minimum criatin in clearance of how many mL/min is needed to live without dialysis?

10

What value represents a normal glomerular filtration rate?

100 to 125 mL/min

The nurse is collecting data for a patient who has kidney disease. How much urine will the nurse need to collect for a urinalysis?

10mL

The nurse is catheterising a patient after voiding to determine the amount of residual urine in the bladder what should the nurse consider as being the normal amount of urine within the bladder after urination?

25mL

Normally, the bladder contains less than how many mL after urination?

50

The nurses reviewing a urinalysis report. What should the nurse recognized as the normal average pH of urine?

6

What interventions, in addition to monitoring vital signs, should the nurse plan for in a patient returning from a renal arteriogram?

A pressure dressing and sandbag used to apply pressure. Check distal pulses in leg every 30 to 60 minutes. Implement bed rest for 12 hours, and instruct the patient not to bend and leg

The nurse is collecting data for a patient with kidney disease. Which of the following would indicate a normal urinalysis finding?

Amber color, specific gravity of 1.010, small quantities of enzymes

The nurses testing the urine pH for a patient in the HCP's office. The test indicates a pH of 7.0. Which question does the nurse ask the client?

Are you following a vegetarian diet?

The nurse is providing care for a patient admitted for a suspected kidney infection. Which area of the body does the nurse expect the patient to identify as a source of pain?

Bilateral flanks

The nurse is caring for a patient who has a renal biopsy. For which complication should the nurse monitor the patient during the 24 hours after the procedure?

Bleeding

The nurse is providing care for a patient who has undergone placement of a suprapubic catheter. Which postprocedure nursing care is avoided?

Change the catheter with sterile technique daily

The nurse is caring for a patient who has kidney disease and an acid base imbalance. In what way do the kidneys help maintain acid base balance in the body?

Conserving or excreting bicarbonate ions

The nurses collecting data for a patient with kidney disease. What adventitious lung sound is the nurse most likely to note from fluid overload?

Crackles

The nurse contributes to the plan of care for a patient who has edema. Which of the following is the best indicator of a patient's fluid volume status?

Daily weight

The nurses collecting information from an older adult patient and the health care provider's office. The patient reports frequent urination. Which effect of aging does the nurse recognize

Decreased bladder size and muscle tone

The nurse is collecting data for a patient who has suspected kidney disease. A high specific gravity of urine is associated with which of the following?

Dehydration, diabetes mellitus, heart failure, nephrosis

The nurse contributes to the plan of care for an older patient. The nurse recognizes which of the following occur with aging to plan care?

Detrusor muscle tone decreases. Number of nephrons decreases

When collecting a urine specimen from a female patient, which of these actions should the nurse take?

Direct the patient to wash her perineum before collecting the urine specimen


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