Week 5: Elimination EAQ

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What is the maximum recommended length for enema tube insertion in an adolescent?

10 CM

The nurse receives an order to prepare a solution for administering a cleansing enema for a 15-year-old client. What is the volume of solution that the nurse should prepare?

500 to 750 mL

A client has surgery for the creation of a colostomy. Postoperatively, what color does the nurse expect a viable stoma to be?

Brick red

A client is diagnosed with hepatitis A. The nurse provides the client with information about untoward signs and symptoms related to hepatitis. The nurse instructs the client to contact the primary healthcare provider if the client develops what symptom?

Clay-colored stools

A 9-year-old child with chronic kidney disease is undergoing peritoneal dialysis. For which associated complication should the nurse monitor the child?

Cloudy return dialysate

A client is taking fertility drugs for the first time. Which adverse effect of the drug should the nurse inform the client about?

Constipation

After surgery for creation of an ileostomy, a client is to be discharged. Before discharge, what is the primary nursing intervention?

Evaluating the client's ability to care for the ileostomy

A client with Hodgkin disease is placed on an ABVD combination chemotherapy regimen. Because doxorubicin is part of this therapy, what education will the nurse provide about this drug?

Expect urine to turn red for a few days after taking this drug.

A client who is taking rifampin tells the nurse, "My urine looks orange." What action will the nurse take?

Explain this is expected.

A client who had a transurethral resection of the prostate is transferred to the postanesthesia care unit with an intravenous (IV) line and a urinary retention catheter. For which major complication is it mostimportant for the nurse to assess during the immediate postoperative period?

Hemorrhage

After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone?

Hyponatremia and decreased urine output

A child with nephrotic syndrome visits the clinic for follow-up. During the visit the parent states that the child is always tired and has no appetite. The nurse notes that the child has a muddy, pale complexion. What problem does the nurse suspect?

Impending renal failure

A nurse bases the plan of care for a 15-month-old toddler with celiac disease on the pathophysiology of the disorder, which is characterized by what?

Inability to metabolize gluten

A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system?

Loop of Henle

A nurse educates the client about the relationship between the kidneys and blood pressure. Which term should the nurse use to describe the part of the kidney that senses changes in blood pressure?

Macula densa

What is the priority nursing action in the care of a young child with severe diarrhea?

Maintaining fluid and electrolyte balance

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action should the nurse take next?

Notify the healthcare provider that the potassium level is below normal

The nurse finds that a client has reduced urinary output. Which condition would the nurse document in the client's medical record?

Oliguria

A client has a colon resection with an anastomosis. What assessments by the nurse support a suspicion of impending shock? Select all that apply.

Oliguria Irritability Hypotension

The nurse is educating student nurses about the anatomy and physiology of the kidneys. What term does the nurse explain is used for the tip of the pyramid of a kidney?

Papilla

What should nursing care for a child admitted with acute glomerulonephritis be directed toward?

Promoting diuresis

Which part of the nephron secretes creatinine required for elimination?

Proximal tubule

For what additional defect should the nurse assess an infant with exstrophy of the bladder?

Pubic bone malformation

Which intervention would be most beneficial in preventing a catheter-associated urinary tract infection in a postoperative client?

Removing the catheter within 24 hours

A school-aged child with newly diagnosed acute lymphocytic leukemia (ALL) is to undergo induction therapy with prednisone, vincristine, and asparaginase. After several days the child becomes constipated. What does the nurse suspect as the cause?

Vincristine, which decreases peristalsis


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