ATI Urinary

What discharge teaching is appropriate for the nurse to provide to a patient who has had a lithotripsy?

Watch for stone debris in the urine in 1-4wks

which urine test provides the most accurate measurement of renal function?

Creatinine

The mostt serious complication of continual peritoneal dialysis is:

Peritonitis

A home health patient diagnosed with cystitis has been prescribed the medications phenazopyridine (Pyridium). When providing aptient teaching, what should the nurse caution the patient about?

Staining clothing

Which statement by a patient dialysis, taking gentamicin (Garamycin), should cause the nurse the most concern?

"Speak up I cant hear you"

Which statement by a patient on dialysis, taking gentamicin (Garamycin), should cause the nurse the most concern?

"Speak up! I can't hear you"

A nurse is collecting data from a hospital patient who has been admitted with pyelonephritis. He is actually ill with high fever, chills, nausea, and vomiting. He also has severe pain in the flank area. What is the primary goal of treatment?

Prevent further damage to his kidneys that could lead ti renal failure

A nurse is reinforcing teaching with a client who has a urinary tract infection and prescription for ciprofloxacin. Which of the following instructions should the nurse include?

"you should not take an antacid within 2 hours of taking ciprofloxacin" Rationale:Antacids should not be taken within a 2hr timeframe of taking ciprofloxacin. These types of products can interfere with the absorption of the medication.

A lithotripter is a machine that does which of the following?

Uses axtracorporea shock waves to disintegrate renal calculi

A 10 yr old boy tells a nurse that he wants to give his kidney to his grandfather. How many years of age shoulld the nurse explain that kidney donor must be?

18 years old

A patient who has cystitis has been told to drink at least 30ml for each kg of body weight.. Her weight is 154lb. How many ml/day should the nurse instruct the patient to drink?

2100ml

A nurse is caring for a group of newly admitted clients. For which of the following clients should the nurse expect to receive a prescription for urinary catheterization?

A client who is in the ICU for a gastrointestinal bleed. Rationale: The nurse should expect a prescription for urinary catheterization for this client because precise measurement of urinary output is crucial for manageing fluid balance

When reinforcing teaching with the client, the nurse should include which of the following clinical manifestations of internal bleeding?

An internal bleed is not readily visible but is suspected with flank pain, decreasing blood pressure, decreasing urine output, or other signs of hypovolemia or shock (such as severe hypotension; cold, clammy skin; oliguria; and dyspnea). Pain radiating around the flank and front of the abdomen occurs because blood in the tissues around the kidney increases pressure on local nerve tracts

Erythropoietin is a hormone produced by the kidney. What will a deficiency of erythropoietin in a patient in chronic renal failure result in?

Anemia as a result of the diminished number of red blood cells being produced

When a client id being treated for an acute renal calculi, THE HIGHEST PRIORITY for the nurse is which of the following?

Assess pain level and provide timely pain medication

what should nursing care focus on when caring for a patient with a ureteral catheter in place after the removal of a kidney stone?

Assessing for patency

A patient has a nephrostomy tube that has been inserted because of an obstruction in the ureter. What special precautions int he care of the nephrostomy tube should the nurse implement?

Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains

A patient on dialysis asks why he is receiving aluminum hydroxide gel (Amphojel), a phosphate binder, for his renal disorder. What should the nurse explain regarding the action of that Amphojel?

Binds with phosporus to increase the serum calcium level

A 16 yr old patient with acute glomerulonephritis compalins of boredom with bed rest and asks when he can become more active. He asks, "what has to happen for me to get offo bed rest" What is the most accurate statement by the nurse?

Blood pressure drops to normal levels

What laboratory value change should indicate to a nurse that a patient with renal failure has entered the oliguric stage?

Blood urea nitrogen (BUN) level rises

A nurse is caring for a patient after urinary diversion surgery. What postoperative nursing assessment is the priority?

Bowel sounds

A female patient reports very painful urethritis. What should the home health care nurse question the patient about the use of ? (SATA)

Bubblebath Vaginal spray

What is the name of the specific catheter than the urologist will use when the nurse is unable to catherize a male patient with an enlarged prostate?

Coude' catheter

A patient comes to the medical clinic with complaints of urgency, frequency, pain in the area of the symphysis pubis, and dark cloudy urine. What should the nurse suspect that this patient has?

Cystitis, probably from bacterial contamination

A nurse is collecting data from a client who has urosepsis. Which of the following findings should the nurse expect?

Decreased urinary output Rationale: The nurse should expect the client to exhibit manifestation of shock which includes a decrease in urinary output and an increase in urine specific gravity

An artificial kidney (dialysis machine) consists of a cylinder filled with a plasma-like solution called:

Dialysate

A nurse has just received a patient who had a cystoscopy from the post-anesthesia recovery unit. The nurse notices that the patient's urine is tinged with pink. What is the first action the nurse should implement?

Encourage the patient to drink plenty of fluids

What is the true about the urine osmolality when the kidney iis adequately functioning?

Equal to the osmolality of the serum

Patient with end stage renal failure are generally anemic because the kidney sproduce less:

Erythropoitein

Sarah is reinforcing teaching with Anna regarding complications after a renal biopsy. Which of the following should Sarah include?

Hematuria is the presence of blood int he urine and is the most common complication of a renal biopsy. This usually occurs within 48-72hrs and can last up to 3weeks

A nurse is caring for a client who has chronic kidney disease (CKD). The nurse should monitor the client for which of the following manifestations of fluid overload?

Increased blood pressure Rationale: The nurse should monitor the blood pressure of a client who has CKD. A client who is experiencing fluid overload due to CKD will experience an increase in blood pressure.

A nurse reads the serum calcium laboratory report of a patient as 4.2 mEq/L. Which symptoms should the nurse anticipate that the patient might exhibit? (Select all that apply.)

Irritability Tingling sensations in limbs tetany

Which of the following is true of dehydration?

Is characterized by poor skin turgor and "tenting"

A patient with chronic renal failure is to begin renal dialysis treatment and asks for advice about which type of dialysis would be best. Teh patient is considering peritoneal dialysis because it's less expensive and has fewer dietary and fluid restrictions. What is the most accurate information for the nurse to provide about peritoneal dialysis?

It giives more independence and more closely resembles normal kidney function.

a family member of a patient who has returned to the special unit after renal transplantation is alarmed by blood in the urine of the patient. What is the nurse's best explanation when explaining the reason for hematuria in this patient?

It is a normal postoperative expectation

Which of the following are true about Wilms tumor?(SATA)

It is the most common renal ad intra-abdominal mallignant tumor of childhood Abdominal pain, hematuria, fever, weight loss and fatigue are common Surgery must take placewithin 24hr of diagnisis followed by radiotherapy and chemotherapy Patient's abdomin must not be palpated to avoid releasing malignant cellsinto abdominal cavity

A nurse is caring for a patient with a Foley catheter. What actions should the nurse implement to decrease this patient's risk for infection? (SATA)

Keep the bag below the level of the bed Provide perineal care twice a day Use Standard Precautions when handling urine and tubing

A nurse is caring for a male client who has an upper urinary tract infection. The nurse should identify that the infection is in which of the following portions of the urinary tract?

Kidney Rationale:The nurse should identify that pyelonephritis, or inflammation of the kidney, is an infection of the upper urinary tract.

A nurse is caring for a client who has a suspected UTI. Which of the following urinalysis results should the nurse identify as a manifestation of a UTI?

Leukocyte esterase indicates the presence of a urinary tract infection.

A nurse is preparing a male client for intermittent urethral catheterization. Which of the following actions should the nurse take?

Lifting the penis to a position perpendicular to the body, or at a 90° angle, while applying light traction straightens the urethral canal to facilitate catheter insertion.

A nurse is caring for a client who has chronic kidney disease (CKD) and has developed Kussmal respirations. The nurse should identify that the client is experiencing which of the following acid-base imbalances?

Metabolic Acidosis Rationale: Acid retention increases with advancing CKD. A client develops Kussmaul respitations (increase in depth and rate) to promote excretion of carbon dioxide through the lungs.

A nurse is caring for a patient with acute glomerulonephritis,. What should the nurse be aware that the inflammation of the capillary loops in the glomeruli will lead to?

Moderate to high blood pressure

The medical physician who treats disorders of the kidney is called a :

Nephrologist

A nurse is caring for a client who has chronic kidney disease (CKD). Which of the following actions should the nurse take to manage fluid overload?

Obtain the client's blood pressure at least every 4hrs. Rationale: The nurse should obtain the client's blood pressure at least every 4hrs. An increase in the blood pressure can indicate fluid overload and hypertension, which can lead to further kidney damage.

Before peritoneal dialysis begins, the nurse knows that the procedure involves the movement of ***WATER***(solutes) through the peritoneum by means of which process?

Osmosis

Which outcome is most necessary for a patient diagnosed with renal calculi?

Patient is able to describe measures to prevent recurrence of calculi

a home health nurse is performing an evaluation of the home of an older adult patient to assess for any safety issues. What should the nurse recognize as an environmental factor that could lead to functional incontinence?

Patient's room located on the opposite end of the house from the bathroom

A nurse is collecting data from a client who has chronic kidney disease (CKD). The client suddenly develops restlessness and dyspnea, and the nurse auscultates crackles in the client's lungs. Which of the following actions should the nurse take first?

Place the client in a high-fowler's position. Rationale: The first action the nurse should take when using the airway, breathing, circulation approach to client care is to place the client experiencing pulmonary edema in a high-Fowler's position. This action, along with the application of oxygen, facilitates gas exchange and increases the ease of breathing.

A nurse is collecting data from a client who has chronic kidney disease (CKD). Which of the following findings should the nurse identify as a manifestation of the early stages of CKD?

Proteinuria Rationale: An early manifestation of chronic kidney disease is proteinuria. However, this will not produce clinical manifestations until there is enough protein lost in the urine to affect the blood levels.

A nurse is assisting with the development of a plan of care for a client who has cystitis. Which of the following interventions should the nurse include in the plan?

Provide the client with a war sitz baths rationale: Providing the client with warm sits bath can relieve some of the discomfort associated with cystitis

A nurse is preparing to remove a client's indwelling urinary catheter. Which of the following actions should the nurse take?

Removing an indwelling urinary catheter while inflation solution remains in the balloon is likey to cause trauma to the urethral canal. Therefore, the nurse should deflate tthe balloon completely prior to removing an indwelling urinary catheter.

A nurse is caring for a patient with an atroventricular (VA) fistula in the forearm and assesses that a trill is absent when palpating te venous side of the fistula. What action should the nurse implement?

Report to th charge nurse that the fistula is occluded

A nurse assesses a Grey Turner sign in a patient who was admitted 2 days earlier after an automobile accident. What does this finding indicate?

Retroperitoneal bleeding and brusing over the flank

A nurse is caring for a group of clients in an ambulatory care clinic is collecting urine for several prescribed diagnostic tests. F or which of the following tests is a random sample voided into a clean cup appropriate?

Routine urinalysis can be done on a random clean-voided specimen during normal voiding into a clean urine cup

A nurse is planning the care for an older patient. Whihc age-related chnage sin the kidney function should the nurse consider when providing care to this patient? (SATA)

Sclerosis of renal blood vessels Decreasing glomerular filtration Decreasing ability to concentrate or dilute urine Decreasing erythropoietin

What is the usual cause of the autoimmune disease of acute glomerulonephritis?

Streptococcal infection

A patient being assessed by the physician states, "I wet mypants every time i cough" The nurse recognizes this as which type of incontinece?

Stress incontinence

When systolic arterial blood pressure eclines to approximately 70mm/Hg

The GFR decreases and acute kiney injury can occur

A nurse is reviewing the medical record of an older adult male client. The nurse should identify that which of the following findings places the client at risk for developing a urinary tract infection (UTI)?

The client has prostate disease Rationale: A client who has prostate disease is at an increased risk for developing a UTI due to the enlarged prostate causing reduced bladder capacity and delayed bladder emptying.

what is the meaning of an elevated serum creatinine?

The kidneys are not filtering creatinine; this is a sign of kidney failure

A nurse is applying a condom catheter for a client who is uncircumcised. Which of the following actions should the nurse take?

The nurse houls leave space of 2.5-5cm between the tip pf the penis and the end of the catheter. This space helps prevent irritation of the tip of the penis and allows full drainage of urine.

A nurse is caring for a client who needs to collect a midstream urine specimen. Which of the following actions should the nurse take?

Urinating a small amount before the collection helps cleanse the urethral meatus of any bacteria that might be present.

Why are patients diagnosed with chronic renal failure and on dialysis prone to injury?

bone demineralization and peripheral neuropathy

A nurse is aware that if a ureter is blocked by a kidney stone, the urine backs up into the kidney causing _____

hydronephrosis

A nurse is performing frequent catheterizations for residual urine. What causes the greatest concern for the nurse?

introduction of pathogens into the bladder

A nurse is assessing a patient with renal impairement. Which facial characteristics is a sign of fluid retention?

periorbital edema

The major risk of peritoneal dialysis is _____.

peritonitis

Which of the followinig is TRUE about hyperkalemia?

refers to an elevation in serum potassium

a nurse is preparing to insert an indwelling catheter for a client. Which of teh following actions should the nurse instruct the client to perform during the insertion procedure?

the nurse should instruct the cilent to bar down as if to void because this relaxes the external sphincter and aids in the insertion procedure.