ch 57,58, 59 prep u
Hemoglobin
A patient with a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test of renal function relating to erythropoiesis. When assessing the oxygen transport ability of the blood, the nurse should prioritize the review of what blood value?
When about 80% of the nephrons are no longer functioning
The care team is considering the use of dialysis in a patient whose renal function is progressively declining. Renal replacement therapy is indicated in which of the following situations?
Creatinine clearance level
The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator?
More prone to develop hypernatremia
Which of the following is an effect of aging on upper and lower urinary tract function?
Proteinuria
Which of the following is the hallmark of the diagnosis of nephrotic syndrome?
"Do you urinate while sleeping?"
While reviewing a patient's chart, the nurse notes the patient has been experiencing enuresis. To assess if this remains an ongoing problem for the patient, the nurse will ask which of the following questions?
The client should limit fluid intake for 24 hours.
You are reviewing the guidelines for the care of clients undergoing intravenous or retrograde pyelography. All of the following are guidelines for postprocedural and discharge care except one. Choose the incorrect choice.
BUN is increased in renal disease and urinary obstruction.
Your client is having a blood urea nitrogen (BUN) test run. What do you recall from your studies that is true about BUN levels?
Creatinine clearance level
A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for?
After discarding the 8:00 am specimen
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure?
"I am allergic to shrimp."
A patient is scheduled for a test with contrast to determine kidney function. What statement made by the patient should the nurse inform the physician about prior to testing?
Creatinine clearance
Which of the following does the nurse recognize is the best clinical measure of renal function?
Pyridium
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Check the patient's urine for hematuria.
A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?
Recurring infection prevention
A 32-year-old client has been admitted to the renal unit with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. As her nurse, what would be a significant aspect of your discharge education?
Hyperkalemia
Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure?
Potassium
Retention of which electrolyte is the most life-threatening effect of renal failure?
Change in cognitive functioning
The most common presenting objective symptoms of a urinary tract infection in older adults, especially in those with dementia, include?
"I'm allergic to shellfish."
A nurse is collecting a health history on a client who's to undergo a renal angiography. Which statement by the client should be the priority for the nurse to address?
Excess fluid intake
A nurse, when caring for a client, notes that the specific gravity of the client's urine is low. What could have lead to the low specific gravity of urine?
All options are correct.
A 32-year-old client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure and postprocedural assessments. What postprocedural assessment will you perform on the client?
Renal circulation
A 32-year-old flight attendant is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure. The client asks what the angiography will reveal. What is your response as her nurse?
Glucose
A 42-year-old client is being seen by a urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically reabsorbed and not secreted in urine?
Glucose
A 42-year-old client is being seen by an urologist in the group where you practice nursing. She is experiencing some secretion abnormalities, for which diagnostics are being performed. Which of the following substances are typically reabsorbed and not secreted in urine?
350 mL
A 45-year-old editor is a client on the rehab unit where you practice nursing. He was involved in an MVA, which left him with paraplegia, and he is working toward living at home with his wife. He is currently developing an individualized CIC schedule, as he prefers to not wear a leg bag. What is the maximum amount of urine he should allow to collect before catheterization?
Creatinine clearance
A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change?
Assess the patient's back and shoulder areas for signs of internal bleeding
A client has undergone a renal biopsy. After the test, while the client is resting, the client complains of severe pain in the back, the arms, and the shoulders. In such a case, which of the following appropriate nursing interventions should be offered by the nurse?
Assess the patient's back and shoulder areas for signs of internal bleeding.
A client has undergone a renal biopsy. After the test, while the client is resting, the client complains of severe pain in the back, the arms, and the shoulders. In such a case, which of the following appropriate nursing interventions should be offered by the nurse?
check the client's pedal pulses frequently.
A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should:
700 mL
A client is a victim of an MVA and is unconscious. In compliance with a physician's order to insert an indwelling catheter, you place the catheter and note the drainage of a large amount of yellow urine with normal odor. How much urine will you allow to drain before clamping the tube?
Pruritus
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?
Maintain skin and stomal integrity.
A client undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. Which of the following postoperative procedures should the nurse perform?
fatigue and weakness.
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
The risk of developing a vaginal yeast infection as a consequent of antibiotic therapy
A female patient has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the patient, the nurse should address what topic?
Decreased glomerular filtration rate
A geriatric nurse is performing an assessment of body systems on an 85-year-old patient. The nurse should be aware of what age-related change affecting the renal or urinary system?
"A biopsy is sometimes necessary for diagnosing and evaluating the extent of kidney disease."
A kidney biopsy has been scheduled for a patient with a history of acute renal failure. The patient asks the nurse why this test has been scheduled. What is the nurse's best response?
Urine output of 20 ml/hour
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?
"Remember to drink frequently, even if you don't feel thirsty."
A nurse is aware of the high incidence and prevalence of fluid volume deficit among older adults. What related health education should the nurse provide to an older adult?
A 24-hour urine specimen and a serum creatinine level midway through the urine collection process
A nurse is caring for a patient with impaired renal function. A creatinine clearance measurement has been ordered. The nurse should facilitate collection of what samples?
Assess peripheral pulses. Compare color and temperature between the involved and uninvolved extremities. Examine the puncture site for swelling and hematoma formation.
A patient had a renal angiography and is being brought back to the hospital room. What nursing interventions should the nurse carry out after the procedure to detect complications? (Select all that apply.)
Reassure the patient that this is not unexpected and then monitor the patient for further bleeding.
A patient with recurrent urinary tract infections has just undergone a cystoscopy and complains of slight hematuria during the first void after the procedure. What is the nurse's most appropriate action?
Diabetes mellitus
Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem?
Encourage high fluid intake.
Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to:
Excreting protein
In starting your new job as a nurse with a group of renal specialists, you begin your orientation with a thorough review of renal function. While the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which of the following is NOT a function of the kidneys?
The patient's kidneys can produce sufficiently concentrated urine.
Results of a patient's 24-hour urine sample indicate osmolality of 510 mOsm/kg, which is within reference range. What conclusion can the nurse draw from this assessment finding?
Complete the prophylactic antibiotic therapy.
The nurse discusses a care plan with a male patient who is to be discharged after a biopsy. He is instructed to maintain limited activity and report signs of systemic infection, urinary tract infection, or bleeding. Which additional instructions should the nurse include in the care plan?
The patient's bladder is not completely empty
The nurse is assessing a patient's bladder by percussion. The nurse elicits dullness after the patient has voided. How should the nurse interpret this assessment finding?
When the urine output is less than 30 mL/h
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?
Renin
The nurse is aware, when caring for patients with renal disease, that which of the following substances, made in the glomeruli, directly controls blood pressure?
Pyridium (phenazopyridium HCl)
The nurse is caring for a patient complaining of orange-colored urine. The nurse suspects which of the following as the cause of the urine discoloration?
Blood-tinged urine
The nurse is caring for a patient following a cystoscopic examination. Following the procedure, the nurse informs the patient that which of the following may occur?
An increased urine specific gravity
The nurse is caring for a patient who has a fluid volume deficit. When evaluating this patient's urinalysis results, what should the nurse anticipate?
Assess the patient for signs of bleeding and inform the physician.
The nurse is caring for a patient who has returned to the postsurgical suite after post-anesthetic recovery from a nephrectomy. The nurse's most recent hourly assessment reveals a significant drop in level of consciousness and BP as well as scant urine output over the past hour. What is the nurse's best response?
Chronic kidney disease
The nurse is caring for a patient with a medical history of sickle cell anemia. The nurse understands this predisposes the patient to which of the following possible renal or urologic disorders?
9
The nurse is evaluating the urinary system of an older adult male client who reports that his stream seems to have decreased. The nurse educates the client that urine flow rate decreases with age, and that the average flow rate in older men is?
At the lower border of the 12th rib and the spine
The nurse is performing a focused genitourinary and renal assessment of a patient. Where should the nurse assess for pain at the costovertebral angle?
Specific gravity of the patient's urine Testing for the presence of glucose in the patient's urine Microscopic examination of urine sediment for RBCs Microscopic examination of urine sediment for casts
The nurse is preparing to collect an ordered urine sample for urinalysis. The nurse should be aware that this test will include what assessment parameters? Select all that apply.
"I will feel a warm sensation as the dye is injected."
The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective?
Specific gravity 1.035
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is:
Intake of medication such as phenytoin (Dilantin
The nurse observes the patient's urine to be orange. Which additional assessment would be important for this patient?
It may indicate multiple medications administered taken by the patient.
To obtain information about the chief complaint and medical history of an older male patient, the nurse asks the patient about his medication history. What is the importance of obtaining a medication history?
1.010 to 1.025
When fluid intake is normal, the specific gravity of urine should be which of the following?
10:1
Which of the following is a normal BUN to creatinine ratio?