Chapter 25 (30-40): Disorders of Renal Function

A middle-aged woman is admitted with acute pyelonephritis. Which assessment finding correlates with this diagnosis?

Flank pain, dysuria, and nausea/vomiting

Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis?

Group A Β-hemolytic streptococci

Manifestations of polycystic kidney disease include which of the following?

Increase in kidney size bilaterally

A frantic parent reports a large mass in the child's abdomen; after diagnostic testing, the health care provider diagnoses a Wilms tumor, stage IV. After the provider leaves the room, the parents ask the nurse, "What does this mean?" Which response by the nurse is most accurate?

"A cancer of the kidney has most likely spread to the lungs."

A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply. -Daily tub baths -Avoiding bubble baths -Wiping from front to back after a bowel movement -Careful hand washing

-Avoiding bubble baths -Wiping from front to back after a bowel movement -Careful hand washing

One of the most damaging effects of urinary obstruction on kidney structures is which effect?

Urinary stasis

A nine year-old boy has been diagnosed with the nephritic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options. -Hypoalbuminemia -Increased glomerular membrane permeability. -Decreased colloidal osmotic pressure -Proteins escape from plasma to glomerular filtrate. -Accumulation of fluid in interstitial tissue (edema).

-Hypoalbuminemia -Increased glomerular membrane permeability. -Decreased colloidal osmotic pressure -Proteins escape from plasma to glomerular filtrate. -Accumulation of fluid in interstitial tissue (edema).

Select the manifestations of renal cell carcinoma. Select all that apply. -Often silent in the early stages -Hematuria -Palpable flank mass -Does not metastasize

-Often silent in the early stages -Hematuria -Palpable flank mass

A nurse is caring for a child with Wilms tumor, stage I. Which statements are true regarding this diagnosis? Select all that apply -Prognosis is poor even with treatment. -Prognosis is good with treatment. -The tumor is limited to the kidney and can be excised with the capsular surface intact. -The tumor has undergone hematogenous metastasis, most commonly involving the lung.

-Prognosis is good with treatment. -The tumor is limited to the kidney and can be excised with the capsular surface intact.

Which individual is at the highest risk of developing a urinary tract infection (UTI)?

A 30-year-old woman with poorly controlled diabetes mellitus

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute postinfectious glomerulonephritis

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?

Heavy smoking

Which factor contributes to the development of polycystic kidney disease?

Hereditary mutations in polycystin I and II

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

Lower extremities

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminemia is a predictor of future nephropathies.

The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects which physiologic principle?

Salt and water tubular reabsorption

One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte?

Sodium

Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?

State of hydration

A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?

Strain the urine.

A young adult with a history of intermittent flank pain, repeated urinary tract infections (UTIs), and hematuria is diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which pathophysiologic abnormality most likely has contributed to the development of ADPKD?

The client has inherited a tendency for epithelial cells in the tubules to proliferate inappropriately.

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

Uric acid

A cytotechnologist is performing genetic testing on a series of tissues. One tissue comes back with the WT1 mutation, and it's mapped to chromosome 11. What disease will the client most likely develop?

Wilms tumor

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply. -Straining the client's urine -Addressing the client's pain -Restricting the client's oral fluid intake -Keeping track of intake and output -Inserting a Foley catheter

-Straining the client's urine -Addressing the client's pain -Keeping track of intake and output