Chapter 33

Calcium

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?

Increase washout of urine

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?

Wilms tumor

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?

Taking antimicrobials to treat Escherichia coli while forcing fluids

A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager?

State of hydration

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?

Bacterial infection

Acute pyelonephritis is a result of:

Corticosteroids

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

Uric acid stones

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which type of kidney stones?

Recently had a urinary tract infection

An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?

Catheter-associated bacteriuria

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?

Lower extremities

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

Escherichia coli

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.

will not undergo an acute kidney injury by decreasing renal blood flow.

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client:

Flank pain in the back Abrupt onset of fever and chills Urinary urgency and frequency

Several clients in clinic today are reporting urinary signs/symptoms. Which reported manifestation(s) leads the health care provider to suspect acute pyelonephritis? Select all that apply.

Autosomal recessive

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

Plasma proteins

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

Urine cloudy with strong odor

The nurse caring for an older adult notes a marked decrease in mental acuity over a 24-hour period. What assessment indicates the most likely cause of this change?

Increase in blood pressure

The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

increased blood pressure

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?

straining the clients urine addressing the client's pain keeping track of intake and output

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply.

Renal cell carcinoma

What is the most common cancer of the kidney?

Proteinuria and generalized edema

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

A 79-year-old client with an indwelling catheter

Which client is likely at the greatest risk of developing a urinary tract infection?

Large asymptomatic abdominal mass and hypertension

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?

acute postinfectious glomerulonephritis.

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

Acute postinfectious glomerulonephritis

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:

A client who has a urinary catheter in place due to confusion

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit bacteriuria?

Drink lots of fluids to help relieve the signs/symptoms of UTIs.

The nurse is caring for a client with recurring urinary tract infections (UTIs). The client asks, "Other than taking antibiotics, what else can I do?" Which response by the nurse is most accurate?

Increased nitrates

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?

Reduced production of erythropoietin

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause?

Autosomal recessive polycystic kidney disease (ARPKD)

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?

Extracorporeal shock wave lithotripsy (ESWL)

Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)?

Protein

Which substance would not be found in glomerular filtrate?

Increased blood pressure

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

protein in the urine.

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include:

Hyperparathyroidism

A client is diagnosed with renal calcium stone formation. Which endocrine imbalances could contribute to this condition?

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

A nurse is caring for a child with Wilms tumor, stage I. Which statements are true regarding this diagnosis? Select all that apply.

"Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe."

A student presents to the campus clinic with reports of frequent, burning urination and is diagnosed with an acute lower urinary tract infection (UTI) caused by Escherichia coli. What teaching will the health care provider most likely provide to the student?

There is possible obstruction in the urinary tract.

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

a streptococcal infection 7 to 12 days prior to onset.

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

Hydronephrosis

A client has a dilated renal pelvis due to obstruction of urine outflow from the kidney. The pressure of filtrate formation is damaging the renal structures. Which condition is most likely?

Uric acid

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?

Age/elderly Prescription methicillin and other synthetic antibiotics Diuretics Procedures involving radiocontrast media Nonsteroidal anti-inflammatory drugs (NSAIDs)

A client is concerned that medication may damage the kidneys. Which factors place the client at most risk for developing a drug-related nephropathy? Select all that apply.

Smoking cessation program

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?

Heavy smoking

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?

Acute pyelonephritis

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?

glomerular damage.

A 9-year-old boy has just been diagnosed with the nephritic syndrome. The first stage of his disease will result in:

Group A β-hemolytic streptococci

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?