Genitourinary Disorders
To treat a urinary tract infection (UTI), a client is prescribed sulfamethoxazole (Gantanol), 2 g by mouth initially, and then 1 g by mouth three times daily. The nurse should teach the client that sulfamethoxazole is most likely to cause which adverse effect? 1. Anxiety 2. Headache 3. Diarrhea 4. Dizziness
3. Diarrhea RATIONALES: Sulfamethoxazole is most likely to cause diarrhea. Nausea and vomiting are other common adverse effects. This drug rarely causes anxiety, headache, or dizziness.
The nurse is caring for a client with acute pyelonephritis. Which nursing intervention is most important? 1. Administering a sitz bath twice per day 2. Increasing fluid intake to 3 L/day 3. Using an indwelling urinary catheter to measure urine output accurately 4. Encouraging the client to drink cranberry juice to acidify the urine
2. Increasing fluid intake to 3 L/day RATIONALES: Acute pyelonephritis is a sudden inflammation of the interstitial tissue and renal pelvis of one or both kidneys. Infecting bacteria are normal intestinal and fecal flora that grow readily in urine. Pyelonephritis may result from procedures that involve the use of instruments (such as catheterization, cystoscopy, and urologic surgery) or from hematogenic infection. The most important nursing intervention is to increase fluid intake to 3 L/day. This helps empty the bladder of contaminated urine and prevents calculus formation. Administering a sitz bath would increase the likelihood of fecal contamination. Using an indwelling urinary catheter could cause further contamination. Encouraging the client to drink cranberry juice to acidify urine is helpful but isn't the most important intervention.
A client with a suspected diagnosis of renal cancer is ordered to undergo a renal biopsy to confirm the diagnosis. The client informs a nurse that she will not sign the informed consent form. Which action should the nurse take? 1. Explain the importance of signing the consent form. 2. Request that the client's husband sign the consent form. 3. Notify a physician that the client refuses to give consent. 4. Inform the client that she's delaying treatment by refusing to sign the consent form.
3. Notify a physician that the client refuses to give consent. RATIONALES: The nurse should inform the physician of the client's refusal. Although the client has the right to refuse treatment, the physician should make sure that the client understands the implications so that she can make an informed decision. The nurse shouldn't try to coerce the client to sign the consent form; doing so violates the client's right to refuse treatment. The husband can't legally sign the consent form because the client hasn't been deemed incapable. The nurse should not inform the client that she's delaying treatment; instead the nurse should support the client's decision.
The nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to: 1. limit oral fluid intake for 1 to 2 weeks. 2. report the presence of fine, sandlike particles in the nephrostomy tube. 3. notify the physician about cloudy or foul-smelling urine. 4. report bright pink urine within 24 hours after the procedure.
3. notify the physician about cloudy or foul-smelling urine. RATIONALES: The client should report the presence of foul-smelling or cloudy urine. Unless contraindicated, the client should be instructed to drink large quantities of fluid each day to flush the kidneys. Sandlike debris in the nephrostomy tube is normal because of residual stone products. Hematuria is common after lithotripsy.
