GI, GU, Renal Exam

When obtaining a nursing history on a client with a suspected gastric ulcer, which signs and symptoms should the nurse expect to assess? Select all that apply. 1. Epigastric pain at night. 2. Relief of epigastric pain after eating. 3. Vomiting. 4. Weight loss. 5. Melena.

3,4,5

The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement? 1. Encourage the client to eat a low-purine diet and limit foods such as organ meats. 2. Explain the importance of not drinking water two (2) hours before bedtime. 3. Discuss the importance of limiting vitamin D-enriched foods. 4. Prepare the client for extracorporeal shock wave lithotripsy (ESWL).

3. Discuss the importance of limiting vitamin D-enriched foods.

A patient has sought care because of recent dark-colored stools. As a result, a fecal occult blood test has been ordered. The nurse should instruct the patient to avoid which of the following prior to collecting a stool sample? A) NSAIDs B) Acetaminophen C) OTC vitamin D supplements D) Fiber supplements

A

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. Which pat ient statement indicates that the nurses teaching aboutmanagement of the skin reaction has been effective? a. I can buy some aloe vera gel to use on the area. b. I will expose the treatment area to a sun lamp daily. c. I can use ice packs to relieve itching in the treatment area. d. I will scrub the area with warm water to remove the scales.

A

A patient with acute pancreatitis has been started on total parenteral nutrition (TPN). Following the administration of the TPN, which of the following should the nurse plan to monitor? a) Blood glucose levels every 4 to 6 hours b) Auscultate the abdomen for bowel sounds every 4 hours c) Complaints of nausea and vomiting d) Measure the abdominal girth every shift

A

The nurse assists the patient who has undergone bariatric surgery in making dietary selections. Which types of food items should be recommended? a. High-protein b. High-carbohydrate c. High-fat d. High-roughage

A

The nurse cares for a 34-yr-old woman after bariatric surgery. The nurse determines that discharge teaching related to diet is successful if the patient makes which statement? a. "A high-protein diet that is low in carbohydrates and fat will prevent diarrhea." b. "Food should be high in fiber to prevent constipation from the pain medication." c. "Three meals a day with no snacks between meals will provide optimal nutrition." d. "Fluid intake should be at least 2000 mL per day with meals to avoid dehydration."

A

The nurse is caring for a pt diagnosed with esophageal cancer who is experiencing diarrhea after conventional esophageal surgery. The nurse anticipates that the primary health care provider will request which medication to manage diarrhea? A. Loperamide (Imodium) B. Mesalamine (Pentasa) C. Minocycline (Minocin) D. Pantoprazole (Protonix)

A

What should the nurse include in the discharge education provided to a female patient who underwent bariatric surgery? a. "Postpone pregnancy for 12 to 18 months." b. "Irregular menstruation for 12 months is likely." c. "A result of the surgery is loss of fertility." d. "You will need hormone replacement therapy."

A

A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client's status after dialysis? a. Vital signs and weight. b. Potassium level and weight. c. Vital signs and BUN. d. BUN and creatinine levels.

A Following dialysis, the client's vital signs are monitored to determine whether the client is remaining hemodynamically stable. Weight is measured and compared with the client's predialysis weight to determine effectiveness of fluid extraction. Laboratory studies are done as per protocol but are not necessarily done after the hemodialysis treatment has ended.

A client asks which fluids to avoid in light of repeated urinary tract infections​ (UTIs). Which food should the nurse teach the client to​ avoid? (Select all that​ apply.) A.Alcoholic beverages B.Citrus juices C.Coffee D.Milk E.Cranberry juice

A,B,C A.Alcoholic beverages B.Citrus juices C.Coffee

Which topic is important to include in the home care teaching for a client with a urinary tract infection​ (UTI)? (Select all that​ apply.) A.Proper nutrition B.Good hygiene methods C.Wearing polyester underwear D.Voiding every 5 to 6 hours E.Adequate fluid consumption

A,B,E

The nurse is caring for a client with a urinary tract infection​ (UTI). Which condition should the nurse determine as a possible​ cause? (Select all that​ apply.) A.Structural deviations B.Excessive oral fluid intake C.Renal scarring D.Use of antibiotics E.Vesicoureteral reflux

A,C,E A.Structural deviations C.Renal scarring E.Vesicoureteral reflux The causes of UTIs include structural​ deviations, renal​ scarring, and vesicoureteral reflux. Excessive oral fluid intake or use of antibiotics does not cause UTIs.

During the oliguric phase of AKI, you monitor the patient for (select all that apply) A. hypertension. B. electrocardiographic (ECG) changes. C. hypernatremia. D. pulmonary edema. E. urine with high specific gravity.

A. hypertension. B. electrocardiographic (ECG) changes. D. pulmonary edema. You monitor the patient in the oliguric phase of AKI for hypertension and pulmonary edema. When urinary output decreases, fluid retention occurs. The severity of the symptoms depends on the extent of the fluid overload. In the case of reduced urine output (anuria and oliguria), the neck veins may become distended and have a bounding pulse. Edema and hypertension may develop. Fluid overload can eventually lead to heart failure, pulmonary edema, and pericardial and pleural effusions. The patient is monitored for hyponatremia. Damaged tubules cannot conserve sodium, and the urinary excretion of sodium may increase, resulting in normal or below-normal levels of serum sodium. Monitoring may reveal ECG changes and hyperkalemia. Initially, clinical signs of hyperkalemia are apparent on electrocardiogram, which demonstrate peaked T waves, widening of the QRS complex, and ST-segment depression. Urinary specific gravity is fixed at about 1.010.

OVERFLOW Urinary Incontinence is commonly caused by _______. What type of drugs are used to treat OVERFLOW Urinary Incontinence? Choose all that apply A. α-1 adrenergic receptor antagonists B. α-1 adrenergic receptor agonists C. M3 receptor antagonists D. B3 agonists

A. α-1 adrenergic receptor antagonists

A nurse is caring for an infant postsurgery for pyloric stenosis. Which nursing interventions are appropriate when providing care for this infant? Select all that apply. A) Administer analgesics, per order. B) Instruct the parents on proper diapering to avoid pressure over the incision. C) Encourage swaddling and rocking to facilitate relaxation. D) Teach the parents to remove the Steri-Strips during the infant's first bath postsurgery. E) Monitor temperature once per shift.

ABC

A nurse assesses a male client who has symptoms of cirrhosis. Which questions should the nurse ask to identify potential factors contributing to this laboratory result? (Select all that apply.) a. How frequently do you drink alcohol? b. Have you ever had sex with a man? c. Do you have a family history of cancer? d. Have you ever worked as a plumber? e. Were you previously incarcerated?

ANS: A, B, E When assessing a client with suspected cirrhosis, the nurse should ask about alcohol consumption, including amount and frequency; sexual history and orientation (specifically men having sex with men); illicit drug use; history of tattoos; and history of military service, incarceration, or work as a firefighter, police officer, or health care provider. A family history of cancer and work as a plumber do not put the client at risk for cirrhosis.

What should the nurse include in a postoperative plan of care for a patient who has undergone bariatric surgery? a. Avoid ambulating the patient. b. Give 30 mL of water every 2 hours. c. Give solid foods along with liquids. d. Avoid sugar-free liquids in the patient's diet.

ANS: B While performing postoperative care for a patient who has undergone bariatric surgery, the nurse should give 30 mL of water every 2 hours to maintain the patient's fluid and electrolyte balance. Limiting ambulation can result in deep vein thrombosis (DVT). Therefore, the nurse should encourage the patient to perform early ambulation. The combination of solids and liquids in the patient's diet should be avoided because it puts stress on the gastrointestinal system, causing the patient discomfort. Sugar-rich liquids can result in dumping syndrome, so the nurse should give sugar-free liquids to the patient.

The health care provider has written all of these orders for a client with a diagnosis of Excess Fluid Volume. The client's morning assessment reveals bounding peripheral pulses, weight gain of 2 lb, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time?

Administer furosemide (Lasix) 40 mg IV push.

After hemodialysis

After dialysis, assess the vascular access for any bleeding or hemorrhage. When you move the patient or help with ambulation, avoid trauma to or excessive pressure on the affected arm. Assess for blebs (ballooning or bulging) of the vascular access that may indicate an aneurysm that can rupture and cause hemorrhage.

This is often discribed as severe tearing pain on defecation, accompanied by hematochezia, bright red blood is often noted on the stool or tissue paper.

Anal fissure

A patient on the medical-surgical unit with acute kidney failure is to begin continuous arteriovenous hemofiltration (CAVH) as soon as possible. What is the priority action at this time? 1. Call the charge nurse and transfer the patient to the ICU. 2. Develop a teaching plan for the patient that focuses on CAVH. 3. Assist the patient with morning bath and mouth care before transfer. 4. Notify the physician that the patient's mean arterial pressure is 68 mm Hg.

Ans: 1 CAVH is a continuous renal replacement therapy that is prescribed for patients with kidney failure who are critically ill and do not tolerate the rapid shifts in fluids and electrolytes that are associated with hemodialysis. A teaching plan is not urgent at this time. A patient must have a mean arterial pressure (MAP) of at least 60 mm Hg or more for CAVH to be of use. The physician should be notified about this patient's MAP; it is a priority, but not the highest priority. When a patient urgently needs a procedure, morning care does not take priority and may be deferred until later in the day. Focus: Prioritization

How does RN care for a client with PEG tube?

Assess client for abdominal complications - bowel sounds, diarrhea, cramps Assess for irritation and signs of infection at insertion site - skin redness, warmth, discolored and foul smelling drainage, pain Assess for patency of tube by flushing with approximately 30 cc of water prior to any feeding or medication administration.

A nurse is caring for a newly admitted patient with a suspected GI bleed. The nurse assesses the patients stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location? A) Sigmoid colon B) Upper GI tract C) Large intestine D) Anus or rectum

B

A patient who has dysphagia as a consequence of a stroke is receiving enteral feedings through a percutaneous endoscopic gastrostomy (PEG). Which of the following interventions should the nurse integrate into this patient's care? A. Flush the tube with 30 ml of normal saline every 4 hours. B. Flush the tube before and after feedings if the patient's feedings are intermittent. C. Flush the PEG with 100 ml of sterile water before and after medication administration. D. To prevent fluid overload, avoid flushing when the patient is receiving continuous feeding.

B

The client passes a kidney stone, ant it is sent to the lab for analysis. The results indicate it was a calcium oxalate stone. Which dietary instructions should be included for this client at discharge? A. Increase consumption of wheat bran B. Avoid eating spinach and other green leafy vegetables C. Limit fluid intake to 1 liter per day D. Avoid fruit juices

B Spinach and other green leafy vegetables are high in oxalate and should be avoided.

A client is admitted with a diagnosis of acute pancreatitis. The medical and nursing measures for this client are aimed toward maintaining nutrition, promoting rest, maintaining fluid and electrolytes, and decreasing anxiety. Which interventions should the nurse implement? Select all that apply. A. Provide a low-fat diet B. Administer analgesics C. Teach relaxation exercises D. Encourage walking in the hall E. Monitor cardiac rate and rhythm F. Observe for signs of hypercalcemia

B) Administer analgesics C) Teach relaxation exercises E) Monitor cardiac rate and rhythm

The nurse is caring for a client diagnosed with a urinary tract infection​ (UTI). Which assessment finding supports this​ diagnosis? (Select all that​ apply.) A.Clear urine B.Abdominal pain C.Flank pain D.Burning sensation on urination E.Hypothermia

B,C,D B.Abdominal pain C.Flank pain D.Burning sensation on urination -Assessment findings that support the diagnosis of a UTI include abdominal​ pain, flank​ pain, and a burning sensation when urinating.​ Cloudy, dark,​ foul-smelling urine is also expected with a UTI. Hyperthermia​ (fever), not​ hypothermia, supports the diagnosis of a UTI.

The nurse is admitting a client with suspected urinary calculi. Which diagnostic tests will the nurse anticipate being ordered to diagnose urinary calculi and/or the possible complications associated with this diagnosis? (Select all that apply) A. Chest x-ray B. Urinalysis C. Computed tomography (CT) scan of the kidney D. Renal ultrasound E. Intravenous pyelogram (IVP)

B,C,D,E Urinalysis is used to assess for hematuria, WBCs, and crystal fragments. A renal ultrasound can detect stones and hydroephrosis. A CT scan of the kidney can show calculi and obstruction. IVP can visualize the kidneys, ureters, and bladder, and will demonstrate clear evidence of calculi.

How can the following drugs help with URGE incontinence? A. Anticholinergic Drugs? B. Beta3 receptor Agonists? A. Anticholinergic Drugs?--relaxes bladder muscles via antagonism of M3 receptors

B. Beta3 receptor Agonists? -relaxes bladder muscles via AGONISM of Beta3 receptors

The nurse is teaching the parents of an​ 18-month-old female toddler with a urinary tract infection​ (UTI). Which should be included in the teaching to prevent the future risk of a​ UTI? A.Increase the​ child's fluid intake. B.Cleanse the perineal area front to back. C.Provide the child with a daily cup of​ low-sugar cranberry juice. D.Increase the​ child's intake of vitamin C.

B.Cleanse the perineal area front to back.

A clinic patient has described recent dark-colored stools;the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patients current health status would contraindicate FOBT? A) Gastroesophageal reflux disease (GERD) B) Peptic ulcers C) Hemorrhoids D) Recurrent nausea and vomiting

C

A patient asks the nursing assistant for a bedpan. When the l patient is finished, the nursing assistant notifies the nurse that the patient has bright red streaking of blood in the stool. What is this most likely a result of? A) Diet high in red meat B) Upper GI bleed C) Hemorrhoids D) Use of iron supplements

C

A patient is receiving continuous tube feedings through a percutaneous endoscopic gastrostomy (PEG). To maintain safe and effective delivery of the tube feeding, which action by the nurse is most appropriate? A. Flush the tube with 50 ml of water every 8 hours after checking for residual volume. B. Obtain a daily radiograph for verification of tube placement. C. Check tube placement and residual volume every 4 - 6 hours. D. Place the patient on the left side with the head of the bed elevated to 45 degrees

C

An adult patient is scheduled for an upper GI series that will use a barium swallow. What teaching should the nurse include when the patient has completed the test? A) Stool will be yellow for the first 24 hours postprocedure. B) The barium may cause diarrhea for the next 24 hours. C) Fluids must be increased to facilitate the evacuation of the stool. D) Slight anal bleeding may be noted as the barium is passed.

C

The nurse provides discharge education to a patient who has undergone bariatric surgery. Why does the nurse instruct the patient to restrict foods that are high in carbohydrates? a. To reduce the risk of hernia b. To reduce the risk of venous stasis c. To reduce the risk of dumping syndrome d. To reduce the risk of small bowel obstruction

C

A patient is recovering in the intensive care unit (ICU) after receiving a kidney transplant approximately 24 hours earlier. What is an expected assessment finding for this patient during the early stage of recovery? A. Hypokalemia B. Hyponatremia C. Large urine output D. Leukocytosis with cloudy urine output

C. Large urine output Patients frequently experience diuresis in the hours and days immediately after kidney transplantation. Electrolyte imbalances and signs of infection are unexpected findings that warrant prompt intervention.

What type of drugs are used to treat URGE Urinary Incontinence? Choose all that apply A. α-1 adrenergic receptor antagonists B. α-1 adrenergic receptor agonists C. M3 receptor antagonists D. B3 agonists

C. M3 receptor antagonists D. B3 agonists

The nurse is teaching a female client about the prevention of urinary tract infections​ (UTIs). Which information should the nurse​ include? A."Empty the bladder every 2​ hours." B."Void after​ intercourse." C."Avoid bubble​ baths." D."Wash the perineum after​ intercourse."

C."Avoid bubble​ baths

After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which diet choice for a snack 2 hours before bedtime indicates that the teaching has been effective?

Cherry gelatin and fruit

A client who is being treated for pyloric obstruction has a nasogastric (NG) tube in place to decompress the stomach. The nurse routinely checks for obstruction which would be indicated by what amount? A. 150 mL B. 250 mL C. 350 mL D. 450 mL

D

An inpatient has returned to the medical unit after a barium enema. When assessing the patients subsequent bowel patterns and stools, what finding should the nurse report to the physician? A) Large, wide stools B) Milky white stools C) Three stools during an 8-hour period of time D) Streaks of blood present in the stool

D

An unresponsive​ 30-year-old male patient is found lying next to an empty bottle of Valium. What should you do​ first? A. Assess his vital signs. B. Administer naloxone. C. Administer oral glucose. D. Open the airway.

D

Total parental nutrition (TPN) should be used cautiously in patients with pancreatitis due to which of the following? a) They can digest high-fat foods. b) They are at risk for hepatic encephalopathy. c) They are at risk for gallbladder contraction. d) They cannot tolerate high-glucose concentration.

D

Which assessment data support to the nurse the clients diagnosis of gastric ulcer? A. Presence of blood in the clients stool for the past month. B. Reports of a burning sensation moving like a wave. C. Sharp pain in the upper abdomen after eating a heavy meal. D. Complaints of epigastric pain 30-60 minutes after ingesting food.

D

Your patient has been exposed to a toxin and is complaining of abdominal pain. What is the likely position in which you will transport the​ patient? A. Prone B. Supine C. Reverse Trendelenburg D. Lateral recumbent

D

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? A. Encouraging clear liquids B. Obtaining a prescription for morphine C. Assisting the client into a semi-Fowler position D. Administering prescribed anticholinergic medication

D. Administering prescribed anticholinergic medication

When caring for a patient during the oliguric phase of acute kidney injury, what would be an appropriate nursing intervention? A. Weigh patient three times weekly B. Increase dietary sodium and potassium C. Provide a low-protein, high-carbohydrate diet D. Restrict fluids according to the previous day's fluid loss

D. Restrict fluids according to the previous day's fluid loss Patients in the oliguric phase of acute kidney injury have fluid volume excess with potassium and sodium retention. They will need to have dietary sodium, potassium, and fluids restricted. Daily fluid intake is based on the previous 24-hour fluid loss (measured output plus 600 mL for insensible loss). The diet also needs to provide adequate, not low, protein intake to prevent catabolism. The patient should also be weighed daily, not just three times per week.

The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?

Edema of the lips, tongue, and pharynx

The nurse reviews the stages of chronic kidney disease​ (CKD) before caring for a client with the disorder. Which stage of CKD should the nurse identify as occurring when the kidneys are unable to excrete metabolic waste and maintain fluid and electrolyte balance​ adequately? A. Corneal failure B. Decreasing renal reserve C. Renal insufficiency D. ​End-stage renal disease

End-stage renal disease Rationale: Chronic renal disease​ (CKD) progresses slowly. Loss of function may not be recognized for many years.​ End-stage renal​ disease, or stage​ 5, is the stage where the kidneys are finally unable to excrete metabolic wastes and to regulate fluid and electrolyte balance adequately.

The nurse provides teaching to a pregnant patient who reports symptoms of gastroesophageal reflux disease (GERD) keeping her awake at night. Which statement should the nurse identify that indicates the need for further teaching?

I should eat a large snack before bedtime

What are the clinical presentation of ascites

Increased abdominal girth, weight gain, tense abdomen, shifting dullness, positive fluid wave, umbilical hernia. Can lead to impaired ambulation, respiratory distress, and back pain

Which are predisposing factors for acute kidney injury?

Liver disease Hospitalization Recent surgery

A 49-year-old man with a history of heavy alcohol use and liver cirrhosis has been admitted to the hospital's medical unit due to an exacerbation of his health problems that has resulted in massive ascites. The nurse should be prepared to implement which of the following interventions in an effort to resolve the patient's ascites?

Low-sodium diet and administration of diuretics

The nurse creates a plan of care for a client with​ end-stage renal disease​ (ESRD). To what should the nurse pay particular attention when planning this​ care? A. Meal planning when dietary modifications are required B. Medication regimens and their side effects C. Monitoring input and output D. Daily weights

Meal planning when dietary modifications are required Rationale: The nurse should involve the client in meal planning if dietary modifications are required. The nurse can provide teaching about the medication​ regimen, but the client is not usually involved in planning these regimens. Weighing the client and monitoring input and output are interventions carried out by the​ nurse, with little involvement by the client.

Bladder cancer

Painless hematuria is the most common symptoms of the bladder cancer

A nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula

peritonitis

Rebound tenderness, muscular rigidity, spasms. Pain increases with movement. Abdominal distention, fever, tachycardia, tachypnea, N/V, altered bowel habits may be present.

What is the pharmacological treatment of choice for ascites?

Spironolactone

The nurse reviews findings from the assessment of a client with​ end-stage renal disease​ (ESRD). Which finding should the nurse identify as the most common cardiac complication of this​ disease? A. Systemic hypertension B. Cardiomyopathy C. Hypolipidemia D. Tetralogy of Fallot

Systemic hypertension Rationale: Hypertension results from excess fluid​ volume, increased​ renin-angiotensin activity, and increased peripheral vascular resistance.​ Hyperlipidemia, not​ hypolipidemia, often occurs with ESRD. Heart​ failure, not​ cardiomyopathy, results from ESRD. Tetralogy of Fallot is a congenital heart abnormality not caused by ESRD.

The nurse is teaching a patient the use of antacids to treat gastroesophageal reflux disease (GERD). Which instruction should the nurse include? "Avoid long-term use as it can cause gynecomastia." "Do not crush tablets prior to taking antacids." "Take antacids 1 to 2 hours before or after medications." "Notify the healthcare provider of extrapyramidal effects."

Take antacids 1 to 2 hours before or after medications."

Liver and bile

The liver has multiple functions, but its main function within the digestive system is to process the nutrients absorbed from the small intestine. Bile from the liver secreted into the small intestine also plays an important role in digesting fat.

The nurse is planning the care of a patient who has a diagnosis of chronic pancreatitis. As part of this patient's early discharge planning, the nurse is identifying goals for self-care in collaboration with the patient. Which of the following goals is the most likely priority?

The patient will abstain from drinking alcohol.

How can diet be changed to treat hemorrhoids

Well balanced high-fiber diet; avoiding foods that aggravate symptoms like caffeinated beverages, citrus foods and spicy foods

The nurse is caring for a patient after bariatric surgery. What should be included in the plan of care (select all that apply.)? Select all that apply. a. Teach the patient to increase carbohydrate intake. b. Assess for incisional pain versus anastomosis leak. c. Maintain elevation of the head of bed at 35-45 degrees. d. Monitor for vomiting that is a common complication. e. Instruct the patient to consume liquids frequently during meals. f. Assist with early independent ambulation during hospitalization.

b,c,d,f

After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective? a)"I can have a glass of low-fat milk at bedtime." b)"I will have to eliminate all spicy foods from my diet." c)"I will have to use herbal teas instead of caffeinated drinks." d)"I should keep something in my stomach all the time to neutralize the excess acids."

c."I will have to use herbal teas instead of caffeinated drinks."

A client presents to the emergency department with symptoms of right​ lower-quadrant pain,​ fatigue, nausea, and vomiting. Laboratory work is completed that indicates that the client has urinary calculi. The client asks the nurse​ "How are urinary calculi​ diagnosed? What should the​ nurse's response​ include? a Blood cultures b CBC c Chemistry panel d Intravenous pyelography

d (Rationale Intravenous pyelography is one of the tests that is used to diagnose urinary calculi. Other diagnostic tests that may also be used include a urinalysis and​ kidneys, ureters, and bladder​ x-ray (KUB). A​ CBC, chemistry​ panel, and blood cultures will not diagnose calculi.)

A patient has an AV fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safety? a. Take blood pressures only in the right arm to ensure safety. b. Use the fistula for all venipunctures and intravenous infusions c. Ensure that small clamps are attached to the AV fistula dressing. d. Assess the fistula for the presence of a bruit and thrill every 4 hours

d. AV fistulas are created by an anastamosis of an artery and a vein within the subcutaneous tissues to create access for hemodialysis. Fistulas should be evaluated for the presence of thrills (palpate over the area) and bruits (auscultate with a stethoscope) as an assessment of patency. Blood pressures or venipunctures are not done on the extremity with the fistula because of the clotting, infection, or damage to the fistula.

A patient who is receiving radiation therapy for breast cancer is most likely to experience which side effect?

fatigue

Contributing factors after acute kidney injury

lack of blood flow to the kidneys, blockage in urine flow that causes infections, or direct kidney damage by infections, medications, toxins, or autoimmune conditions.

What are the signs/symptoms of anal fissure

pain with and after defecation, which may be associated with bright red blood on toilet tissues

Acute Pancreatitis Nursing Interventions

relieve pain IV or PCA (hydromorphone, morphine, fentanyl), NPO Strict, NG Tube with Suction to decompress area, Bedrest, Monitor Lungs, Incentive Spirometer, TPN Nutrition (Blood sugar every 6 hours) After recovery: Avoid big meals and alcohol, High protein low fat diet

Signs and symptoms of Kidney stones

severe abdominal pain, groin pain, painful urination, fever, nausea and vomiting

What are some side effects of radiation therapy?

skin damage and burning. Skin atrophy, changes in pigmentation, and chronic dermatitis may result. Frequent assessment and monitoring of the skin's condition are needed. When external radiation is planned, the specific area on the body is marked to indicate the port at which external radiation will be directed. These markings must not be washed off.

The nurse reviews the results of diagnostic tests performed on a client with suspected chronic kidney disease​ (CKD). Which stage of the disease should the nurse suspect the client is experiencing when the glomerular filtration rate​ (GFR) is mildly​ decreased? A. Stage 3 B. Stage 2 C. Stage 1 D. Stage 4

stage 2 ​Rationale: A client with mildly decreased GFR is diagnosed with stage 2 chronic kidney disease. GFR in stage 1 is increased. GFR in stage 3 is moderately decreased. GFR in stage 4 is severely decreased.

The nurse is assessing a patient with gastroesophageal reflux disease (GERD) who is experiencing increasing discomfort. Which patient statement indicates that additional patient education about GERD is needed?

"I eat small meals throughout the day and have a bedtime snack."

Which information will the nurse include when teaching a patient with newly diagnosed gastroesophageal reflux disease (GERD)?

"It will be helpful to keep the head of your bed elevated on blocks."

What should I recommend for hemorrhoids?

- Eat high-fiber foods. Eat more fruits, vegetables and whole grains. ... — Use topical treatments. Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent. - Soak regularly in a warm bath or sitz bath. ... - Take oral pain relievers.

Continent Urinary Diversion: Nursing Management Postop

-monitor output from additional drainage tubes [patency, amount, type of drainage] -irrigate cecostomy tube remove mucus / prevent blockage] -Urine output [<30 ml/hr or no output for 15 min = tell Dr] -ongoing assessment of stoma -S/Sxs of infection -pain management -proper positioning -patient education

Which clinical manifestations would the nurse expect to assess for the client diagnosed with a ureteral renal stone? 1. Dull, aching flank pain and microscopic hematuria. 2. Nausea; vomiting; pallor; and cool, clammy skin. 3. Gross hematuria and dull suprapubic pain with voiding. 4. No symptoms.

1. Dull flank pain and microscopic hematuria are manifestations of a renal stone in the kidney. ***2. The severe flank pain associated with a stone in the ureter often causes a sympathetic response with associated nausea; vomiting; pallor; and cool, clammy skin. 3. Gross hematuria and suprapubic pain when voiding are manifestations of a stone in the bladder. 4. Kidney stones and bladder stones may produce no signs/symptoms, but a ureteral stone always causes pain on the affected side because a ureteral spasm occurs when the stone obstructs the ureter. TEST-TAKING HINT: Note that options "1" and "3" both have assessment data that indicate bleeding. The test taker can usually eliminate these as possible answers or eliminate the other two options that do not address blood. Renal stones are painful; therefore "4" could be eliminated as a possible answer.