Nurs 107 Chap 47 PrepU Assessment of Kidney and Urinary fxn

The nurse is caring for a client scheduled for urodynamic testing. Following the procedure, which information does the nurse provide to the client? "You will be sent home with a urinary catheter." "You can stop taking the prescribed antibiotic." "You may resume consuming caffeinated, carbonated, and alcoholic beverages." "Contact the primary provider if you experience fever, chills, or lower back pain."

"Contact the primary provider if you experience fever, chills, or lower back pain."

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? Monitor the client for an allergy to iodine contrast material. Assess the client's mental changes. Evaluate the client for periorbital edema. Monitor the client for signs of electrolyte and water imbalance.

"Do you take multiple vitamin preparations?"

While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? "Is it painful when you urinate?" "Do you have a strong desire to void?" "Do you urinate while sleeping?" "Does it burn when you urinate?"

"Do you urinate while sleeping?"

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? With the first specimen voided after 8:00 am After discarding the 8:00 am specimen 6 hours after the urine is discarded At 8:00 am, with or without a specimen

After discarding the 8:00 am specimen

Which hormone causes the kidneys to reabsorb sodium? Aldosterone Prostaglandins Growth hormone Antidiuretic hormone

Aldosterone

Which hormone causes the kidneys to reabsorb sodium? Antidiuretic hormone Aldosterone Growth hormone Prostaglandins

Aldosterone

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? Computed tomography (CT scan) Angiography Cystoscopy Radiography

Angiography

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? "A contrast medium will be used to help see the structures better." "An x-ray will be done to view your kidneys, ureters, and bladder." "You'll have a pressure dressing on your groin after the test." "You don't need to do any fasting before this noninvasive test."

Any voiding disorders The patient's occupation The presence of hypertension or diabetes

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient reports severe pain in the back, arms, and shoulders. Which intervention should be offered by the nurse? Provide analgesics to the patient. Enable the patient to sit up and ambulate. Assess the patient's back and shoulder areas for signs of internal bleeding. Distract the patient's attention from the pain.

Assess the patient's back and shoulder areas for signs of internal bleeding.

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? Infection Allergic reaction Bleeding Dehydration

Bleeding

Which value does the nurse recognize as the best clinical measure of renal function? Urine-specific gravity Circulating ADH concentration Volume of urine output Creatinine clearance

Creatinine clearance

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? Blood urea nitrogen level Uric acid level Creatinine clearance level Serum potassium level

Creatinine clearance level

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? Increased fluid intake Diabetes insipidus Decreased fluid intake Glomerulonephritis

Decreased fluid intake

A client has a full bladder. Which sound would the nurse expect to hear on percussion? Dullness Resonance Tympany Flatness

Dullness

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: Encourage high fluid intake. Strain all urine for 48 hours. Monitor for hematuria. Apply moist heat to the flank area.

Encourage high fluid intake.

Which substance stimulates the bone marrow to produce red blood cells? Erythropoietin Prostacyclin Renin Prostaglandin E

Erythropoietin

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? Infection Nephrotic syndrome Acute renal failure Obstruction of the lower urinary tract

Infection

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? Evaluate the client for periorbital edema. Monitor the client for signs of electrolyte and water imbalance. Assess the client's mental changes. Monitor the client for an allergy to iodine contrast material.

Monitor the client for an allergy to iodine contrast material

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? Unusually smooth skin Increased alertness Pruritus Hypoventilation

Pruritus

The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure? Albumin Renin Vasopressin Cortisol

Renin

A nurse is preparing an education program about renal disease. Which risk factor should the nurse include when teaching? Select all that apply. Sickle-cell anemia Spinal cord injury Immobility Seizures Hypotension

Sickle-cell anemia Spinal cord injury Immobility

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: Specific gravity 1.035 Bright yellow urine Creatinine 0.7 mg/dL Protein 15 mg/dL

Specific gravity 1.035

Which is an effect of aging on upper and lower urinary tract function? Acid-base balance Increased blood flow to the kidney Increased glomerular filtration rate Susceptibility to develop hypernatremia

Susceptibility to develop hypernatremia

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? The costovertebral angle Around the umbilicus Above the symphysis pubis The upper abdominal quadrants on the left and right side

The costovertebral angle

A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract? Urethra Bladder Pelvic floor muscles Ureters

Ureters

The most frequent reason for admission to skilled care facilities includes which of the following? Myocardial infarction Stroke Congestive heart failure Urinary incontinence

Urinary incontinence

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: check the client's pedal pulses frequently. remove the dressing on the puncture site after vital signs stabilize. apply pressure to the puncture site for 30 minutes. keep the client's knee on the affected side bent for 6 hours.

check the client's pedal pulses frequently.

An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should: confirm all of the medications and supplements normally taken. confirm which beverages the client normally consumes. palpate the client's bladder before and after voiding. assess the client's usual intake of sodium.

confirm all of the medications and supplements normally taken.

A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of: prostate irritation. microorganism transfer. client discomfort. incorrect urine output values.

microorganism transfer.

The term used to describe total urine output less than 0.5 mL/kg/hour is anuria. oliguria. dysuria. nocturia.

oliguria.

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: acute prostatitis. renal calculi. interstitial cystitis. an overdistended bladder.

renal calculi.

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? "Have you noticed any vaginal bleeding?" "Do you take phenytoin daily?" "Have you had a recent urinary tract infection?" "Do you take multiple vitamin preparations?"

"Do you take multiple vitamin preparations?"

The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder? Proteinuria Kidney stone formation Neurogenic bladder Chronic kidney disease

Chronic kidney disease

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? Client denies frequency and urgency. Client rates pain at a 3 on a scale of 0 to 10. Client reports increasing fatigue. Urine output is 100 ml/hr.

Client reports increasing fatigue.

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? Bladder ultrasonography Cystoscopy Radiography Computed tomography with contrast

Computed tomography with contrast

Which nursing assessment finding indicates the client has not met expected outcomes? The client reports a pain rating of 3 two hours post-kidney biopsy. The client voids 75 cc four hours post cystoscopy. The client has blood-tinged urine following brush biopsy. The client consumes 75% of lunch following an intravenous pyelogram.

The client voids 75 cc four hours post cystoscopy.

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? The specific gravity will be low The specific gravity will be inversely proportional The specific gravity will be high. The specific gravity will equal to one

The specific gravity will be high

Which term best describes a total urine output less than 500 mL in 24 hours? Oliguria Polyuria Nocturia Dysuria

Oliguria

A client is having a blood urea nitrogen (BUN) test. BUN level is: increased in renal disease and urinary obstruction. decreased in nephrotic syndrome. decreased in renal disease and urinary obstruction. unchanged in renal disease.

increased in renal disease and urinary obstruction.

The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse? "I had my last cigarette 3 hours ago with my morning coffee." "I do not have a pacemaker, artificial heart valve, or artificial joints." "I took my blood pressure medication with my morning coffee an hour ago." "I did not take my multivitamin this morning."

"I took my blood pressure medication with my morning coffee an hour ago."

The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? "I will feel a warm sensation as the dye is injected." "I should let the staff know if I feel claustrophobic." "I will need to drink all of the dye as quickly as possible." "I should remove all jewelry before the test."

"I will feel a warm sensation as the dye is injected."

When fluid intake is normal, the specific gravity of urine should be 1.000. less than 1.010. greater than 1.025. 1.010 to 1.025.

1.010 to 1.025.

A nurse is caring for a client with a fluid and electrolyte imbalance. What urine specific gravity would the nurse expect to measure? 1.008 1.000 1.028 1.018

1.018

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio? 4:1 6:1 8:1 10:1

10:1

The nurse is assessing a patient upon admission to the hospital. What significant nursing assessment data is relevant to renal function? Select all that apply. The presence of hypertension or diabetes The patient's occupation Any voiding disorders The patient's financial status The ability of the patient to manage activities of daily living

Any voiding disorders The patient's occupation The presence of hypertension or diabetes

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? Keep the patient on bed rest for 72 hours. Check the patient's urine for hematuria. Apply moist heat, every 4 hours for the first 48 hours to aid healing. Place a bed board under the mattress to add support.

Check the patient's urine for hematuria.

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? Creatinine clearance Liver function studies Therapeutic index GI absorption rate

Creatinine clearance

The nurse analyzes a urinalysis report. He is aware that the presence of this substance in the urine indicates a blood level that exceeds the kidney's reabsorption capacity. Select the substance. Sodium Creatinine Bicarbonate Glucose

Glucose

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? Decreased potassium Decreased blood urea nitrogen (BUN) Increased serum creatinine Increased serum albumin

Increased serum creatinine

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. Specific gravity compares the density of urine to the density of distilled water. Which is an example of how urine concentration is affected? On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity. On a hot day, a person who is perspiring profusely and taking little fluid has high urine output with a low specific gravity. When the kidneys are diseased, the ability to concentrate urine may be impaired, and the specific gravity may vary widely. A person who has a high fluid intake and who is not losing excessive water from perspiration, diarrhea, or vomiting has scant urine output with a high specific gravity.

On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.

A client in moderate pain is admitted for possible kidney stones. The client appears diaphoretic and has frequent periods of nausea and vomiting. The client reports sudden oliguria and initial portable bladder ultrasound shows 300 mL in the bladder after the client voided 50 mL. Which action should the nurse anticipate performing first for this client? Place a urinary cathether. Provide ondansetron intravenously. Provide intravenous hydomorphone. Repeat the portable bladder ultrasound.

Place a urinary cathether.

Retention of which electrolyte is the most life-threatening effect of renal failure? Potassium Phosphorous Calcium Sodium

Potassium

The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to notify the health care team if bloody urine is noted. carefully handle urine because it is radioactive. drink liberal amounts of fluids. maintain bed rest for 2 hours.

drink liberal amounts of fluids

When the bladder contains 400 to 500 mL of urine, this is referred to as functional capacity. specific gravity. renal clearance. anuria.

functional capacity.