PrepU Chapter 33
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?
urine cloudy with strong odor
A teenager has been admitted with the diagnosis of Alport syndrome. The client has been passing large amounts of blood in the urine. Knowing that this disorder is inherited and associated with other abnormalities, the nurse should focus the assessment on which area?
visual disturbances and hearing loss
Both type 1 and type 2 diabetes mellitus can cause damage to the glomeruli of the kidneys. Which kidney disease is diabetic nephropathy associated with?
nephrotic syndrome
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?
there is possible obstruction in the urinary tract
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
what is the most common cause of a lower urinary tract infection?
Escherichia coli
Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?
Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month
The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:
a streptococcal infection 7 to 12 days prior to onset
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 gave antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed which complication?
acute post-infectious glomerulonephritis
Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?
catheter-associated bacteriuria
A pregnant woman who is beginning her third trimester has been diagnosed with a urinary tract infection (UTI). Which factors most likely predisposed this client to the development of a UTI?
dilation of the upper urinary structures
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?
drink lots of fluids to help relieve the signs/symptoms of UTIs
The nurse is reviewing the laboratory results for a client. Which laboratory findings would the nurse correlate with nephrotic syndrome?
elevated urine protein level (>3.5 g/day) and hypoalbuminemia
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
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?
increased nitrites
what is the usual cause of acute pyelonephritis?
infection
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
Which substance would not be found in glomerular filtrate?
protein
A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to:
saturation of urine with calcium salts
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
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:
"All glomeruli and all parts of the glomeruli are involved."
A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs?
hygiene practices to reduce exposing the urethral meatus to Escherichia coli
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.
age/elderly, prescription methicillin and other synthetic antibodies, diuretics, procedures involving radiocontrast media, NSAIDs
A nurse is caring for a client with diabetic glomerulosclerosis. The presence of which substance in the urine would be used in diagnosing this condition?
albumin
The nurse assesses a client in an ambulatory care facility. Which manifestation(s) leads the nurse to advocate for investigation of possible acute pyelonephritis? Select all that apply
flank pain in the back, abrupt onset of fever and chills urinary urgency and frequency
Which signs and symptoms would you expect to see in a client diagnosed with acute nephritic syndrome?
hematuria and proteinuria
The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?
plasma protein
A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?
plasmapheresis
Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems?
polycystic kidney disease
The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?
increased blood pressure
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
increased nitrates
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?
smoking cessation program
