Ch 32 Structure and Function of the Kidney

A nurse is evaluating a client's morning laboratory values. Which result requires that the nurse notify the health care provider? Creatinine: 10.6 mg/dL (937.04 µmol/L) Blood urea nitrogen: 20.0 mg/dL (7.14 mmol/L) Sodium: 148 mEq/L (148 mmol/L) Potassium: 3.4 mEq/L (3.4 mmol/L)

Creatinine: 10.6 mg/dL (937.04 µmol/L)

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood? Blood urea nitrogen Bicarbonate Erythropoietin Uric acid

Blood urea nitrogen

A client expresses frustration at the inconvenience of having to collect urine for an entire day and night as part of a prescribed 24-hour urine collection test. The client asks the nurse, "Why is this test necessary since I gave a single urine sample 2 days ago?" How could the nurse best respond to this question?

"Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

A nurse is teaching a client scheduled for a cystoscopy about the procedure. Which statement made by the client verifies that the teaching has been successful?

- "The doctor will insert a lighted tube through my urethra into my bladder in order to inspect the inside of the bladder."

​​An older adult man is brought into the clinic by his daughter, who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level?

- Serum creatinine

The nurse is analyzing the results of a client's urinalysis. Which results require the nurse to follow up as they represent abnormal results? Amber-colored urine Casts present Bilirubin positive Leukocyte esterase negative Specific gravity 1.010

-Casts present -Bilirubin positive

​​Which diagnostic study would be effective in determining direct visualization of the bladder and ureters? Cystoscope Ultrasonography Renal angiography MRI

-Cystoscope

The nurse has delegated obtaining a urine specimen for testing to the nursing assistant. What does the nurse emphasize the assistant should do to ensure accuracy of testing? Obtain a freshly voided specimen. Encourage the client to drink water prior to obtaining the specimen. Teach the client the purpose of the test. Record the volume of urine obtained in the medical record.

-Obtain a freshly voided specimen.

Which condition causes an elevation in the level of blood urea nitrogen (BUN)? gastrointestinal bleeding excessive fluid intake pituitary disease pneumonia

-gastrointestinal bleeding

The health care provider has ordered a urinalysis for a normally healthy client admitted to the hospital with dehydration. The client has been vomiting for the past 3 days and has had minimal oral intake. Upon analysis of the results, the urine specific gravity reflects:

1.040

A client's urine results reveal proteinuria and microalbuminuria. The health care provider is likely to prescribed an examination that will assist in quantifying the amount of protein loss by the kidney. For which examination should the nurse prepare to educate the client?

24-hour urine test

When explaining urinalysis results that show the presence of cast cells, the nurse informs the client that casts cells develop when the client has which urine abnormality? Select all that apply. A high protein concentration of the urine An elevated urine pH High urine osmolality More than one bacteria present in the urine

A high protein concentration of the urine High urine osmolality

A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be:

Abnormal glomerular filtration

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test. BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 25 mg/dL (8.92 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 30 mg/dL (10.71 mmol/L) to creatinine 2.5 mg/dL (221.0 µmol/L) BUN 40 mg/dL (14.28 mmol/L) to creatinine 2 mg/dL (176.80 µmol/L)

BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) 10:1 ratio

When the urologist wants to directly visualize the bladder, urethra, and ureteral orifices, what diagnostic test would he use?

Cystoscopy

The nurse collects a urine sample but forgets the sample in the client's room for several hours. What is the nurse's best action?

Discard the sample and recollect in the morning.

When caring for the client with kidney failure, the nurse anticipates that which laboratory test abnormalities will be present? Select all that apply.

Elevated potassium Decreased calcium Increased creatinine

When teaching the client with gout about the cause of the disease, which cause should the nurse relate? Increased levels of uric acid in the blood cause gout. Urea, in the form of blood urea nitrogen, causes gout. Retention of sodium can cause gout. High blood pressure causes gout.

Increased levels of uric acid in the blood cause gout.

A client has suffered damage to the anterior pituitary gland, reducing the ability to respond to increases in plasma osmolality. The nurse should monitor for what expected assessment findings? Select all that apply. A urine specific gravity of 1.000 A urine to serum osmolality of 1.5:1 An increase in body weight Increased thirst and fluid consumption Decreased urine output

Increased thirst and fluid consumption A urine specific gravity of 1.000 A urine to serum osmolality of 1.5:1

An older adult man is brought into the clinic by his daughter, who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level? BUN level 24-hour urine test Urine test, first void in morning Serum creatinine

Serum creatinine

Gout and the development of kidney stones are often attributed to high levels of what compound? Uric acid Urea Protein Albumin

Uric acid

A client arrives in the emergency department semi-comatose. Her breath has a "fruity" smell. Their initial blood glucose level is >600. Her mouth and mucous membranes are dry. The health care providers suspect the client may be experiencing hyperglycemic hyperosmolar syndrome. In this situation, the nurse can expect the client's lab results to reflect:

an increase in glomerular filtration rate [GFR].

In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find: excess output of blood-tinged urine. complaints of flank pain rotating around the abdominal muscles. significant decrease in urine output due to decrease in renal blood flow. an increase in GFR due to relaxation of the afferent arterioles.

significant decrease in urine output due to decrease in renal blood flow.