Chapter 33

A nurse on a geriatric unit is assessing four clients. Which client is MOST likely to exhibit bacteriuria?

A client who has urinary catheter in place due to confusion

A nurse is caring for a client with systemic lupus erythematosus (SLE). The client asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which factor was present in the urine.

Blood or protein.

Which client would the nurse consider having the HIGHEST risk for developing a UTI?

Client with obstructed urinary outflow from a kidney stone

The nurse encourages a female client with recurrent UTIs to drink which liquid on a daily basis?

Cranberry juice

Most common uncomplicated urinary tract infections are caused by ______ that enter through the urethra.

Escherichia coli

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason?

The client's urine contains material from the degradation of red blood cells.

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"

What can be said about acute, drug-induced interstitial nephritis?

-It may be related to a sensitivity to sulfonamide drugs -It manifests as a fever, hematuria, mild proteinuria, and possibly a rash -It may result in acute renal failure

The nurse assess a client in an ambulatory care facility. Which manifestations leads the nurse to advocate for investigation of possible acute pyelonephritis? Select all that apply.

-Urinary urgency and frequency -Flank pain in the back -Abrupt onset of fever and chills

A 9-year old Child has been diagnosed with the nephrotic syndrome. Place the following stages in the development of this health problem in ascending order. Use all options.

1. Hypoalbuminemia 2. Increased glomerular membrane permeability 3. Proteins escape from plasma to glomerular filtrate 4. Decreased colloidal osmotic pressure 5. Accumulation of fluid in interstitial tissue (edema)

A 34-year old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few dats and that she looked like she may have the flu. What is the MOST likely diagnosis?

Acute pyelonephritis

the nurse suspects that a newborn who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

The nurse is assessing a client who has unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

Increase in blood pressure

The nurse evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected UTI. Which finding should the nurse report as evidence of a UTI?

Increase nitrites

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestations?

Increased blood pressure

A nurse is assessing a client's risk for developing a hospital acquired UTI and determines that which of the following places the client at GREATEST risk?

Indwelling urinary catheter

The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections.

Knowledge of aseptic technique when inserting urethral catheters.

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

The initiating event in the development of nephrotic syndrome is derangement in the glomerular membrane that causes increased permeability to which substance?

Plasma proteins.

Which condition/disorder would the nurse see as being likely to cause the MOST serious long-term problems?

Polycystic Kidney Disease

Which substance would not be found in glomerular filtrate?

Protein

A child has been admitted to the pediatric unit with a tentative diagnosis of lipoid nephrosis. While taking the history, which items lead the nurse to suspect the diagnosis is accurate? Select all that apply.

Recent upper respiratory infection Recent routine vaccines

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client's hemoglobin is 8.8 g/dL (88g/L). The nurse suspects this lab value is related to which cause?

Reduced production of erythropoietin

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

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes 2 packs of cigarettes a day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?

Smoking Cessation program

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

The nurse is reviewing the lab results for a client. Which lab findings would the nurse correlate with nephrotic syndrome?

elevated urine protein levels (>3.5 g/day) and hypoalbuminemia