Chapter 57: Introduction to the Urinary System -

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions?

"I can resume my usual activities without restriction."

A client is scheduled for a creatinine clearance test. The nurse should explain that this test is done to assess the kidneys' ability to remove a substance from the plasma in:

1 min

When fluid intake is normal, the specific gravity of urine should be which of the following?

1.010 to 1.025

When fluid intake is normal, the specific gravity of urine should be:

1.010 to 1.025

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

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?

Creatinine clearance level

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with 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.

Retention of which electrolyte is the most life-threatening effect of renal failure?

Potassium

A client has been asked to provide a clean-catch midstream urine specimen. It is important that the instructions are clear and that things are done in the proper order. Select the proper sequence of events for obtaining a specimen from a client.

Wash hands and remove the lid from the specimen container without touching the inside of the lid. Open the antiseptic towelette package and cleanse the urethral area. Begin voiding into the toilet. Void 30 to 50 mL of the midstream urine into the collection container, taking care not to contaminate the container. Carefully replace the lid, dry the container if necessary, and wash hands.

The nurse is caring for a client who has a fluid volume deficit. When evaluating this client's urinalysis results, what should the nurse anticipate?

An increased urine specific gravity

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient complains of severe pain in the back, arms, and shoulders. Which of the following appropriate nursing interventions should be offered by the nurse?

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

Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse?

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

The nurse is performing a focused genitourinary and renal assessment of a patient. Where should the nurse assess for pain at the costovertebral angle?

At the lower border of the 12th rib and the spine

Which value does the nurse recognize as the best clinical measure of renal function?

Creatinine clearance

Which term describes painful or difficult urination?

Dysuria

Regulation of electrolyte balance is a management goal for patients suffering from renal disease. Which of the following lab results is considered the most life-threatening effect of renal failure?

Hyperkalemia

A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. What postprocedural assessment will the nurse perform on the client?

Hypersensitivity response Monitor site condition. Palpate pedal pulses.

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?

Pruritus

A client with kidney injury secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of kidney injury for which the nurse should monitor the client?

Retention of potassium

A nurse is preparing a client diagnosed with benign prostatic hyperplasia (BPH) for a lower urinary tract cystoscopic examination. The nurse should caution the client about what common temporary complication of this procedure?

Urinary retention

The care team is considering the use of dialysis in a client whose renal function is progressively declining. Renal replacement therapy is indicated in which of the following situations?

When about 80% of the nephrons are no longer functioning

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.

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.

A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine?

glucose

A nurse is working with a client who will undergo invasive urologic testing. The nurse has informed the client that slight hematuria may occur after the testing is complete. The nurse should recommend what action to help resolve hematuria?

increased fluid intake following the test

A client is having a blood urea nitrogen (BUN) test. BUN level is:

increased in renal disease and urinary obstruction.

The nurse is caring for a client who is going to have an open renal biopsy. What nursing action should the nurse prioritize when preparing this client for the procedure?

keep the pt NPO prior to the procedure

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?

"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?

After discarding the 8:00 am specimen

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?

Check the patient's urine for hematuria.

Diagnostic testing of an adult client reveals renal glycosuria. The nurse should recognize the need for the client to be assessed for what health problem?

Diabetes mellitus

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.

Glucose

The nurse is caring for a client suspected of having renal dysfunction. When reviewing laboratory results for this client, the nurse interprets the presence of which substances in the urine as most suggestive of pathology?

Glucose and protein

A client with a history of incontinence will undergo urodynamic testing in the health care provider's office. Because voiding in the presence of others can cause situational anxiety, the nurse should perform what action?

Help the client to relax before and during the test.

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

The nurse is assessing a client's bladder by percussion. The nurse elicits dullness after the client has voided. How should the nurse interpret this assessment finding?

The client's bladder is not completely empty.

The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?

When the urine output is less than 30 mL/h

Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys?

excreting protein

Which of the following hormones is secreted by the juxtaglomerular apparatus?

Renin

A nurse is caring for a 73-year-old client with a urethral obstruction related to prostatic enlargement. When planning this client's care, the nurse should be aware of the risk of what complication?

Urinary tract infection

The nurse is reviewing the electronic health record of a client with a history of incontinence. The nurse reads that the health care provider assessed the client's deep tendon reflexes. What condition of the urinary/renal system does this assessment address?

Bladder dysfunction

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition?

Decreased fluid intake

A geriatric nurse is performing an assessment of body systems on an 85-year-old client. The nurse should be aware of what age-related change affecting the renal or urinary system?

Decreased glomerular filtration rate

A client with recurrent urinary tract infections has just undergone a cystoscopy and reports slight hematuria during the first void after the procedure. What is the nurse's most appropriate action?

Reassure the client that this is not unexpected and then monitor the client for further bleeding.

Which is the correct term for the ability of the kidneys to clear solutes from the plasma?

Renal clearance