Genitourinary Disorders

A client had a percutaneous nephrolithotomy to remove a kidney stone. The client is being discharged with drainage tubes from the kidney. What should the nurse instruct the client to do after the procedure? Select all that apply.

Avoid heavy lifting for 2 to 4 weeks. Report fever or chills to the health care provider (HCP). Go to the emergency department for bleeding from the drainage tubes.

A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan?

Increase daily fluid intake to at least 2 to 3 L.

Two weeks after being diagnosed with a streptococcal infection, a client develops fatigue, a low-grade fever, and shortness of breath. The nurse auscultates bilateral crackles and observes jugular vein distention. Urinalysis reveals red and white blood cells and protein. After the physician diagnoses poststreptococcal glomerulonephritis, the client is admitted to the medical-surgical unit. Which immediate action should the nurse take?

Monitor patient blood pressure.

Which steps should a nurse follow to insert a straight urinary catheter?

Prepare the client and equipment, create a sterile field, put on gloves, clean the urinary meatus, and insert the catheter until urine flows.

The nurse notes that the dialysate drainage of a client receiving peritoneal dialysis is cloudy. Which action should the nurse take?

Report the finding to the healthcare provider.

A client comes to the emergency department reporting a sudden onset of sharp, severe, radiating pain in the lumbar and left flank regions. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. What is the nurse's priority action?

Strain all urine.

A client with chronic renal failure receives hemodialysis treatments through a mature arteriovenous (AV) fistula. What intervention will the nurse include in the care plan?

Auscultate the AV fistula for a bruit.

Which clinical finding should a nurse look for in a client with chronic renal failure?

uremia

A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction?

"Increase your carbohydrate intake."

A client with a urinary tract infection is ordered co-trimoxazole. The nurse should provide which medication instruction?

"Drink at least eight 8-oz (240 mL) glasses of fluid daily."

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?

Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl

Which nursing action is most appropriate for a client who has urge incontinence?

Have the client urinate on a timed schedule.

A client undergoes a nephrectomy. In the immediate postoperative period, which nursing intervention has the highest priority?

Assess urine output hourly.

The client asks the nurse, "How did I get this urinary tract infection?" What should the nurse tell the client causes cystitis?

an ascending infection from the urethra

A client has nephrotic syndrome. To aid in the resolution of the client's edema, the health care provider prescribes 25% albumin. In addition to an absence of edema, the nurse should evaluate the client for which expected outcome?

blood pressure elevation

A client with chronic kidney disease (CKD) has a blood urea nitrogen (BUN) of 100 mg/dL, serum creatinine of 6.5 mg/dL, potassium of 6.1 mEq/L, and lethargy. What is the priority nursing assessment?

cardiac rhythm

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:

notify the physician about cloudy or foul-smelling urine.

The nurse determines that interventions for decreasing fluid retention have been effective when the nurse makes which assessment in child with nephrotic syndrome?

decreased abdominal girth

The most significant sign of acute renal failure is:

decreased urine output.

A client with type 2 diabetes mellitus who is taking metformin is scheduled for a computed tomography (CT) with contrast of the abdomen tomorrow. Which priority nursing assessment is done before the procedure?

ensuring that the metformin has been withheld for 48 hours prior to the scan

A client with acute renal failure has the following laboratory results. Based on these findings, which of the following should the nurse administer? hemoglobin 9.2 g/dL blood urea nitrogen 22 mg/dL creatinine 0.7 mg/dL potassium 4.8 mEq/L

erythropoietin

The client is six hours post-open hysterectomy. Intravenous fluids are infusing at 125 mL/hr, urinary catheter has drained 170 mL since surgery, and the client reports pain as a 3 out of 10. What is the nurse's priority concern?

fluid balance

A client has urge incontinence. When obtaining the health history, the nurse should ask the client about which factors that could precipitate incontinence?

loss of urine when coughing

A client is admitted with fever and flank pain and is diagnosed with pyelonephritis. What is a priority nursing intervention in a client with this disorder?

monitoring laboratory values, especially WBCs

A client with acute renal failure is undergoing dialysis for the first time. The nurse monitors the client closely for dialysis disequilibrium syndrome. Which assessment is the priority?

neurological status

The nurse is teaching the client how to recognize infection in the shunt. What sign should the nurse tell the client to assess each day?

swelling at the shunt site

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?

urine output of 250 ml/24 hours

Which factor should be checked when evaluating the effectiveness of an alpha-adrenergic blocker given to a client with benign prostatic hyperplasia (BPH)?

voiding pattern