GU
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
Infection
A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:
Renal calculi
The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned?
"I took my usual dose of Coumadin last night."
The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective?
"I will feel a warm sensation as the dye is injected."
The nurse is explaining the steps for collecting a clean catch urine specimen to a client. Which statement by the client indicates effective teaching?
"I'll start to urinate for a few seconds and then start to collect the specimen."
A client asks the nurse why a creatinine clearance test is accurate. The nurse is most correct to reply which of the following?
"Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."
A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client?
"Do you take multiple vitamin preparations?"
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?"
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 renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client?
"You don't need to do any fasting before this noninvasive test."
A nurse measures a patient's urinary output every 8 hours. The nurse weighs the importance of these results by comparing the normal 24-hour urinary output with the patient's condition and medication. The normal 24-hour output should be:
1-2 L/day
When fluid intake is normal, the specific gravity of urine should be which of the following?
1.010-1.025
Which value represents a normal BUN-to-creatinine ratio?
10:1
A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?
150
The nurse received report on a hospitalized patient who was being evaluated for renal disease. The nurse was told that the patient had oliguria. Select the output record that would be consistent with that diagnosis.
350-500 mL/24 hr
The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom?
A dull sound when percussing over the bladder
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
Nephrotoxicity can occur as a result of the use of aminoglycosides such as gentamicin. Select all of the following statements which are true.
Aminoglycosides can result in increased levels of BUN and serum creatinine, indicating nephrotoxicity.
The nurse is caring for a patient who has been NPO for 2 days pending a diagnostic procedure that has been repeated cancelled. When evaluating this patient's urinalysis, what would the nurse anticipate?
An increased urine specific gravity
Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?
Angiography
A nurse is caring for a client diagnosed with acute renal failure. The nurse notes on the intake and output record that the total urine output for the previous 24 hours was 35 mL. Urine output that's less than 50 ml in 24 hours is known as:
Anuria
After undergoing renal arteriogram, in which the left groin was accessed, a client complains of left calf pain. Which intervention should the nurse perform first?
Assess peripheral pulses in the left leg
A patient had a renal angiography and is being brought back to the hospital room. What nursing interventions should the nurse carry out after the procedure to detect complications? Select all that apply.
Assess peripheral pulses, compare color and temperature between the involved and uninvolved extremities, examine the puncture site for swelling and hematoma formation.
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?
Assess the patient's back and shoulder areas for signs of internal bleeding.
A client is having a blood urea nitrogen (BUN) test.
BUN level is: increased in renal disease and urinary obstruction.
As women age, many experience an increased sense of urgency to void, as well as an increased risk of incontinence. This is usually the result of age-related changes in which part of the renal system?
Bladder
The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?
Bleeding
The nurse is caring for a client after a cystoscopic examination. Following the procedure, the nurse informs the client that which effect may occur?
Blood-tinged urine
Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes?
Client reports increasing fatigue
A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing post-procedure care, the nurse should:
Check the client's pedal pulses frequently.
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.
The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder?
Chronic kidney disease
The most frequent reason for admission to skilled care facilities includes which of the following?
Urinary incontinence
The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to:
drink liberal amounts of fluids.
The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find?
Costovertebal angle tenderness
Which value does the nurse recognize as the best clinical measure of renal function?
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
The health care provider ordered four tests of renal function for a patient suspected of having renal disease. Which of the four is the most sensitive indicator?
Creatinine clearance level
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 client has a full bladder. Which sound would the nurse expect to hear on percussion?
Dullness
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:
Encourage high fluid intake
The nurse is instructing a 3-year-old's mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
Enuresis
Which substance stimulates the bone marrow to produce red blood cells?
Erythropoietin
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
Excreting protein
When the bladder contains 400 to 500 mL of urine, this is referred to as:
Functional capacity
To assess circulating oxygen concentration, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which diagnostic test?
Hemoglobin
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?
Increased serum creatinine
The nurse observes that the client's urine is orange. Which additional assessment would be important for this client?
Intake of medications such as phenytoin
The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?
Kidney stones
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?
Monitor the client for an allergy to iodine contrast material.
During the physical examination of a client, the nurse monitors for signs that may indicate a urinary tract disorder. Which of the following would suggest that the client may have a urinary tract disorder?
Periorbital edema
The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration?
Phenazopyridine hydrochloride
A client with a history of chronic renal infections is to undergo CT with contrast. Before the procedure, the nurse should complete which action?
Place emergency medical equipment in the procedure room.
Retention of which electrolyte is the most life-threatening effect of renal failure?
Potassium
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?
Pruritis
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?
Renin
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 preparing the procedure room for a client who will undergo an intravenous pyelogram. Which item(s) should the nurse include?
Suction equipment
Which is an effect of aging on upper and lower urinary tract function?
Susceptibility to develop hypernatremia
Which nursing assessment finding indicates the client has not met expected outcomes?
The client voids 75 cc four hours post cystoscopy.
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?
The costovertebral angle
A client with a genitourinary problem is being examined in the emergency department. When palpating the client's kidneys, the nurse should keep in mind which anatomic fact?
The left kidney usually is slightly higher than the right one.
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?
Ureters
The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?
Urinary urgency
The nurse is reviewing the client's lab results. Which lab result requires follow up by the nurse? Select all that apply.
Urine: RBC 20, BUN 28 mg/dL
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
A client is having a blood urea nitrogen (BUN) test. BUN level is:
increased in renal disease and urinary obstruction.
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine?
Glucose
The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse?
"I took my blood pressure medication with my morning coffee an hour ago."
A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of:
Microorganism transfer
The term used to describe total urine output less than 0.5 mL/kg/hr is:
Oliguria
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.
