GU PU (5+)

The nurse should instruct the client to report signs of adverse reaction to the antibiotic or indications that the urinary tract infection is not clearing.

Blood in the urine is not an expected outcome, rash is an adverse response to the antibiotic, and an elevated temperature indicates a persistent infection. These signs should be reported to the HCP. Cloudy urine can be expected during the first few days of antibiotic treatment. Mild nausea is a side effect of antibiotic therapy, but it can be managed with eating small, frequent meals. Urinating every 3 to 4 hours or more is expected, particularly if the client is increasing the fluid intake as directed.

It indicates abdominal blood vessel damage.

A client is having peritoneal dialysis. During the exchange, the nurse observes that the solution draining from the client's abdomen is consistently blood tinged. The client has a permanent peritoneal catheter in place. What clinical judgment should the nurse make about the blood-tinged drainage?

with little or no warning

A characteristic of urge incontinence is involuntary urination

limiting fluid intake

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important?

"What childhood immunizations and illnesses did you have?"

After trying for a year to conceive, a couple consults a fertility specialist. When obtaining a history from the husband, which question should the nurse ask? Mumps is a leading cause of male infertility. Dietary practices, hobbies, and travel are not likely contributors to male infertility.

diabetes insipidus

The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated?

stress incontinence

Loss of urine when coughing occurs with

recurrent urinary tract infections

The client with acute pyelonephritis wants to know the possibility of developing chronic pyelonephritis. The nurse's response is based on knowledge of which disorder that most commonly leads to chronic pyelonephritis?

Provide perineal care at least once a day. Maintain a closed drainage system. Encourage the client to drink 3,000 mL of fluids a day

What should the nurse do to prevent catheter-associated urinary tract infection? Select all that apply.

The client should not have her hip externally rotated when she is positioned for the procedure.

When the nurse is conducting a preoperative interview with a client who is having a vaginal hysterectomy, the client states that she forgot to tell her surgeon that she had a total hip replacement 3 years ago. Why should the nurse communicate this information to the perioperative nurse?

pyuria

Which laboratory value supports a diagnosis of pyelonephritis?

a 28-year-old who is sexually active

Which woman is at greatest risk for bacterial vaginosis?

Diabetes insipidus is characterized by

a great thirst (polydipsia) and large amounts of dilute, watery urine with a specific gravity of 1.001 to 1.005. Diabetes mellitus presents with polydipsia, polyuria, and polyphagia, but the client also has hyperglycemia. Diabetic ketoacidosis presents with weight loss, polyuria, and polydipsia, and the client has severe acidosis. A client with SIADH cannot excrete dilute urine; the client retains fluid and develops a sodium deficiency.

Signs and symptoms of prostatic hypertrophy include

difficulty starting the flow of urine, urinary frequency and hesitancy, decreased force of the urine stream, interruptions in the urine stream when voiding, and nocturia.

The nurse should instruct a client receiving a sulfonamide such as co-trimoxazole to

drink at least eight 8-oz (240 mL) glasses of fluid daily to maintain a urine output of at least 1,500 ml/day. Otherwise, inadequate urine output may lead to crystalluria or tubular deposits. For maximum absorption, the client should take this drug at least 1 hour before or 2 hours after meals. No evidence indicates that antacids interfere with the effects of sulfonamides. To prevent a photosensitivity reaction, the client should avoid direct sunlight during co-trimoxazole therapy.

Terazosin

is an antihypertensive drug that is also used in the treatment of BPH. The client should monitor his blood pressure to ensure he does not develop hypotension, syncope, or orthostatic hypotension. The client should be instructed to change positions slowly. Terazosin does not cause glycosuria, restlessness, or changes in the heart rate.

Pyelonephritis is diagnosed by the presence of

pyuria, leukocytosis, hematuria, and bacteriuria. The client exhibits fever, chills, and flank pain. Myoglobinuria is seen with any disease process that destroys muscle. Ketonuria indicates a diabetic state. Because the client with pyelonephritis typically has signs of infection, the WBC count is more likely to be high rather than low.

During the oliguric phase of ARF,

urine output decreases markedly, possibly leading to fluid overload. Limiting oral and I.V. fluid intake can prevent fluid overload and its complications, such as heart failure and pulmonary edema. Encouraging coughing and deep breathing is important for clients with various respiratory disorders. Promoting carbohydrate intake may be helpful in ARF but doesn't take precedence over fluid limitation. Controlling pain isn't important because ARF rarely causes pain.

blood pressure heart rate respiratory rate skin turgor daily weight

A client is experiencing hypovolemic shock. Which assessments best assist in evaluating the client's fluid status? Select all that apply.

Control the amount of protein intake to 59 to 70 g/day.

A client diagnosed with chronic renal failure is undergoing hemodialysis. Post dialysis, the client weighs 59 kg. The nurse should teach the client to make which dietary changes?

Ensure that the catheter is draining freely.

A client has a ureteral catheter in place after renal surgery. What should the nurse do to provide safe care of the ureteral catheter?

difficulty starting the flow of urine

A client has prostatic hypertrophy. What should the nurse assess when conducting a focused assessment of the client's ability to urinate?

involuntary urination

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

"Drink eight glasses of water a day and urinate every 2 hours."

A client who is recovering from transurethral resection of the prostate (TURP) experiences urinary incontinence and has decreased the fluid intake because of the incontinence. What is the nurse's best response to the client?

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

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

erythropoietin

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/dhemoglobin 9.2 g/dL blood urea nitrogen 22 mg/dL creatinine 0.7 mg/dL potassium 4.8 mEq/LL potassium 4.8 mEq/L

BP

A client with benign prostatic hypertrophy (BPH) is being treated with terazosin 2 mg at bedtime. What should the nurse tell the client to monitor on a regular basis?

presence of fatigue and weakness

A client with chronic renal failure (CRF) has a hemoglobin of 10.2 g/dl and hematocrit of 40%. Which choice would be a primary assessment?

red, sensitive skin around the stoma site

A nurse is caring for a client who had an ileal conduit 3 days earlier. Which assessment finding, if made by the nurse, would indicate a need for a further consultation with the enterostomal nurse?

supporting the client's emotional status

A nurse is providing in-service education for staff members about evidence collection after sexual assault. The educational session is successful when staff members focus their initial care on which step?

blood in peritoneal dialysis

Because the client has a permanent catheter in place, blood-tinged drainage should not occur. Persistent blood-tinged drainage could indicate damage to the abdominal vessels, and the health care provider (HCP) should be notified. The bleeding is originating in the peritoneal cavity, not the kidneys. Too-rapid infusion of the dialysate can cause pain, not blood-tinged drainage.

hemoglobin mg/dL potassium 4.8 mEq/L9.2 g/dL blood urea nitrogen 22 mg/dL creatinine 0.7 mg/dL potassium 4.8 mEq/L

Erythropoietin assists in the production of red blood cells, which are low as evidenced by the hemoglobin level. All other laboratory values are within normal limits.

soap

The client with an ileal conduit will be using a reusable appliance at home. The nurse should teach the client to clean the appliance routinely with which product?

fluid imbalance info

The client would have ambulation without dyspnea as a sign of improvement with fluid volume excess. Amber urine is a sign of a continued imbalance of fluid volume and the client's response of thirst is likely due to fluid restriction, not an indication of improvement. The foot of bed elevation would be a treatment and not a sign of improvement with fluid volume excess.

urine retention

The inability to empty the bladder is

Collect the urine in a preservative-free container and keep on ice. Encourage daily amounts of fluids. Discard the initial voiding but save all others for 24 hours.

The nurse is caring for a client with nephropathy. The health care provider orders a 24-hour urine collection. Which actions are necessary to ensure proper collection of the specimen? Select all that apply.

massages the client's legs.

The nurse is observing an unlicensed assistive personnel (UAP) give care to a client after gynecologic surgery. The nurse should intervene if the UAP:

Ambulation to the bathroom without noted dyspnea.

The nurse is reading the nurse's note from the previous shift to evaluate the client with a risk for impaired skin integrity due to fluid volume excess. Which aspects would demonstrate this improvement?

Urinary incontinence has many causes and can often be improved with intervention.

The nurse is teaching the caregiver of an older adult client about urinary incontinence. What statement should the nurse make to the caregiver about urinary incontinence in the older adult?

Chronic pyelonephritis

is most commonly the result of recurrent urinary tract infections. Chronic pyelonephritis can lead to chronic renal failure. Single cases of acute pyelonephritis rarely cause chronic pyelonephritis. Acute renal failure is not a cause of chronic pyelonephritis. Glomerulonephritis is an immunologic disorder, not an infectious disorder.

During dwell time, the dialysis solution is allowed to remain in the peritoneal cavity

for the time prescribed by the health care provider (HCP) (usually 20 to 45 minutes). During this time, the nurse should monitor the client's respiratory status because the pressure of the dialysis solution on the diaphragm can create respiratory distress.

Hemodialysis clients

have their protein requirements individually tailored according to their post-dialysis weight. The protein requirement is 1.0 to 1.2 g/kg body weight per day. Hence, for a 59-kg weight, the amount of protein will be 59 to 70 g/day. Sodium should be restricted to 3 g/day. The 1,000 calories a day is not sufficient; if calories are not supplied in adequate amount, the body will use tissue protein for energy, which will lead to a negative nitrogen balance and malnutrition. Fluid intake needs to be restricted to 500 to 700 mL plus the urine output

Bacterial vaginosis

is the most common vaginal infection in reproductive-age women, and up to 50% of women may be asymptomatic. Bacterial vaginosis is not usually transmitted sexually, and treatment of the male sex partner has not been beneficial in preventing recurrence of bacterial vaginosis. Bacterial vaginosis is not associated with aging, chronic illness, menopause, or onset of menstruation.

Observe respiratory status.

A client is receiving peritoneal dialysis. What should the nurse assess while the dialysis solution is dwelling in the client's abdomen?

Document presence of a thrill.

When assessing a client prescribed hemodialysis, the nurse notes the client's blood pressure is 140/82 mm Hg, heart rate is 82 beats/min, and respirations are 12 breaths/min. The nurse also notes a continuous vibration over the client's fistula. What is the appropriate action by the nurse?

blood in the urine rash fever above 100° F (37.8° C)

When teaching the client with a urinary tract infection about taking a prescribed antibiotic for 7 days, the nurse should tell the client to report which symptoms to the health care provider (HCP)? Select all that apply.

With adequate fluid replacement

fluid volume in the intravascular space expands, raising the client's blood pressure. As compensatory mechanisms, heart and respiratory rates generally increase with both fluid volume deficit and overload, making those assessments essential. Skin turgor and daily weights are essential assessments in the client with any fluid imbalance. The hemoglobin level reflects red blood cell concentration, not overall fluid status.

Measure the circumference of both calves and note the difference.

A client recovering from an abdominal hysterectomy has pain in her right calf. What should the nurse do next?

Frequent dribbling of urine

is common in male clients after some types of prostate surgery or may occur in women after the development of a vesicovaginal or urethrovaginal fistula.