Renal system

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Which client is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old client with an indwelling catheter

Which individual likely faces the greatest risk for the development of chronic kidney disease?

A client with a recent diagnosis of type 2 diabetes who does not monitor blood sugars or control diet

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen

Acute pyelonephritis is a result of:

Bacterial infection

A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen?

Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear.

The nurse is caring for a client with recurring urinary tract infections (UTIs). The client asks, "Other than taking antibiotics, what else can I do?" Which response by the nurse is most accurate?

Drink lots of fluids to help relieve the signs/symptoms of UTIs.

The nurse is caring for a client with suspected dehydration. Which results does the nurse recognize will help confirm this diagnosis?

Elevated urine specific gravity

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

Escherichia coli

When caring for the client with proteinuria, the nurse recognizes that dysfunction in which structure of the kidney allows protein to leak into the urine?

Glomerulus

A nurse is caring for a client who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this client?

Hydration

The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. What is the most appropriate response by the nurse?

In renal disease, vitamin D is unable to be transformed to its active form.

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

Increased creatinine and blood urea nitrogen (BUN) levels

A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which measures should the client integrate into his or her lifestyle to reduce the risk of recurrence?

Increased fluid intake and dietary changes

A nurse is assessing a client's risk for developing a hospital-acquired urinary tract infection (UTI) and determines that which of the following places the client at greatest risk?

Indwelling urinary catheter

Which is the most important factor in reducing hospital-acquired (nosocomial) urinary tract infections?

Using urinary catheters only when necessary and their prompt removal when no longer needed

A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have?

Prerenal failure

The nurse would be most concerned when the glomerular filtrate contains:

Protein

An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?

Recently had a urinary tract infection

The nurse caring for an older adult notes a marked decrease in mental acuity over a 24-hour period. What assessment indicates the most likely cause of this change?

Urine cloudy with strong odor

A client is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The client asks the nurse what this test is used for. What is the nurse's best response?

This test provides a gauge of renal function."

The nursing student, while studying anatomy and physiology, correctly identifies which of the following to be responsible for carrying urine to the bladder?

Ureters

Gout and the development of kidney stones are often attributed to high levels of what compound?

Uric acid

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

acute postinfectious glomerulonephritis.

The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:

concentrate urine.

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

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

A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs?

hygiene practices to reduce exposing the urethral meatus to Escherichia coli

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include:

protein in the urine.

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.

In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:

significant decrease in urine output due to decrease in renal blood flow.

A client with end-stage kidney disease has developed anemia. The nurse teach this client that the reason anemia has developed is:

the damaged kidney is unable to produce erythropoietin.


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