urinary/renal

During change-of-shift report, which of the following patients would the nurse see first? A. a 36 y/o Fe with cloudy urine B. 57 y/o Fe who is post op for a lithotripsy with blood-tinged urine. C. 32 y/o M who has not urinated the entire shift. D. 84 y/o M with confusion who is complaining of pain when he pees

C. 32 y/o M who has not urinated the entire shift.

What dietary restrictions are required with chronic kidney failure? SOTA a. Decreased fluid intake B. decreased sodium intake C. Decreased Protein intake. D. Limit Potassium Intake E. Limit Vitamin D intake.

all of them

Which of the following nursing actions is most important in caring for the client following lithotripsy? a) Administer allopurinol (Zyloprim). b) Notify the physician of hematuria. c) Monitor the continuous bladder irrigation. d) Strain the urine carefully for stone fragments.

d) Strain the urine carefully for stone fragments. The nurse should strain all urine following lithotripsy. Stone fragments are sent to the laboratory for chemical anaysis.

When a patient has a kidney stone, how much fluid should you encourage them to drink per day?

2000-3000 mL/day

After a kidney transplant, what shoud urine ouput be for a pateint

30 mL/hr

Which of the following is a characteristic of the intrarenal category of acute renal failure? a) Decreased creatinine b) High specific gravity c) Increased BUN d) Decreased urine sodium

c) Increased BUN The intrarenal category of acute renal failure encompasses an increased BUN, increased creatinine, a low specific gravity of urine, and increased urine sodium.

If you have a confused patient needing bladder re-training, what methods would the nurse use?

Regular bladder schedule. Assist patient to the bathroom, bsc, or bedpan every 2 hours.

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan? a) Assess the AV fistula for a bruit and thrill. b) Keep the AV fistula site dry. c) Take the client's blood pressure in the left arm. d) Keep the AV fistula wrapped in gauze.

a) Assess the AV fistula for a bruit and thrill. The nurse needs to assess the AV fistula for a bruit and thrill because if these findings aren't present, the fistula isn't functioning. The AV fistula may get wet when the client isn't being dialyzed. Immediately after a dialysis treatment, the access site should be covered with adhesive bandages, not gauze. Blood pressure readings or venipunctures shouldn't be taken in the arm with the AV fistula.

The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find? a) Cola-colored urine b) Hyperalbuminemia c) Peripheral neuropathy d) Hypotension .

a) Cola-colored urine Clinical manifestations of acute glomerulonephritis include cola-colored urine, hematuria, edema, azotemia, and proteinuria

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? a) Hypovolemic shock caused by hemorrhage b) Abdominal distention owing to reflex cessation of intestinal peristalsis c) Paralytic ileus caused by manipulation of the colon during surgery d) Pneumonia caused by shallow breathing because of severe incisional pain

a) Hypovolemic shock caused by hemorrhage If bleeding goes undetected or is not detected promptly, the patient may lose significant amounts of blood and may experience hypoxemia. In addition to hypovolemic shock due to hemorrhage, this type of blood loss may precipitate a myocardial infarction or transient ischemic attack.

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant? a) Recent history of streptococcal infection b) History of osteoporosis c) Previous episode of acute pyelonephritis d) History of hyperparathyroidism

a) Recent history of streptococcal infection Glomerulonephritis can occur as a result of infections from group A beta-hemolytic streptococcal infections, bacterial endocarditis, or viral infections such as hepatitis B or C or human immunodeficiency virus (HIV). A history of hyperparathyroidism or osteoporosis would place the client at risk for developing renal calculi. A history of pyelonephritis would increase the client's risk for chronic pyelonephritis.

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a) Risk for infection b) Impaired urinary elimination c) Toileting self-care deficit d) Activity intolerance

a) Risk for infection The peritoneal dialysis catheter and regular exchanges of the dialysis bag provide a direct portal for bacteria to enter the body. If the client experiences repeated peritoneal infections, continuous ambulatory peritoneal dialysis may no longer be effective in clearing waste products. Impaired urinary elimination, Toileting self-care deficit, and Activity intolerance may be pertinent but are secondary to the risk of infection

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important? a) Providing pain-relief measures b) Limiting fluid intake c) Encouraging coughing and deep breathing d) Promoting carbohydrate intake

b) Limiting fluid intake 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.

A patient with cystitis is receiving phenazopyridine (Pyridium) for pain and is voiding a bright red-orange urine. What should the nurse do? a. Report this immediately b. Explain to the patient that this is normal c. Increase fluid intake d. Collect a specimen

b. Explain to the patient that this is normal

The nurse is caring for a patient diagnosed with chronic glomerulonephritis. The nurse will observe the patient for the development of which of the following? a) Metabolic alkalosis b) Hypophosphatemia c) Hypokalemia d) Anemia

d) Anemia Anemia, hyperkalemia, metabolic acidosis, and hyperphosphatemia occur in chronic glomerulonephritis.

The nurse notes that the client's urine is blood-tinged following cystoscopy. Which of the following nursing actions should the nurse do next? a) Instruct the client to increase fluid intake. b) Inspect the client's urinary meatus .c) Notify the physician of the finding. d) Document the finding in the health record.

d) Document the finding in the health record. The physician does not need to be contacted as blood-tinged urine is an expected finding following cystoscopy due to trauma of the procedure. The nurse should document the finding and continue to monitor the client. The client should be encouraged to increase fluid intake to help flush the urinary tract of microorganisms. The urinary meatus does not need to be inspected.

Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes? a) Weight loss b) Absence of pain c) Diuresis d) Fever

d) Fever Fever is an indicator of infection or transplant rejection.

The nurse is passing out medications on a medical-surgical unit. A male patient is preparing for hemodialysis. The patient is ordered to receive numerous medications including antihypertensives. Which of the following is the best action for the nurse to take? a) Administer the medications as ordered. b) Ask the patient if he wants to take his medications. c) Check with the dialysis nurse about the medications. d) Hold the medications until after dialysis.

d) Hold the medications until after dialysis.

The nurse is caring for a patient who underwent a kidney transplant. The nurse understands that rejection of a transplanted kidney within 24 hours after transplant is termed which of the following? a) Acute rejection b) Chronic rejection c) Simple rejection d) Hyperacute rejection

d) Hyperacute rejection After a kidney transplant, rejection and failure can occur within 24 hours (hyperacute), within 3 to 14 days (acute), or after many years. A hyperacute rejection is caused by an immediate antibody-mediated reaction that leads to generalized glomerular capillary thrombosis and necrosis. The term "simple" is not used in the categorization of types of rejection of kidney transplants.

The nurse is administering calcium acetate (PhosLo) to a patient with ESKD. When is the best time for the nurse to administer this medication? a) 2 hours before meals b) 2 hours after meals c) At bedtime with 8 ounces of fluid d) With food

d) With food Hyperphosphatemia and hypocalcemia are treated with medications that bind dietary phosphorus in the GI tract. Binders such as calcium carbonate (Os-Cal) or calcium acetate (PhosLo) are prescribed, but there is a risk of hypercalcemia. The nurse administers phosphate binders with food for them to be effective.

A patient who is receiving continuous bladder irrigation following a transurethral resection of the prostate (TURP) complains of "spasm-like" pain over his lower abdomen. What should the initial intervention be by the nurse? a. Inform the nurse in charge b. Decrease the continuous bladder irrigation flow c. Administer the prescribed analgesic d. Check the catheter and drainage system for obstruction

d. check the catheter and drainage system for obstruction.

After a patient has had a kidney biospy, the nurse should include what actions in the patient's care to minimize complications?

turn on side the biopsy was on, monitor for infection, or fever