CH 89

1. Instill Xylocaine jelly into the urethra 2. Encourage the client to drink fluids 3. Obtain a urinalysis and a urine culture 4. Pass the cystoscope into the client's bladder

2143

.A 37-year-old male client presents at the emergency department with excruciating pain that comes in waves, nausea, vomiting, and chills. The nurse suspects the client has kidney stones. What test would be ordered to confirm or rule out this condition? A) KUB flat plate of the abdomen B) Uric acid studies C)Cystogram D) Renal arteriogram

A) KUB flat plate of the abdomen

The nurse is preparing a client for a cystoscope. What is the meaning of the prefix "cysto"? A) Pertaining to the bladder B) Pertaining to the kidney C) Pertaining to the renal pelvis D) Pertaining to the ureter

A) Pertaining to the bladder

stress incontinence

A sudden increase in intra-abdominal pressure

A nurse is caring for a client receiving peritoneal dialysis following kidney failure. What measure should the nurse employ for this client? A) Encourage the client to breathe deeply. B) Cool the dialysate solution before use. C) Allow the client to drink water before dialysis. D) Leave the solution in the peritoneum for only 30 minutes.

A) Encourage the client to breathe deeply.

A nurse is caring for a client with urge incontinence. What should the nurse include in the client education? A) Tell the client to perform Kegel exercises daily. B) Ask the client to decrease fluid intake. C) Ask the client to void small amounts frequently. D) Tell the client to perform Credé maneuvers.

A) Tell the client to perform Kegel exercises daily.

The nurse monitoring clients for symptoms of renal failure knows that oliguria is common in the early phases of renal failure. How would the nurse describe this condition? A) Urinary output is <400 mL in a 24-hour period. B) Urinary output is >400 mL in a 24-hour period. C) Urinary output has stopped altogether. D) Urinary output is <100 mL/day.

A) Urinary output is <400 mL in a 24-hour period.

A client is diagnosed with hydronephrosis. What occurs in this condition? A) Urine forms, but the flow of urine from the kidney is obstructed. B) Calculi and lithiasis form primarily in the kidneys. C) Fibrous bands form along the ureters or the urethra, thereby narrowing it. D) Multiple clusters of benign tumors form on the kidneys.

A) Urine forms, but the flow of urine from the kidney is obstructed.

The nurse is preparing a client for urodynamic tests. Which of the following of this series is a noninvasive assessment of the status of micturition and generally the first test done in a urodynamic evaluation? A) Uroflowmetry B) Residual urine volume C) Cystometrogram D) Urethral pressure profile

A) Uroflowmetry

A child is admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which findings should the nurse expect to observe? Select all that apply. A. Ascites B. Anorexia C. Weight loss D. Proteinuria E. Decreased serum lipids F. Periorbital and facial edema

A. Ascites B. Anorexia D. Proteinuria F. Periorbital and facial edema

The nurse is assigned to care for a child who is suspected of have glomerulonephritis. The nurse reviews the child's record and notes that which findings are associated with the diagnosis of glomerulonephritis. Select all that apply. A. Headache B. Hypertension C. Red-brown urine D. Periorbital edema E. Increased urine output F. A low blood urea nitrogen (BUN) level

A. Headache C. Red-brown urine D. Periorbital edema

The nurse is planning care for a child with hemolyticuremic syndrome (HUS). The child has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to include which interventions in the care of the child? Select all that apply. A. Provide adequate nutrition B. Restriction of fluids, as prescribed C. Institute measures to prevent infection. D. Monitoring the arteriovenous (AV) fistula E. Administer blood products to treat severe anemia. F. Anticipate the child will have central nervous system involvement.

A. Provide adequate nutrition B. Restriction of fluids, as prescribed C. Institute measures to prevent infection E. Administer blood products to treat severe anemia. F. Anticipate the child will have central nervous system involvement.

A routine urinalysis is performed on a 59-year-old female client who has kidney disease and electrolyte imbalances. Which of the following abnormality would the nurse suspect to be documented? A) Abnormal pH B) Abnormal specific gravity C) Glycosuria D) Ketonuria

B) Abnormal specific gravity

. A 28-year-old female client presents at the emergency department with a rapid onset of fever and chills, with flank pain, pyuria, nausea, vomiting, and headache. Laboratory results indicate bacteriuria, WBCs, and casts. What condition should the nurse suspect? A) Chronic cystitis B) Acute pyelonephritis C) Interstitial cystitis D) Glomerulonephritis

B) Acute pyelonephritis

The nurse is checking the laboratory results of a 76-year-old woman who had a urinalysis performed. The nurse notes that there is calcium in her urine. What condition does this abnormal substance in the urine signify? A) Infection B) Bone degeneration C) Kidney disease D) Hypertension

B) Bone degeneration

reflex incontinence

Bladder instability as a result of upper motor lesions

A 60-year-old female client who is experiencing stress urinary incontinence is not considered a good candidate for surgical repair of the problem. Her healthcare provider recommends a pessary. Which of the following describes this treatment? A) A small electrode connected to a generator is placed in the vagina or rectum. B) The healthcare provider applies firm, gentle pressure above the bladder. C) A device is inserted into the vagina to support the organs of the pelvis. D) A computer is used to monitor how well the client does Kegel exercises.

C) A device is inserted into the vagina to support the organs of the pelvis.

A nurse is caring for a client with complaints of frequent urination. When assessing the urinalysis report, the nurse should look for what component to confirm a normal urinalysis? A) A specific gravity of 1.030 to 1.050 B) A pH level ranging from 12 to 16 C) Absence of glucose in the urine D) Presence of red blood cells (RBCs)

C) Absence of glucose in the urine

The nurse is reading the laboratory results of a client being evaluated for urinary functioning and notes that bilirubin is present in the urine. What condition would the nurse suspect? A) Gout B) Diabetes C) Hepatitis D) Calculi

C) Hepatitis

The nurse is teaching a student nurse about the incidence and etiology of nephromas. Which of the following accurately describes this condition? A) Kidney tumors are almost always benign. B) Kidney tumors occur more frequently in women. C) Kidney tumors are rare in people under 30 years of age. D) Some nephromas have a hereditary risk factor.

C) Kidney tumors are rare in people under 30 years of age. D) Some nephromas have a hereditary risk factor.

A client has to undergo a cystoscopy for removal of a kidney polyp. What nursing measure should the nurse undertake when caring for this client? A) Ask the client to reduce salt intake for 2 weeks after the cystoscopy. B) Make sure the client is not allergic to iodine dye before the cystoscopy. C) Report any darkening urine after the cystoscopy. D) Ask the client not to drink fluids immediately after the cystoscopy.

C) Report any darkening urine after the cystoscopy.

A nurse is caring for a client who is receiving dialysis. An order on the client's chart reads "Guaiac all stools." What should the nurse do? A) Monitor all stools for consistency and color. B) Measure all stools to monitor the output. C) Send all stools for occult blood test. D) Send all stools for a culture and sensitivity test.

C) Send all stools for occult blood test.

A nurse is caring for a client with an ileal conduit for urinary diversion following bladder removal. What measure should the nurse employ when caring for this client? A) Change the conduit appliance daily. B) Use a synthetic barrier cream that contains karaya. C) Use a solvent to loosen the appliance during removal. D) Wet the skin before applying the new appliance.

C) Use a solvent to loosen the appliance during removal.

The nurse is reinforcing discharge instructions to the parent of a 2-year old child who has had an orchiopexy to correct cryptorchidism. Which statement by the parent indicates a need for further teaching? A. "I'll check his temperature." B. "I'll give him medication so he'll be comfortable" C. "I'll let him decide when to return to his play activities" D. "I'll check his voiding to be sure there are no problems"

C. "I'll let him decide when to return to his play activities"

oliguria

Decreased urine output; less than 400 mL

reflex incontinence

Due to bladder instability as a result of upper motor lesions or neuropathies

urge incontinence

Irritation of the bladder wall by urine components

benign prostatic hyperplasia

Normal condition in aging men in which the prostate continues to grow and narrow the urethra

........is the common early phase of acute renal failure characterized by urine production of less than 400 mL in 24 hours.

Oliguria

stasis

Urine that stays in the bladder

stricture

a narrowing of a passage in the body

cystography

a radiographic examination of the bladder after instillation of a contrast medium via a urethral catheter

hydronephrosis

abnormal condition of water in the kidney

anuria

absence of urine; output less than 100mL

stones

calculi

inflammation of the urinary bladder

cystitis

A voiding ________ is a fluoroscopic test performed to diagnose vesicoureteral reflux.

cystourethrogram

Following identification of a mass by imaging studies, a client undergoes a needle biopsy of the kidney for a specific diagnosis. Which should the nurse consider for this procedure? a) Place a soft pillow under the client's abdomen. b) Prepare the client for general anesthesia. c) Place the client in a side-lying position. d) Apply pressure to the site to minimize bleeding.

d) Apply pressure to the site to minimize bleeding.

painful urination

dysuria

The nurse is assessing the urinary functioning of a client. Which of the following conditions are most likely to result in urinary alterations? Select all that apply. A) Staphylococcus infection B) Uncontrolled hypertension C) Diabetes mellitus D) Collagen/vascular disease E) Hypothyroidism F) Bronchitis

B) Uncontrolled hypertension C) Diabetes mellitus D) Collagen/vascular disease

The nurse is assisting with gathering admission assessment data on a 2 year old child who has been diagnosed with nephrotic syndrome. The nurse collects data knowing that which is a common characteristic associated with nephrotic syndrome? A. Hypotension B. Generalized edema C. Increased urinary output D. Frank, bright red blood in the urine

B. Generalized edema

The nurse is caring for a client who has renal failure. Which of the following is a characteristic of this disease? A) Waste products are removed from the blood into the kidneys. B) Azotemia occurs and potassium is retained in the blood. C) The phases of renal failure are always characterized by overproduction of urine. D) Abnormal levels of potassium, calcium, and phosphate are found in the blood.

D) Abnormal levels of potassium, calcium, and phosphate are found in the blood

The nurse is caring for an elderly client in a nursing home who has a urinary diversion in which the ureters are brought to the abdominal wall as a stoma. This is known as what type of diversion? A) Ileal conduit urinary diversion B) Cutaneous ureterostomy C) Continent cutaneous diversion D) Neobladder to urethra diversion

B) Cutaneous ureterostomy

The nurse caring for clients in a healthcare facility discusses the risk factors of bladder cancer with a client who is being tested for the disease. Which of the following is one of these risk factors? A) Drinking alcohol B) Having lung cancer C) Exposure to UV rays D) Frequent urinary tract infections

B) Having lung cancer

A client is scheduled for cystoscopy to determine which of her kidneys is diseased. Which of the following is a nursing consideration when caring for this client? A) Obtain a urine culture immediately after the test. B) Help the client with sitz baths to ease voiding. C)Report any blood-tinged urine following the procedure. D)Keep the client NPO for 24 hours following the procedure.

B) Help the client with sitz baths to ease voiding.

A postoperative elderly female client is prescribed morphine to control pain related to knee replacement. The medication causes the client to be confused and agitated with attempts to get out of bed on her own. Restraints are ordered, which cause the client to be incontinent. What type of incontinence is this client experiencing? A) True incontinence B) Iatrogenic incontinence C) Stress incontinence D) Urge incontinence

B) Iatrogenic incontinence

neurogenic

Type of congenital or acquired disease that cause true or total incontinence

Following identification of a mass by imaging studies, a client undergoes a needle biopsy of the kidney for a specific diagnosis. Which of the following is a nursing consideration for this procedure? A) Prepare the client for general anesthesia. B) Place the client in a side-lying position. C) Place a soft pillow under the client's abdomen. D) Apply pressure to the site to minimize bleeding.

D) Apply pressure to the site to minimize bleeding.

residual urine volume

Test done to determine if the client emptied the bladder completely. After client empties their bladder they are cathed to collect whatever urine remains in the bladder; If residual volume is greter then 150-200ml a disorder of the bladder or urethra is probably causing urinary retention.

A nurse is caring for a client with renal calculi. Which objective should the nurse include in the short-term goals for a client with renal calculi? a) Pain that is of tolerable level b) Urination without difficulty or pain c) Evidence of passage of stone d) Reduced urine output each time

a) Pain that is of tolerable level

Daily assessment of the patency of a dialysis graft or fistula by the client should include palpating for a __________________.

thrill

shunt

tube implanted in the body to redirect the flow of a fluid; Device inserted into the blood vessels to facilitate repeated dialysis

nephroma

tumor/cancer of the kidney

stent

wire-mesh tube used to keep arteries open; hollow tube.

pessary

appliance inserted into the vagina to support the uterus

-lithiasis

presence or formation of stones

pyuria

pus in the urine

Kegel exercises

repetitious contraction and relaxation of the pubococcygeal muscle to improve vaginal tone and urinary continence

Clients should be placed in a _______________ position for 24 hours following a renal biopsy.

supine

A nurse is caring for a client with renal calculi. What measure should the nurse employ for this client? A) Encourage the client to drink at least 1 liter of fluids daily. B) Strain all urine through a piece of gauze, cheesecloth, or strainer. C) Ask the client to try to avoid ambulating, if possible. D) Encourage the client to consume plenty of dairy products.

B) Strain all urine through a piece of gauze, cheesecloth, or strainer.

A nurse is caring for a female client with recurrent urinary tract infection (UTI). What measure should the nurse employ with this client? A) Instruct the client to take a bath with mild soap. B) Tell the client to take vitamin D tablets daily. C) Instruct the client to wipe the perineal area from back to front. D) Instruct the client to void before and after intercourse.

D) Instruct the client to void before and after intercourse.

A nurse is caring for a client who is receiving hemodialysis. During dialysis, what measure should the nurse or the dialysis nurse employ when caring for this client? A) Check the shunt every 20 to 30 minutes for vibration. B) Measure blood pressure on the nondominant hand. C) Encourage the client to drink enough orange juice. D) Keep two clamps on the dressing over the cannula.

D) Keep two clamps on the dressing over the cannula.

The student nurse studying the urinary system learns the functions of the upper and lower urinary tract. Which of the following is a function of the lower urinary tract? A) Filter by-products of metabolism. B) Adjust fluid and electrolyte balance. C) Deliver urine to the bladder. D) Store urine until micturition occurs.

D) Store urine until micturition occurs.

A 48-year-old client is undergoing testing to confirm kidney disease. Which of the following tests uses a collected urine specimen to indicate glomerular filtration rate and renal insufficiency? A) Urinalysis B) Blood urea nitrogen (BUN) C)Uric acid studies D)Creatinine clearance test

D)Creatinine clearance test

10. A nurse is preparing a client for an intravenous pyelogram (IVP). What measure should the nurse employ? A) Keep the client NPO (nothing by mouth) for at least 4 hours. B) Avoid the use of laxatives before the procedure. C)Provide the client with only a few sips of water if thirsty. D)Determine whether the client is allergic to shellfish.

D)Determine whether the client is allergic to shellfish.

nephrectomy

surgical removal of a kidney

...........incontinence refers to incontinence that can be reversed with diagnosis and treatment of the precipitating cause.

Transient

A nurse is preparing a client for an intravenous pyelogram (IVP). What intervention should the nurse be prepared to implement? a) Determine whether the client is allergic to shellfish. b) Avoid the use of laxatives before the procedure. c) Avoid the use of laxatives before the procedure. d) Provide the client with only a few sips of water if thirsty.

a) Determine whether the client is allergic to shellfish.

. A nurse is caring for a client with prerenal failure. The nurse is required to record the client's fluid intake and output. Which of these measures of 24-hour urine output would the nurse document as oliguria? a) 75 mL/day b) 250 mL/day c) 2.50 mL/day d) 7.50 mL/day

b) 250 mL/day

A nurse is caring for a client with ESRD. What should the nurse monitor this client for? Select all that apply. a) Increased appetite b) Anasarca c) Uremic frost d) Hypotension e) bleeding disorders

b) Anasarca c) Uremic frost e) bleeding disorders

The nurse is checking the laboratory results of a 76-year-old woman who had a urinalysis performed. The nurse notes that there is calcium in her urine. What condition does this abnormal substance in the urine signify? a) Kidney disease b) Bone degeneration c) Hypertension d) Infection

b) Bone degeneration

The nurse is reviewing the laboratory results of a client being evaluated for urinary functioning and notes that bilirubin is present in the urine. What condition would the nurse suspect? a) Diabetes b) Hepatitis c) Calculi d) Gout

b) Hepatitis

. A nurse is caring for a client who is experiencing a flare-up of chronic glomerulonephritis. Which measure should the nurse employ when caring for this client? a) Encourage the client to drink plenty of fluids b) Place the client in the orthopneic position c) Provide the client with a protein-rich diet d) Encourage the client to remain ambulatory

b) Place the client in the orthopneic position

A nurse is caring for a client experiencing urge incontinence. What should the nurse include in the client education? a) Tell the client to perform Credé maneuvers. b) Tell the client to perform Kegel exercises daily. c) Ask the client to decrease fluid intake. d) Ask the client to void small amounts frequently.

b) Tell the client to perform Kegel exercises daily.

hematuria

blood in the urine

. A routine urinalysis is performed on a 59-year-old female client diagnosed with kidney disease and electrolyte imbalances. Which abnormality would the nurse suspect to be documented? a) Abnormal pH b) Ketonuria c) Abnormal specific gravity d) Glycosuria

c) Abnormal specific gravity

A nurse is caring for a client who reports frequent urination. When assessing the urinalysis report, the nurse should look for what component to confirm a normal urinalysis? a) Presence of red blood cells (RBCs) b) A pH level ranging from 12 to 16 c) Absence of glucose in the urine d) A specific gravity of 1.030 to 1.050

c) Absence of glucose in the urine

A nurse is scaring for a client who is receiving peritoneal dialysis. What measure should the nurse take after the procedure? a) Ask the client to avoid breathing deeply. b) Place the client flat for 24 hours. c) Assess the client for constipation d) Encourage increased fluid intake for 24 hours

c) Assess the client for constipation

A postoperative client is prescribed morphine to control pain related to knee replacement. The medication causes the client to be confused and agitated with attempts to get out of bed on her own. Restraints are ordered, which cause the client to be incontinent. What type of incontinence is this client experiencing? a) Stress incontinence b) Urge incontinence c) Iatrogenic incontinence

c) Iatrogenic incontinence

A female client is required to provide a urine sample for a culture and sensitivity test. Which intervention should the nurse perform? a) Ask the client to insert a container and start voiding b) Send the urine sample to the laboratory within 24 hours c) Instruct the client to clean the perineal are before voiding d) Give the client nothing by mouth (NPO) for 8 to 10 hours before the test

c) Instruct the client to clean the perineal are before voiding

A nurse is caring for a client with end-stage renal disease (ESRD). What measures should the nurse employ when caring for this client? a) Encourage fluid intake b) Provide a sodium-rich diet c) Weigh the client daily d) Keep the room cool and breezy

c) Weigh the client daily

When educating the client who is a heavy smoker about his increased risk of developing various kinds of cancer, what should the nurse instruct the client to watch out for as the first sign of bladder cancer? a) Loss of body weight b) Pain in the flanks c) Sensation of a mass in the flanks d) Blood in the urine without any pain

d) Blood in the urine without any pain

A nurse is assisting a healthcare provider perform a needle biopsy of a client's kidney. What is the first step the nurse should perform? a) Place a sandbag under the client's abdomen b) Apply pressure to the biopsy site c) Keep the client lying flat for 24 hours d) Give the client a sedative as ordered

d) Give the client a sedative as ordered

A client is scheduled for cystoscopy to determine which of her kidneys is diseased. Which should the nurse consider when caring for this client? a) Report any blood-tinged urine following the procedure. b) Keep the client NPO for 24 hours following the procedure. c) Obtain a urine culture immediately after the test. d) Help the client with sitz baths to ease voiding.

d) Help the client with sitz baths to ease voiding.

A 37-year-old male client presents at the emergency department reporting excruciating pain that comes in waves, along with nausea, vomiting, and chills. The nurse suspects the client has kidney stones. What test would be ordered to confirm or rule out this condition? a) Renal arteriogram b) Uric acid studies c) Cystogram d) KUB flat plate of the abdomen

d) KUB flat plate of the abdomen

A nurse is preparing a client for a cystoscopy procedure. What information should the nurse provide the client? a) Voiding may be uncomfortable for 1 to 2 weeks b) Salt and fluid intake should be restricted after the procedure c) Urine is sent for culture immediately after cystoscopy d) Urine may be reddish immediately after cystoscopy

d) Urine may be reddish immediately after cystoscopy

Process that assumes the work of damaged, nonfunctioning kidneys; a procedure to remove waste products from the blood of patients whose kidneys no longer function

dialysis

Casts

fibrous or protein materials, such as pus and fats, that are thrown off into the urine in kidney disease

urine retention

inability to empty the bladder

glomerulonephritis

inflammation of the glomeruli of the kidney

pyelonephritis

inflammation of the renal pelvis and the kidney

Crushing stones

lithotripsy

renal failure

loss of kidney function resulting in its inability to remove waste products from the body and maintain electrolyte balance; kidneys lose ability to adapt to varying intakes of food and fluids

True incontinence

loss of urine without warning

Crede maneuver

massage from top of bladder to bottom by starting above the pubic bone and rocking the palm of the hand steadily downward to help drain urine