CH.53 Prep U's- Assessment of Kidney and Urinary Function

The lower urinary tract consists of...

* Bladder * Urethra * Pelvic floor muscles

The upper urinary tract is composed of...

* Kidneys * Renal pelvis * Ureters

When fluid intake is normal, the specific gravity of urine should be:

1.010 to 1.025

The nurse is reviewing the results of a client's renal function study. The nurse understands that which value represent a normal BUN-to-creatinine ratio?

10:1

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

Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse?

Assess the patient's back and shoulder areas for signs of internal bleeding.

Enuresis

Bedwetting; literally, "in urine."

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should:

Check the client's pedal pulses frequently to detect reduced circulation to the feet caused by vascular injury.

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes?

Client reports increasing fatigue. Fatigue, shortness of breath, and exercise intolerance are consistent with unexplained anemia, which can be secondary to gradual renal dysfunction.

Which value does the nurse recognize as the best clinical measure of renal function?

Creatinine clearance is a good measure of the glomerular filtration rate (GFR), the amount of plasma filtered through the glomeruli per unit of time.

A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following?

Cystoscopy

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

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to:

Encourage high fluid intake.

An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:

Encourage high fluid intake. A nuclear scan of the kidney involves the IV administration of a radioisotope. Fluid intake is encouraged to flush the urinary tract to promote excretion of the isotope.

When the bladder contains 400 to 500 mL of urine, this is referred to as

Functional Capacity

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.

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?

Infection

Pruritus

Itching

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

Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. Specific gravity compares the density of urine to 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.

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?

Pruritus

Which of the following is an age-related change associated with the renal system?

Renal arteries thicken

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 aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?

Renin

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

Anuria

Total urine output less than 50 mL in 24 hours

The most frequent reason for admission to skilled care facilities includes which of the following?

Urinary incontinence

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 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.

Etiologies associated with increased urine specific gravity include...

diabetes mellitus, patients who have recently received high density radiopaque dyes, and fluid deficit.

Renal clearance

the ability of the kidneys to clear solutes from the plasma

Specific gravity

the weight of particles dissolved in the urine

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?" Enuresis is defined as involuntary voiding during sleep.

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 * BUN increased * Serum albumin would be decreased

Common tests of renal function include which of the following? Select all that apply.

* Renal concentration test * Creatinine clearance * Serum creatinine * Blood urea nitrogen (BUN)

In which of the following renal disorders would one suspect a decreased urine specific gravity (dilute urine)? Select all that apply

*Diabetes insipidus * Glomerulonephritis * Severe renal damage

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.