Chapter 33: Disorders of Renal Function

A young adult client has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause? "Do you have a history of heart failure?" "Have you recently had kidney stones?" "Have you ever been diagnosed with diabetes?" "Have you had any type of infection within the past 2 weeks?"

"Have you had any type of infection within the past 2 weeks?"

The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects which physiologic principle?

Salt and water tubular reabsorption

A client has been taking up to 2400 mg of ibuprofen per day for chronic pain following a motor vehicle accident. The client is diagnosed with chronic analgesic nephritis. The client states, "I thought that taking too many drugs hurt your liver if anything, not your kidneys." What is the most appropriate response to the client's statement?

"Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs."

Which client is likely at the greatest risk of developing a urinary tract infection? A pregnant woman who has been experiencing urinary frequency A client with a diagnosis of chronic kidney disease who requires regular hemodialysis A 79-year-old client with an indwelling catheter A confused, 81-year-old client who is incontinent of urine

A 79-year-old client with an indwelling catheter

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?

Acute pyelonephritis

Acute pyelonephritis is a result of:

Bacterial infection

A client has recently been diagnosed with systemic lupus erythematosus (SLE) glomerulonephritis. Knowing the treatment options, the nurse should anticipate educating the client (who has a positive renal biopsy result) on which medications usually prescribed? Select all that apply.

Captopril, an ACE inhibitor Prednisone, a corticosteroid

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.

A middle-aged woman is admitted with acute pyelonephritis. Which assessment finding correlates with this diagnosis? poorly controlled hypertension Flank pain, dysuria, and nausea/vomiting systemic infection scarring and deformation of the renal calyces and pelvis

Flank pain, dysuria, and nausea/vomiting

What is the usual cause of acute pyelonephritis?

Infection

The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

Increase in blood pressure

A nurse is giving discharge instructions for a client who was diagnosed with acute pyelonephritis 3 days previously. Which instruction is important for the nurse to discuss when teaching the client?

It is important that the client take the prescribed antibiotic for the duration of the prescription.

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

Lower extremities

The nurse is presenting an educational program about renal carcinoma. The nurse determines that the participants understand early signs of the disease when they identify which as an early sign or symptom? Hematuria Flank pain Palpable flank mass None of the above

None

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)? Male client 2 days postoperative hip fracture repair whose Foley catheter was removed on postoperative day 1 Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month Woman who has just given birth and had a straight urinary catheter inserted prior to delivery Middle-aged male client admitted for dehydration due to strenuous exercise in hot weather

Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month

Which substance would not be found in glomerular filtrate?

Protein

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome? Hematuria and anemia Proteinuria and generalized edema Renal colic and increased serum sodium Increased creatinine with normal blood urea nitrogen

Proteinuria and generalized edema

A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?

Strain the urine.

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply.

Straining the client's urine Addressing the client's pain Keeping track of intake and output

A client suffering from chronic hypertension is beginning to show the symptoms of glomerular disease. This client's kidney damage is due to what phenomenon?

The higher pressures force protein and cells through the glomerular membrane, resulting in glomerular inflammation.

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

A nurse is caring for an older adult client with a urinary tract infection (UTI). The nurse understands which information about UTI's in the older adult population? Select all that apply.

UTI is relatively common in older adults. Client may have no symptoms. The UTI may be reflected in a change in the client's mental state.

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

Uric acid

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? Hearing aid batteries are run down No bowel movement in 48 hours Exacerbation of osteoarthritis Urine cloudy with strong odor

Urine cloudy with strong odor

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

a streptococcal infection 7 to 12 days prior to onset.

A nurse is caring for a client with diabetic glomerulosclerosis. The presence of which substance in the urine would be used in diagnosing this condition?

albumin

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI?

increased nitrites

The nurse assesses a client in an ambulatory care facility. Which manifestation(s) leads the nurse to advocate for investigation of possible acute pyelonephritis? Select all that apply.

flank pain in the back abrupt onset of fever and chills urinary urgency and frequency

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