elimination
When working with a client who has end-stage renal disease (ESRD) and is receiving peritoneal dialysis, the concept of diffusion can be explained by which statement?
"If your potassium level is high, then K+ particles will move from your peritoneal cavity into the dialysis solution, where the concentration of K+ is lower."
A patient undergoing rehabilitation reports problems with constipation. Which suggestion would be least appropriate?
"Keep your fluid intake to fewer than 2 liters per day."
A client with marked oliguria is ordered a test dose of 0.2 g/kg of 15% mannitol solution intravenously over 5 minutes. The client weighs 132 lb (60 kg). How many grams would the nurse administer?
12g
The nurse is calculating the urinary output for the infant. The infant's diaper weighed 40 g prior to placing the diaper on the infant. After removal of the wet diaper, the diaper weighed 75 g. How many milliliters of urine can the nurse document as urinary output? Record your answer using a whole number.
35mL "For each 1 gram of increased weight, this is the equivalent of 1 milliliter of fluid."?
While reading a client's history, the nurse notes that a client has a colostomy. When assessing the client, the nurse notes that the output is formed stool. What should the nurse do?
Document the output; this is normal.
The nurse is developing a bowel training program for a patient. What education can the nurse provide for the patient that will increase the chance of success of the bowel program?
Have a fluid intake between 2 and 4 L/day. Have an adequate intake of fiber containing foods. Set a daily defecation time that is within 15 minutes of the same time every day
The nurse notes that a client has not voided in over 18 hours and is still unable to void when prompted. What is the nurse's priority assessment?
Last bowel movement
An infant is breastfed. When assessing the stools, which findings would be typical?
Less constipation than bottle-fed infants
A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
Maintain nutrition.
A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. Which is the most likely diagnosis and possible underlying pathophysiologic problem?
Overactive bladder that may result from both neurogenic and myogenic sources.
After a laminectomy, a client has a palpable bladder and reports lower abdominal discomfort with voiding 60 to 80 mL of urine every 4 hours. The vital signs are BP 110/88 mm Hg, HR 86 bpm, and RR of 20 breaths/min. What is the best nursing intervention?
Perform a bladder scan, and obtain an order for urinary catheterization.
Which term refers to inflammation of the renal pelvis?
Pyelonephritis
A client with diarrhea was instructed by the pharmacist to take bismuth subsalicylate. The client took the medication as instructed for 36 hours and has now called the clinic reporting dark stools that are "nearly black." What is the nurse's best action?
Reassure the client that this is an expected effect of the drug that does not indicate pathology.
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?
Sigmoid colon
One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte?
Sodium
The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is:
Specific gravity 1.035
The nurse is initiating a bladder-training schedule for a patient. What intervention can be provided for optimal success?
Teach bladder massage to increase intra-abdominal pressure. Give up to 3,000 mL of fluid daily. Encourage the patient to wait 30 minutes after drinking a measured amount of fluid before attempting to void.
The nurse palpates a postpartum woman's fundus 2 hours after birth and finds it located to the right of midline and somewhat soft. What is the correct interpretation of this finding?
The bladder is distended.
A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:
arms
The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate?
cloudy, foul odor
The nurse is aware that the most relevant way in which aging affects the pharmacokinetic process of drug administration is decreased:
function of vital organs.
Place the components to the gastrointestinal tract in descending order, describing the route food would take through the body.
mouth esophagus stomach pyloric region duodenum rectum
A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure?
nephrotoxic injury secondary to use of contrast media
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."
A 3-year-old child is hospitalized. The parents are concerned because the child is now refusing to use the potty and is wetting the bed even though the child has achieved toilet training. Which response by the nurse is most appropriate?
"Your child is experiencing regression as a result of stress."
The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is:
Bladder
A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?
Catheterize the client.
A client is scheduled for urodynamic studies and asks the nurse, "What exactly is this study going to show related to my voiding problems?" Which nursing response(s) is accurate related to bladder function assessment via urodynamic studies?
Characteristics of urine flow during voiding Pressure changes in the intra-abdominal area Muscle activity of the external urinary sphincter
In a client in the uremic state of chronic kidney failure (CKD), the nurse will monitor for which signs and symptoms correlated with uremia?
Encephalopathy Anemia Apathy Nausea
Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications?
Iatrogenic
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
Infection
A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?
Kidney
Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?
The stretch receptors in the bladder wall become hypersensitive.
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?"
A client expresses frustration at the inconvenience of having to collect urine for an entire day and night as part of a prescribed 24-hour urine collection test. The client asks the nurse, "Why is this test necessary since I gave a single urine sample 2 days ago?" How could the nurse best respond to this question?
"Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?
"Very few symptoms are associated with renal cancer."
The nurse is teaching the client how to treat diarrhea and discussing general guidelines. The nurse reminds the client to stop taking the antidiarrheal medication and to call the clinic if fever and abdominal pain become severe, after how many days?
2
The nurse is caring for a critically ill client who requires measurement of hourly urine output. When assessing the urine output of the previous shift, the nurse recognizes that which volume reflects a minimum, normal urinary output?
60 mL/hour
A client is suspected to have chronic kidney disease (CKD). The nurse will use which glomerular filtration rate (GFR) to aid in this diagnosis?
60 mL/min/1.73 m2 or less for 3 months
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results?
A blood urea nitrogen level of 42 mg/dL
A client is transferred to the intensive care unit after evacuation of a subdural hematoma. Which nursing intervention reduces the client's risk of increased intracranial pressure (ICP)?
Administering a stool softener as ordered
A male client who has had outpatient surgery is unable to void while lying supine. Which intervention would be most effective in assisting the client to urinate?
Assist the client to a standing position.
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?
Creatinine level of 6 mg/100 mL
A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:
Decrease
A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?
Diabetes mellitus
The nurse is caring for a client who receives hemodialysis. The nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. Which function best describes this process?
Diffusion
An older adult client informs the nurse that they are experiencing urinary incontinence. The client has no other health problems, and states, "I don't want anybody to know about this problem." How will the nurse promote the client's self-esteem?
Discuss the use of protective undergarments to avoid embarrassment from incontinence.
Which of the following is considered a bulk-forming laxative?
Metamucil
The nurse is caring for a client with a spinal cord injury who has no awareness of the need to void. The nurse should document that the client has which type of incontinence?
Reflex (neurogenic) incontinence
The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse?
The intestines are displaced by the growing fetus.
A 56-year-old woman has been diagnosed with CKD. She first went to the doctor due to complications of hypertension. How are hypertension and CKD related?
The mechanisms that produce hypertension in CKD include an increased vascular volume and increased activity of the renin-angiotensin-aldosterone system.
An older adult resident of a long term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which intervention by the care team is most appropriate to confirm urine retention?
Ultrasound bladder scanning to determine the residual volume of urine after voiding.
A 44-year-old client is being treated for dehydration in an acute care hospital. The nurse determines that the rehydration treatment is working by assessing which values?
Urine output of 1500 mL in 24 hours
During a visit to the pediatrician's office, a parent inquires about toilet training the 2-year-old child. Which toilet training readiness factor should the nurse include in teaching the parent about toilet training?
When your child can recognize bladder fullness.q
The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication?
With food
A client reports that he is often unable to retain urine until he locates a toilet because his mobility is decreased. The nurse should recognize the characteristics of what type of incontinence?
functional
A client is prescribed methadone 10 mg three times a day for neuralgia following chemotherapy treatment. The client reports that he is experiencing constipation and asks the nurse for information about preventing constipation. The nurse recommends
increasing the amount of bran and fresh fruits and vegetables
A client with end-stage renal disease has been on peritoneal dialysis at home. Based on the lab work, the client regulates the type of solution to infuse into the abdomen. When there is a high concentration of potassium inside the cell (hyperkalemia), the solution infused has a lower concentration so that the potassium ions will diffuse outward. At this point, the cellular membrane is said to be:
polarized because of the presence of a negative membrane potential.
A nurse is providing education to an older adult client concerning ways to prevent constipation. Which diet choices would support that the education was successful?
prune juice with breakfast hot tea with meals a turkey sandwich with whole-grain bread
Which clinical finding should a nurse look for in a client with chronic renal failure?
uremia
