Kidney ATI
A nurse is caring for a client 4 hr postoperative following a kidney biopsy. Which of the following interventions should the nurse take? (select all that apply) Monitor for hematuria. Check for flank pain. Monitor for extravasation of tissue surrounding the biopsy site. Encourage ambulation. Administer aspirin PRN for pain.
Monitor for hematuria is correct. Monitoring for hematuria is appropriate following a kidney biopsy to assist in detecting bleeding. Check for flank pain is correct. Checking for flank pain is appropriate following a kidney biopsy to assist in detecting bleeding. Monitor for extravasation of tissue surrounding the biopsy site is incorrect. Extravasation is associated with the infiltration of dye or medication around an IV site and is not indicated following a kidney biopsy. Encourage ambulation is incorrect. The client should be on strict bedrest following a kidney biopsy. Administer aspirin PRN for pain is incorrect. Aspirin is not appropriate following a kidney biopsy due to the increased risk for bleeding.
A nurse in a clinic is assessing a client who has a new diagnosis of interstitial cystitis. The nurse should expect which of the following findings? Negative urine culture Denies urgency Denies pain with urination Fever
Negative urine culture A laboratory finding of a negative urine culture is consistent with a diagnosis of interstitial cystitis since it is a non-infectious process.
A nurse is planning care for a client who is scheduled to have a kidney biopsy. Which of the following information should the nurse include in the plan? (Select all that apply) Obtain a urine specimen prior to the procedure. Obtain written, informed consent. Administer diphenhydramine (Benadryl) prior to the procedure. Maintain NPO status prior to the procedure. Obtain coagulation studies.
Obtain a urine specimen prior to the procedure is correct. A urine specimen should be obtained prior to the procedure to allow for post-procedure comparison. Obtain written, informed consent is correct. Because the procedure is invasive it requires written, informed consent. Administer diphenhydramine (Benadryl) prior to the procedure is incorrect. Benadryl may be prescribed prior to a procedure that uses dye rather than for a kidney biopsy. Maintain NPO status prior to the procedure is correct. Clients are often prescribed NPO status for six to eight hours prior to the procedure. Obtain coagulation studies is correct. Coagulation studies are obtained prior to the procedure to evaluate the risk for bleeding from the biopsy site as a potential complication.
A nurse is providing teaching to a client about measure to prevent urinary tract infections (UTIs). Which of the following client statements indicates a need for further teaching?
"I will need to wipe my perineal area from back to front after urination." Wiping the perineal area from back to front increases the risk for urethral contamination and a resulting UTI.
A nurse is caring for a client who will have blood sampling for a serum creatinine level and asks what this test shows. Which of the following responses should the nurse make? "This test will tell your doctor how your kidneys are functioning." "You'll have to ask your doctor." "This test will tell if you have severe renal impairment or a disease." "We'll find out if any medications, such as steroids, are interfering with your kidney function."
"This test will tell your doctor how your kidneys are functioning." This response is appropriate because it answers the client's question simply rather than avoiding it.
A nurse is assessing a client who is to have IV urography. Which of the following data should indicate to the nurse that this procedure is contraindicated for this client? Presence of a metal rod in her tibia Allergy to shellfish History of claustrophobia Prescribed rosiglitazone
Allergy to shellfish Shellfish contain iodine and an allergy to iodine is a contraindication to this procedure.
A nurse assessing a client note that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence? Stress incontinence Urge incontinence Overflow incontinence Reflex incontinence
Overflow incontinence These findings are associated with overflow incontinence, which occurs when the pressure of urine in an overfull bladder overcomes sphincter control.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider? "I drink at least 2 quarts of fluid every day." "The last time I voided it was painful and red-tinged." "My period ended 2 days ago." "I don't eat shellfish because it gives me hives."
"I don't eat shellfish because it gives me hives." The client says she experiences hives after eating shellfish, which indicates a sensitivity. The contrast dye typically used for an IVP is an iodine derivative, and the client with a shellfish sensitivity may have cross-sensitivity to iodine and a serious iodine allergy. This nurse should report these finding to the client's provider.
A nurse is teaching a client who has a new diagnosis of urge incontinence. Which of the following information should the nurse include in the teaching? (Select all that apply) "Your provider might prescribe anticholinergic medications." "You should limit fluids in the evening." "You should restrict your intake of caffeine." "You might require intermittent urinary catheterization." "You might require an anterior vaginal repair."
"Your provider might prescribe anticholinergic medications" is correct. Anticholinergic medications suppress bladder contractions and increase bladder capacity. "You should limit fluids in the evening" is correct. Limiting fluid intake in the evening prior to bedtime helps prevent an overload of fluid in the bladder during hours of sleep. "You should restrict your intake of caffeine" is correct. The restriction of caffeine is effective in the treatment of urge incontinence because caffeine is a bladder irritant. "You might require intermittent urinary catheterization" is incorrect. Intermittent urinary catheterization is used as a treatment for reflex incontinence. "You might require an anterior vaginal repair" is incorrect. An anterior vaginal repair, or colporrhaphy, is a surgical procedure for the treatment of stress incontinence.
A nurse is caring for a client who reports recurrent flank pain, nausea and vomiting for 24 hrs. Which of the following actions is the nurse's priority? Monitor intake and output. Strain the urine. Administer pain medication. Administer an antiemetic.
Administer pain medication. Using Maslow's hierarchy of needs, the nurse's priority is to meet the client's physiological need for comfort. Therefore, the first action the nurse should take is to administer pain medication to relieve the client's flank pain.
A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse indicates an understanding of the values Potassium levels are increased in clients who have polyuria. Specific gravity is decreased in clients who have hypovolemia. BUN is decreased in clients who have dehydration. Creatinine levels are increased in clients who have acute kidney injury.
Creatinine levels are increased in clients who have acute kidney injury. Increased creatinine levels are associated with renal failure.
A nurse is assessing an older adult client who reports a sudden onset of of urinary incontinence. The nurse should recognize which of the following conditions can cause incontinence in the older adult client? Nephrosclerosis Uremia Diverticulitis Cystitis
Cystitis A sudden onset of urinary incontinence or increased confusion can indicate the presence of a urinary tract infection or bacterial cystitis in the older adult client.
A nurse is providing dietary teaching to a client who has history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching? Drink 3 L of fluid every day. Take 3,000 mg of vitamin C daily. Restrict calcium intake to one serving per day. Eat 12 oz of animal protein daily.
Drink 3 L of fluid every day. The nurse should instruct the client to drink at least 3 to 4 L of fluid every day to dilute the urine and reduce the risk for stone formation.
A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care? Cleanse the perineum from back to front. Obtain a prescription for an indwelling urinary catheter. Encourage fluid intake at and between meals. Offer the client the bedpan every 2 hr.
Encourage fluid intake at and between meals. Increased fluid intake dilutes the urine, reduces stasis, and greatly reduces the urinary bacterial count. Consequently, the risk of nosocomial (hospital-acquired) UTI is reduced, even for a client who has a spinal cord injury.
A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take? Apply cold compress to the client's flank area. Restrict protein intake to 2 servings per day. Discourage ambulation. Encourage intake of at least 3 L of fluids per day.
Encourage intake of at least 3 L of fluids per day. The nurse should encourage the client to consume at least 3,000 mL of fluids per day to dilute the urine, increase hydrostatic pressure behind the stone, and move the calculi down the urinary tract.
A nurse is caring for an older adult client who has a urinary tract infection (UTI). Which of the following manifestations should the nurse identify as a finding specifically associated with this client? Urinary retention Low back pain Incontinence Confusion
Confusion Confusion is a clinical finding of UTIs specifically associated with older adult clients.
A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings? BUN 10 mg/dL and creatinine 0.3 mg/dL BUN 23 mg/dL and creatinine 1.0 mg/dL BUN 8 mg/dL and creatinine 0.7 mg/dL BUN 45 mg/dL and creatinine 8 mg/dLBUN 45 mg/dL and creatinine 8 mg/dL An elevation of both BUN and creatinine is an expected finding of chronic kidney disease.
BUN 45 mg/dL and creatinine 8 mg/dL An elevation of both BUN and creatinine is an expected finding of chronic kidney disease.
A nurse is planning care for a client who has cystitis. Which of the following interventions should Instruct the client to take antibiotics until dysuria is no longer present. Instruct the client to avoid drinking carbonated beverages. Instruct the client to drink 240 mL of tomato juice each day. Instruct the client to drink 1 L of fluid each day.
Instruct the client to avoid drinking carbonated beverages. The nurse should instruct the client to avoid drinking carbonated beverages and caffeine to reduce bladder irritation.
A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as contraindication for this diagnostic test? Elevated creatinine level Flank pain Urinary retention Bleeding tendencies
Bleeding tendencies One of the risks of a kidney biopsy is bleeding from the biopsy site. Therefore, a history of bleeding tendencies or coagulation disorders is a contraindication for a kidney biopsy.
A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions Protein in the urine Dehydration Iron deficiency Obesity
Dehydration Dehydration can cause hypercalcemia which increases the risk for renal stone formation. Inadequate fluid intake can result in urinary stasis and promote the formation of calculi.
A nurse is reviewing the medical record of client who has a urinary tract infection (UTI). Which of the following findings should the nurse recognize as a risk factor? COPD Diabetes mellitus Anemia Osteoporosis
Diabetes mellitus Diabetes mellitus is a risk for factor for a UTI due to the increased amount of glucose present in the urine.
A nurse is teaching a client following a cystoscopy about his new prescription for tamsulosin Which of the following adverse effects should the nurse include in the teaching? Temporary loss of libido. Dizziness. Bradycardia Burning with urination
Dizziness Lightheadedness or dizziness is likely with the first several doses. Clients should be taught to rise slowly and carefully from lying or sitting positions until the sensation disappears.
A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor? Hypocalcemia BMI less than 25 Family history Diuretic use
Family history Family history is strongly correlated with the formation of urolithiasis. A nurse should assess a client who has kidney stones for familial tendencies toward stone formation.
A nurse is planning on teaching a client who is scheduled for an intravenous pyelogram IVP. Which of the following statements should the nurse include in the teaching? "The procedure will be cancelled if the urinalysis indicates the presence of red blood cells." "High frequency sound waves will be used to identify renal system structures." "You will be able to resume your regular diet as soon as the test is complete." "After the procedure you will be encouraged to drink plenty of fluids."
"After the procedure you will be encouraged to drink plenty of fluids." The nurse should encourage fluid intake after the procedure to help promote elimination of the dye used during the procedure.
A nurse is teaching a group of nursing students about pyelonephritis. Which of the following statements should the nurse include in the teaching? "Pyelonephritis increases a pregnant woman's risk for preterm labor." "Pyelonephritis is most often caused by Staphylococcus saprophyticus." "Pyelonephritis is an infection of the lower urinary tract." "Pyelonephritis often causes no symptoms in affected clients."
"Pyelonephritis increases a pregnant woman's risk for preterm labor." Pyelonephritis is a serious complication of pregnancy that can lead to preterm labor.
A nurse is teaching a client who is scheduled for a cystoscopy. Which of the following information should the nurse include in the teaching? "You should limit fluids for 12 hr following the procedure." "You may have pink-tinged urine after this procedure." "You can eat a full liquid meal up to 1 hour before the procedure." "You will be placed on your right side during the procedure."
"You may have pink-tinged urine after this procedure." The client might have blood-tinged, or pink, urine after the procedure. The client should report dark red urine because it is an indication of bleeding.
A nurse is caring for a male client who reports nausea and vomiting and is receiving IV fluid therapy. His blood urea nitrogen (BUN) 32 mg/dL, creatinine 1.1 mg/dL. and hematocrit 50%. Which of the following nursing interventions is appropriate? Collect a urine specimen for culture and sensitivity. Continue routine care because the results are within the expected reference range. Decrease the IV fluid infusion rate and limit oral fluid intake. Evaluate urine for amount and for specific gravity.
Evaluate urine for amount and for specific gravity. These results indicate that the client is dehydrated. Specific gravity and urine output measurements can support the laboratory findings. The higher the specific gravity, the more dehydrated the client.
A nurse is reviewing lab values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function? Serum creatinine Blood urea nitrogen (BUN) Serum sodium Urine-specific gravity
Serum creatinine A renal function disorder reduces the excretion of creatinine, resulting in increased levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal function.
