Med surg ch 36

A patient is scheduled for an intravenous pyelogram (IVP). What care should the nurse provide before the patient has this procedure?

Enema evening before the test

The nurse is helping to prepare a patient for a renal biopsy. In which position should the nurse help the patient assume?

Prone

The nurse is reviewing a patients history and physical report. What term should the nurse recognize is being used to describe waste products building up in the blood?

Uremia

A patient has a glomerular filtration rate of 55%. What should this value indicate to the nurse?

The patients other tests will be in the normal range.

The nurse is collecting data for a patient who has suspected kidney disease. What health problems should the nurse consider as being associated with a high urine specific gravity? (Select all that apply.) a. Nephrosis b. Dehydration c. Heart failure d. Diabetes mellitus e. Diabetes insipidus f. Fluid volume excess

A, B, C, D

The nurse is reviewing the anatomy of the kidney with a patient scheduled for renal surgery. What should the nurse explain as being the structural and functional unit of the kidney?

Nephron

The nurse is to obtain orthostatic blood pressure measurements for a patient on dialysis for end-stage renal disease. What should the nurse do when measuring this patients blood pressure?

Obtain blood pressure while the patient is lying, sitting, and standing.

The nurse needs to obtain a urine specimen from a female patient. What action should the nurse take when obtaining this specimen?

Obtain the first voided urine of the day.

A patient recovering from radiological studies of the renal system has a nursing diagnosis of Impaired Urinary Elimination. Which outcome indicates that the nursing interventions have been effective?

Patient voids 35 mL/hour of clear urine.

The nurse is making a visit to the home of a patient with functional incontinence. Which observation indicates that teaching about the disorder has been effective?

Patient wearing sweatpants

A patients urinalysis results are: white blood cells (WBC) 100+/hpf; red blood cells (RBC) 4/hpf; bacteria, moderate amount; nitrite, positive; specific gravity, 1.025; urine, cloudy. What should the nurse recognize these findings indicate?

Urinary tract infection

The nurse is collecting data for a patient with kidney disease. When reviewing a urinalysis report, which range should the nurse recognize as normal specific gravity of urine?

1.002 to 1.035

The nurse determines that a patients urine output is normal. How many mL of urine did the patient void within the last 24 hours?

1000 to 2000ml

A patient is being evaluated for renal dialysis. What creatinine clearance value should the nurse realize this patient must have to live without needing dialysis treatments?

10Ml

The nurse is instructing a patient on the use of Kegel exercises. How many times a day should the nurse recommend that these exercises be performed?

30-80

The nurse is catheterizing a patient after voiding to determine the amount of residual urine in the bladder. What should the nurse consider as being the normal amount of urine within the bladder after urination?

50ml

The nurse is reviewing a urinalysis report. What should the nurse recognize as the normal average pH of urine?

6

The nurse is caring for a patient with an indwelling catheter. What should the nurse include in this patients routine care? (Select all that apply.) a. Encourage fluid intake. b. Maintain a closed system. c. Secure the catheter to the patients leg. d. Clamp the catheter for 1 hour each shift. e. Remove the catheter as soon as possible. F. Use sterile technique when emptying the drainage bag.

A, B, C, E

The nurse is participating in care planning for a patient with urge incontinence. What should the nurse recommend be included in this patients plan of care? (Select all that apply.) a. Void every 2 hours. b. Practice relaxation breathing. c. Use urge inhibition techniques. d. Reduce fluid intake for several hours before sleep. e. Gradually increase length of time between voidings.

A, B, C, E

The nurse is caring for a patient with an elevated uric acid level. Which health problems should the nurse consider as potentially causing this patients elevation? (Select all that apply.) a. Leukemia b. Steroid use c. Malnutrition d. Kidney disease e. Use of thiazide diuretics f. Gastrointestinal bleeding

A, C, D, E

The nurse learns that a patient has a urine pH of 7.9. What question should the nurse ask the patient after learning of this laboratory value?

Are you a vegetarian

The nurse is reviewing normal kidney function with a patient experiencing an acute kidney injury. Which hormones should the nurse include that affect kidney function? (Select all that apply.) a. Estrogen b. Aldosterone c. Parathyroid hormone d. Antidiuretic hormone (ADH) e. Atrial natriuretic hormone (ANH) f. Thyroid-stimulating hormone (TSH)

B, C, D, E

The nurse is caring for a patient with an indwelling urinary catheter. Which instructions should the nurse provide to help prevent development of a urinary tract infection? (Select all that apply.) a. Limit fluid intake to decrease the flow of urine. b. Position the tubing to allow free flow of the urine. c. Use aseptic technique when emptying the drainage bag. d. Wash the perineum with an antibacterial soap every 8 hours. e. Keep the catheter securely taped to prevent catheter movement. f. Empty the urinary bag every 4 hours to prevent stagnation of urine.

B, C, E

The nurse is collecting data for a patient with kidney disease. Which information should the nurse identify as being normal urinalysis findings? (Select all that apply.) a. pH 3.5 b. Amber color c. Small amount of nitrite d. Red blood cells of 8/hpf e. Specific gravity of 1.010 f. Small quantities of enzymes

B, E, F

The nurse is caring for a patient recovering from a renal biopsy. For which complication should the nurse monitor the patient during the 24 hours after the procedure?

Bleeding

The nurse is contributes to the plan of care for an older patient. What should the nurse recognize as normal signs of aging within the renal system? (Select all that apply.) a. Bladder size increases b. Urethral changes position c. Number of nephrons decreases d. Detrusor muscle tone decreases e. Glomerular filtration rate increases

C, D

A patient is recovering from a renal arteriogram. What actions should the nurse take when caring for this patient? (Select all that apply.) a. Check vital signs twice daily. b. Raise the head of the bed to 90 degrees. c. Check distal pulses in leg every 30 to 60 minutes. d. Encourage the patient to ambulate as soon as possible. e. A pressure dressing and sandbag used to apply pressure. f. Implement bedrest for 12 hours, and instruct the patient not to bend leg.

C, E, F

The nurse is reviewing data for a patient with acute kidney injury. Which diagnostic test results should the nurse recognize that indicate kidney injury? (Select all that apply.) a. Hematocrit 20% b. Uric acid 8 ng/dL c. Serum creatinine 4.2 mg/dL d. Blood urea nitrogen 40 mg/100 mL e. Urine output of 100 mL in 24 hours f. Fixed urine specific gravity of 1.010

C, E, F

The nurse is reviewing the results of a patients urinalysis. Which components should the nurse identify as being abnormal in urine? (Select all that apply.) a. Urea b. Water c. Protein d. Ammonia e. Hormones f. Red blood cells

C, F

The nurse is caring for a patient with an acidbase imbalance from kidney disease. How should the nurse explain the role of the kidneys to maintain acidbase balance in the body to the patient?

Conserving or excreting bicarbonate ions

The nurse is collecting data from a patient with kidney disease. Which adventitious lung sound should the nurse recognize as being caused by fluid overload?

Crackles

The nurse reviews the process to obtain a midstream urine specimen for culture and sensitivity with a female patient. Which patient statements indicate understanding of this process? (Select all that apply.) a. A 24-hour urine specimen is needed. b. A second-voided specimen is preferred. c. I should wash from the back to the front. d. The labia should be kept separated while voiding. e. When urine starts to flow, collect it in the clean container provided. f. The genitalia should be thoroughly cleaned with the towelettes provided.

D, F

The nurse contributes to the plan of care for a patient with edema. Which action should the nurse take as the best indicator of this patients fluid volume status?

Daily weight

The nurse is caring for a male patient with functional incontinence. What action should the nurse take to help prevent incontinence?

Ensure that the patient has ready access to the urinal.

The nurse is caring for a patient with a kidney infection. When providing prescribed medications, the nurse should recall that which structure is the capillary network in each nephron?

Glomerulus

The nurse is caring for a patient who is scheduled for a cystoscopy (C&P) with basket extraction of a stone. What is the most important postoperative care for the nurse to provide?

Measuring urine output

The nurse is collecting data from a patient with stress incontinence. Which finding should the nurse document?

The nurse is collecting data from a patient with stress incontinence. Which finding should the nurse document?

A patient with pneumonia has a blood urea nitrogen (BUN) of 32 mg/dL and creatinine of 0.8 mg/dL. What should the nurse realize is the most probable explanation for this finding?

The patient is dehydrated.

The nurse is caring for a patient with kidney disease. How should the nurse end a 24-hour urine test at the end of the 24 hours?

The patient voids at the end of 24 hours, adding it to the collection container.

During an assessment, the nurse notes that a patient has crystals deposited on the skin. What should this finding indicate to the nurse?

Uremic frost

A female patient is embarrassed because of not being able to walk to the bathroom in time before become incontinent of urine. Which type of incontinence should the nurse plan care for this patient?

Urge