Med Surg test 3 (CH 47, 48, 49, 55, 56, 57)

A nurse is caring for a client who has burn injuries to his trunk. The nurse is explaining what to expect from the prescribed hydrotherapy. Which of the following statements by the client indicates an understanding of the teaching? "I will be on a special shower table." "The water temperature will be very cool to ease my pain." "The nurse will use a firm-bristled brush to remove loose skin." "The nurse will use scissors to open small blisters."

"I will be on a special shower table." The special shower table facilitates examination and debridement of the wound during hydrotherapy. An advantage of using the showering technique as opposed to a tub bath is that the water can be kept at a constant temperature and there is a lower risk of wound infection.

A nurse is caring for an adolescent client who has burn wounds on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image? "May I go with my family to the visitor's lounge?" "I'll see my friends when I get home." "My dad is coming to visit. Can you fix my hair for me?" "I told my cousins I'm in protective isolation."

"May I go with my family to the visitor's lounge?" This statement demonstrates a positive self-image. The client is asking to visit with her family in a public setting.

A nurse is providing teaching to a client who is wheelchair-bound and his caregiver about ways to reduce the risk of pressure ulcer formation. Which of the following instructions should the nurse include? "Move between the bed and the wheelchair once every 2 hours." "Make sure that your caregiver massages your skin daily." "Use a rubber ring when sitting at the bedside." "Shift your weight in the wheelchair every 15 minutes."

"Shift your weight in the wheelchair every 15 minutes." This response addresses the safety issue of pressure ulcer risk. Pressure ulcers are most likely to develop if the client does not shift position frequently to relieve pressure.

What is the normal creatinine serum level?

0.6-1.2 0.5-11.1

What is the normal range for specific gravity?

1.005-1.030

What is the normal BUN level?

10-20

A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply.) A. Anuria B. Marked azotemia C. Crackles in the lungs D. Increased calcium level E. Proteinuria

A, B, C, E -Anuria is a manifestation of end-stage kidney disease. -Marked azotemia is elevated BUN and serum creatinine, is a manifestation of end-stage kidney disease. -Crackles in the lungs can indicate the client has pulmonary edema, caused from hypervolemia due to end-stage kidney disease. -Proteinuria is a manifestation of end-stage kidney disease. DECREASED Calcium

Which description characterizes acute kidney injury? SATA A. Primary cause of death is infection B. It almost always affects older people C. Disease course is potentially reversible D. Most common cause is diabetic nephropathy E. Cardiovascular disease is the most common cause of death

A, C

A nurse is planning care for a client who has chronic pyelonephritis. Which of the following action should the nurse take? A. Provide a referral for nutrition counseling B. Encourage daily fluid of 1L C. Palpate the costovertebral angle D. Monitor urinary output E. Administer antibiotics

A, C, D, E

A nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect? (Select all that apply.) A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated serum creatinine E. Elevated serum calcium

A. A manifestation of prerenal AKI is an elevated BUN caused by the retention of nitrogenous wastes in the blood. B. Elevated cardiac enzymes is a manifestation of cardiac tissue injury, not AKI. C. CORRECT: A manifestation of prerenal AKI is reduced urine output. D. CORRECT: A manifestation of prerenal AKI is elevated serum creatinine. E. CORRECT: A manifestation of prerenal AKI is reduced calcium level.

A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication. B. Monitor for hypertension. C. Assess level of consciousness. D. Increase the dialysis exchange rate.

A. An altered level of consciousness is a manifestation of disequilibrium syndrome. The nurse should not administer an opioid medication. The provider may prescribe medication to decrease seizure activity. B. The nurse should monitor for hypotension due to rapid change in fluids and electrolytes causing disequilibrium syndrome. C. CORRECT: The nurse should assess the client's level of consciousness. A change in urea levels can cause increased intracranial pressure. Subsequently, the client's level of consciousness decreases. D. The nurse should decrease the dialysis exchange rate to slow the rapid changes in fluid and electrolyte status when a client develops disequilibrium syndrome.

A nurse in a provider's office is assessing a client who has a severe sunburn. Which of the following classifications should the nurse use to document this burn? A. Superficial thickness B. Superficial partial thickness C. Deep partial thickness D. Full thickness

A. CORRECT: A sunburn is a superficial thickness burn. Superficial burns damage the top layer of the skin. B. A superficial partial‐thickness burn results from flames or scalds. This damages the entire epidermis layer of the skin. C. A deep partial‐thickness burn can result from contact with hot grease. This affects the deep layers of the skin. D. A full‐thickness burn can result from contact with hot tar. This affects the dermis and sometimes the subcutaneous fat layer.

A nurse is providing information about a new prescription for corticosteroid cream to a client who has mild psoriasis. Which of the following should the nurse include in the information? (Select all that apply.) A. Apply an occlusive dressing after application. B. Apply three to four times per day. C. Wear gloves after application to lesions on the hands. D. Avoid applying in skin folds. E. Use medication continuously over a period of several months.

A. CORRECT: An occlusive dressing can enhance the efficacy of the topical corticosteroid on the exposed lesions. B. INCORRECT: Corticosteroid cream is applied twice daily to prevent development of local and systemic adverse effects. C. CORRECT: Gloves worn after the medication can enhance the efficacy of the topical corticosteroid on the exposed lesions of the hands. D. CORRECT: Corticosteroid cream applied to lesions in skin folds increases the risk of yeast infections. E. INCORRECT: Corticosteroid cream used continuously can increase the risk for development of local and systemic adverse effects.

A nurse is preparing to initiate hemodialysis for a client who has acute kidney injury. Which of the following actions should the nurse take? (Select all that apply.) A. Review the medications the client currently takes. B. Assess the AV fistula for a bruit. C. Calculate the client's hourly urine output. D. Measure the client's weight. E. Check serum electrolytes. F. Use the access site area for venipuncture.

A. CORRECT: By reviewing the medications the client currently takes, the nurse can determine which medications to withhold until after dialysis. B. CORRECT: Assessing the AV fistula for a bruit determines the patency of the fistula for dialysis. C. The client's hourly urine output can vary with the remaining kidney function and does not determine the need for dialysis. D. CORRECT: Measuring the client's weight before dialysis is essential for comparing it with the client's weight after dialysis. E. CORRECT: Checking the serum electrolytes determines the need for dialysis. F. The nurse should never use the access site area for venipuncture because compression from the tourniquet can cause loss of the vascular access.

A nurse has a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? (Select all that apply.) A. Identify an allergy to seafood. B. Withhold metformin for 24 hr. C. Administer an enema. D. Obtain a serum coagulation profile. E. Assess for asthma.

A. CORRECT: Clients who have an allergy to seafood are at higher risk for an allergic reaction to the contrast dye they will receive during the procedure. B. CORRECT: Clients who take metformin are at risk for lactic acidosis from the contrast dye with iodine they will receive during the procedure. C. CORRECT: Clients should receive an enema to remove fecal contents, fluid, and gas from the colon for a more clear visualization. D. A serum coagulation profile is essential for a client prior to a kidney biopsy because of the risk of hemorrhage from the procedure. E. CORRECT: Clients who have asthma have a higher risk of an exacerbation as an allergic response to the contrast dye they will receive during the procedure.

A nurse is assessing a client who sustained deep partial‐thickness and full‐thickness burns over 40% of his body 24 hr ago. Which of the following are findings should the nurse expect? (Select all that apply.) A. Dyspnea B. Bradycardia C. Hyperkalemia D. Hyponatremia E. Decreased hematocrit

A. CORRECT: Dyspnea can occur during the initial phase following a burn due to airway injury and uid shifts. B. Tachycardia occurs during the initial phase following a burn due to sympathetic nervous system compensation. C. CORRECT: Hyperkalemia occurs during the initial phase following a burn as a result of leakage of uid from the intracellular space. D. CORRECT: Hyponatremia occurs during the initial phase of a burn as a result in sodium retention in the interstitial space. E. Hct increases during the initial phase of a burn due to hemoconcentration.

A nurse is assessing a client who has seborrheic keratosis on the forehead and nose. Which of the following manifestations should the nurse expect to find? (Select all that apply.) A. Waxy appearance of the lesions B. Black, rough lesions C. Pruritus of the lesions D. Purplish skin stain around the lesion E. Wartlike surface of the lesions

A. CORRECT: Seborrheic keratosis lesions appear waxy in texture. B. CORRECT: Seborrheic keratoses are tan, brown, or black lesions that are rough and become irritated due to friction. C. INCORRECT: Seborrheic keratoses may become irritated from friction but are not pruritic lesions. D. INCORRECT: Seborrheic keratosis does not cause a purplish skin stain around the lesion. E. CORRECT: A wartlike surface of the lesions is common for seborrheic keratosis, and the lesions are removed for cosmetic reasons.

A nurse is providing discharge instructions to a client who had a skin biopsy with sutures. Which of the following client statements indicates a need for further teaching? A. "I can expect redness around the site for 3 days." B. "I will call my doctor if I have a fever." C. "I should apply an antibiotic ointment to the area." D. "I will make a return appointment in 7 days for removal of my sutures."

A. CORRECT: The client should report redness, pain, drainage, or warmth at the biopsy site to the provider. B. INCORRECT: A fever is an indication of an infection, and the provider should be notified. C. INCORRECT: Antibiotic ointment is applied as prescribed by the provider to prevent infection. D. INCORRECT: Removal of the sutures following a biopsy is done 7 to 10 days postprocedure.

A nurse is instructing a client on home care after a culture for a bacterial infection and cellulitis. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Bathe with antibacterial soap. B. Apply antibacterial topical medication to the crusted exudate. C. Apply warm compresses to the affected area. D. Cover affected area with snug fitting clothing. E. Allow lesions to dry before applying topical medication.

A. CORRECT: The client should use antibacterial soap to reduce the bacteria count on the skin. B. INCORRECT: The client should apply topical medication directly to the moist lesion bed. The medication will not penetrate the crusted exudate. C. CORRECT: The client should apply warm compresses to the affected area to promote comfort. D. INCORRECT: The client should wear loose-fitting clothes to avoid irritating the lesion. E. CORRECT: The client should dry the area well before applying a topical medication to allow for spreading the medication more effectively.

A nurse is planning care for a client who has Stage 4 chronic kidney disease. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Assess for jugular vein distention. B. Provide frequent mouth rinses. C. Auscultate for a pleural friction rub. D. Provide a high‐sodium diet. E. Monitor for dysrhythmias.

A. CORRECT: The nurse should assess for jugular vein distention, which can indicate fluid overload and heart failure. B. CORRECT: The nurse should provide frequent mouth rinses due to uremic halitosis caused by urea waste in the blood. C. CORRECT: The nurse should auscultate for a pleural friction rub related to respiratory failure and pulmonary edema caused by acid base imbalances and fluid retention. D. The nurse should monitor serum sodium and reduce the client's dietary sodium intake. E. CORRECT: The nurse should monitor for dysrhythmias related to increased serum potassium caused by Stage 4 chronic kidney disease.

A nurse is planning postprocedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Check BUN and serum creatinine. B. Administer medications the nurse withheld prior to dialysis. C. Observe for signs of hypovolemia. D. Assess the access site for bleeding. E. Evaluate blood pressure on the arm with AV access.

A. CORRECT: The nurse should check the BUN and serum creatinine to determine the presence and degree of uremia or waste products that remain following dialysis. B. CORRECT: The nurse should withhold medications the treatment can partially dialyze. After the treatment, the nurse should administer the medications. C. CORRECT: A client who is post‐dialysis is at risk for hypovolemia due to a rapid decease in fluid volume. D. CORRECT: The nurse should assess the access site for bleeding because the client receives heparin during the procedure to prevent clotting of blood. E. The nurse should never measure blood pressure on the extremity that has the AV access site because it can cause collapse of the AV fistula or graft.

A nurse is planning care for an adult client who sustained severe burn injuries. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Limit visitors in the client's room. B. Encourage fresh vegetables in the diet. C. Increase protein intake. D. Instruct the client to consume 2,000 calories/day. E. Restrict fresh flowers in the room.

A. CORRECT: The nurse should limit the number of visitors and limit the amount of time they can visit to decrease the risk of infection. B. The client should restrict consumption of fresh vegetables due to the presence of bacteria on the surface and the increased risk for infection. C. CORRECT: The client should increase protein consumption, which promotes wound healing and prevents tissue breakdown. D. The client should consume up to 5,000 calories/day because caloric needs double or triple beginning 4 to 12 days following the burn. E. CORRECT: Flowers should not be in the client's room due to the bacteria they carry, which increase the risk for infection.

A nurse is planning care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor serum glucose levels. B. Report cloudy dialysate return. C. Warm the dialysate in a microwave oven. D. Assess for shortness of breath. E. Check the access site dressing for wetness. F. Maintain medical asepsis when accessing the catheter insertion site.

A. CORRECT: The nurse should monitor serum glucose levels because the dialysate solution contains glucose. B. CORRECT: The nurse should monitor for cloudy dialysate return, which indicates an infection. Clear, light‐yellow solution is typical during the out flow process. C. The nurse should avoid warming the dialysate in a microwave oven, which causes uneven heating of the solution. D. CORRECT: The nurse should assess for shortness of breath, which can indicate inability to tolerate a large volume of dialysate. E. CORRECT: The nurse should check the access site dressing for wetness and look for kinking, pulling, clamping, or twisting of the tubing, which can increase the risk for exit‐site infections. F. The nurse should maintain surgical, not medical, asepsis when accessing the catheter insertion site to prevent infection from contamination.

A nurse is planning care for a client who has postrenal AKI due to metastatic cancer. The client has a serum creatinine of 5 mg/dL. Which of the following interventions should the nurse include in the plan? (Select all that apply.) A. Provide a high‐protein diet. B. Assess the urine for blood. C. Monitor for intermittent anuria. D. Weight the client once per week. E. Provide NSAIDs for pain.

A. CORRECT: The nurse should provide a high‐protein diet due to the high rate of protein breakdown that occurs with acute kidney injury. B. CORRECT: The nurse should assess urine for blood, stones, and particles indicating an obstruction of the urinary structures that leave the kidney. C. CORRECT: The nurse should assess for intermittent anuria due to obstruction or damage to kidneys or urinary structures. D. The nurse should weigh the client daily to monitor for fluid retention due to acute kidney injury. E. The nurse should not administer NSAIDs, which are toxic to the nephrons in the kidney.

A nurse administered captopril to a client during a renal scan. Which of the following actions should the nurse take? A. Assess for hypertension. B. Limit the client's fluid intake. C. Monitor for orthostatic hypotension. D. Encourage early ambulation

A. Captopril is an antihypertensive medication. Assess the client for hypotensive effects. B. Increasing the client's fluid intake can help resolve hypotensive effects following the administration of captopril. C. CORRECT: The nurse should monitor for orthostatic hypotension because this is an adverse effect of captopril. This results in a change in blood flow to the kidneys after the initial dose. D. The client is at risk for falls when ambulating due to the hypotensive effects of captopril. The nurse should encourage the client to remain in bed.

A nurse is teaching a client who will have an x‑ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching? A. "you will receive contrast dye during the procedure." B. "An enema is necessary before the procedure." C. "you will need to lie in a prone position during the procedure." D. "The procedure determines whether you have a kidney stone."

A. Clients do not receive any contrast dye for this procedure, as they would for excretory urography. B. Clients do not receive an enema before this procedure, because it does not affect the gastrointestinal system. C. The client will lie supine, not prone. D. CORRECT: The nurse should explain to the client that a KUB can identify renal calculi, strictures, calcium deposits, and obstructions of the urinary system.

A nurse is collecting data from a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider? a. Cloudy, yellow drainage b. WBC 6,000 c. Potassium 4.0 mEq/L d. Report of abdominal fullness

A. Cloudy, yellow drainage Cloudy, yellow drainage is an early manifestation of peritonitis and the nurse should report this finding to the provider. Other manifestations include fever and abdominal tenderness.

A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following findings should the nurse report to the provider? a. Decreased urine output b. Report of burning upon urination c. Pink-tinged urine d. Stress incontinence

A. Decreased urine output A decreased urine output after a TURP indicates obstruction to urine flow by a clot or residual prostatic tissue and should be reported to the provider.

A nurse is caring for a client who has sustained burns over 35% of his total body surface area. Of this total, 20% are full‐thickness burns on the arms, face, neck, and shoulders. The client's voice has become hoarse. He has a brassy cough and is drooling. The nurse should identify these findings as indications that the client has which of the following? A. Pulmonary edema B. Bacterial pneumonia C. Inhalation injury D. Carbon monoxide poisoning

A. Difficulty breathing and production of pink frothy sputum indicate pulmonary edema. B. Productive cough and a fever are indicative of a bacterial infection. C. CORRECT: Wheezing and hoarseness indicate inhalation injury with impending loss of the airway. These require immediate reporting to the provider. D. Confusion and headaches indicate carbon monoxide poisoning.

A nurse is teaching a group of young adult clients about health promotion techniques to reduce the risk of skin cancer. Which of the following instructions should the nurse include? Apply a broad-spectrum sunscreen 5 min before sun exposure. Wear a sun visor instead of a hat when outside in the sun. Avoid exposure to the midday sun. Use a tanning booth instead of sunbathing outdoors.

Avoid exposure to the midday sun. The nurse should instruct clients to avoid skin exposure to the sun, especially during the midday hours of 1000 to 1600 because sun rays are the strongest at that time.

A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching? A. Hemodialysis restores kidney function. B. Hemodialysis replaces hormonal function of the renal system. C. Hemodialysis allows an unrestricted diet. D. Hemodialysis returns a balance to serum electrolytes.

A. Hemodialysis does not restore kidney function, but it sustains the life of a client who has kidney disease. B. Hemodialysis does not replace hormonal function of the renal system due to tissue damage causing dysfunction of the renin‐angiotensin‐aldosterone system. C. Hemodialysis does not allow an unrestricted diet. It requires a diet high in folate and more protein than predialysis restrictions allowed, and low in sodium, potassium, and phosphorus. D. CORRECT: The nurse should explain to the client that hemodialysis restores electrolyte balance by removing excess sodium, potassium, fluids, and waste products, and also restores acid‐base balance.

A nurse in a clinic is preparing to obtain a skin specimen from a client who has a suspected herpes infection. Which of the following actions should the nurse take? (Select all that apply.) A. Scrape the site with a wooden tongue depressor. B. Puncture the crusted area with a sterile needle. C. Swab the crusted area with a sterile cotton-tipped applicator. D. Place cotton-tipped applicator in culturette tube. E. Place culturette tube in ice.

A. INCORRECT: A wooden tongue depressor is used to scrape cells of a skin lesion to test for a fungus. B. CORRECT: Exudate under the crusted area should be collected. The crust or scab should be punctured or lifted to obtain a reliable specimen. C. INCORRECT: Swab the moist lesion bed under the crust with a sterile cotton-tipped applicator to obtain a reliable specimen. D. CORRECT: The cotton-tipped applicator is placed in liquid fixative within the culturette tube. E. CORRECT: The culturette tube is immediately placed in ice when obtaining a viral specimen.

A nurse is educating a female client on the use of calcipotriene (Dovonex) topical medication for the treatment of psoriasis. Which of the following information should the nurse include? (Select all that apply.) A. Recommended for facial lesions. B. Expect a stinging sensation upon application. C. Apply to the scalp. D. Obtain a pregnancy test. E. Limit application to skin folds.

A. INCORRECT: Applying calcipotriene to the face is not recommended because it may cause facial dermatitis. B. CORRECT: Calcipotriene causes stinging and burning sensations when applied to the lesions. C. CORRECT: Calcipotriene solution is applied to scalp lesions. D. CORRECT: Calcipotriene can cause birth defects. Female clients should obtain a pregnancy test before using the medication. E. CORRECT: Applying calcipotriene to skin folds can cause a possible local reaction of itching, irritation, and erythema.

A nurse is providing teaching to a client about a new prescription for clotrimazole (Lotrimin). Which of the following should the nurse include in the teaching? A. "It reduces the discomfort of a herpetic infection." B. "This is a cream to treat a bacterial infection." C. "Apply the topical medication for up to 2 weeks." D. "Allow the area to remain moist before applying."

A. INCORRECT: Clotrimazole is not an antiviral medication to treat a herpetic infection. It is used to treat a fungal infection. B. INCORRECT: Clotrimazole is not an antibacterial medication. It is used to treat a fungal infection. C. CORRECT: Clotrimazole is a medication used to treat a fungal infection and is applied for 1 to 2 weeks after the infection is resolved. D. INCORRECT: Clotrimazole is an antifungal medication and should be applied to a clean, dry surface.

A nurse is caring for a client who has a suspected viral skin lesion. Which of the following laboratory findings should the nurse anticipate reviewing to confirm this diagnosis? A. Potassium hydroxide (KOH) B. Culture and sensitivity C. Tzanck smear report D. Biopsy

A. INCORRECT: Findings of a potassium hydroxide (KOH) test reveal if skin lesions are fungal in origin. B. INCORRECT: Findings of a skin culture and sensitivity test reveal if lesions are bacterial or fungal and indicate antimicrobial medication to be used in treatment. C. CORRECT: A Tzanck smear report confirms if a skin lesion is viral in origin. D. INCORRECT: Findings of a biopsy report confirm or rule out if a lesion is malignant

A nurse is teaching a client who has a history of psoriasis about photochemotherapy and ultraviolet light (PUVA) treatments. Which of the following should the nurse include in the teaching? A. Apply coal tar before each treatment. B. Administer a psoralen medication before the treatment. C. Use this treatment every evening. D. Remove the scales gently following each treatment.

A. INCORRECT: PUVA treatment does not involve the use of coal tar. B. CORRECT: PUVA treatment involves the administration of a medication, such as a psoralen, to enhance photosensitivity. C. INCORRECT: PUVA treatments are completed two to three times each week and not on consecutive days. D. INCORRECT: Removal of scales may cause bleeding and is not recommended when treating psoriasis.

A nurse is providing teaching to a client who has a prescription for methotrexate (Trexall) for severe psoriasis. Which of the following information should the nurse include? A. Drink a glass of wine daily. B. Monitor for evidence of infection. C. Monitor kidney function tests regularly. D. Expect increased bruising.

A. INCORRECT: The client should not drink alcohol when taking methotrexate because the medication can cause liver damage. B. CORRECT: The client should monitor for fever and sore throat, which are signs of infection. Methotrexate can cause blood dyscrasias such as leukopenia. C. INCORRECT: The client should have liver function levels monitored frequently because the medication can cause liver damage. D. INCORRECT: The client should report increased bruising because methotrexate can cause blood dyscrasias such as thrombocytopenia.

A nurse is reinforcing teaching about collecting a 24-hour urine specimen for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse include a. Place signs in the bathroom as a reminder about the test in progress b. Discard the last voided specimen at the end of the collection period. c. Instruct the client to increase exercise during 24-hour period. d. Include the first voided specimen at the start of the collection period.

A. Place signs in the bathroom as a reminder about the test in progress The nurse should place signs in the bathroom and alert family members of the test in progress so that everyone saves the specimens appropriately throughout the test.

A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrites. Which of the following actions should the nurse take? A. Repeat the test early the next morning. B. Start a 24‑hr urine collection for creatinine clearance. C. Obtain a clean‑catch urine specimen for culture and sensitivity. D. Insert an indwelling catheter urinary catheter to collect a urine specimen.

A. Repeating the test early the next morning will not change the urinalysis results. B. A 24‑hr urine collection for creatinine helps to determine kidney function. C. CORRECT: The nurse should obtain a clean‑catch urine specimen for culture and sensitivity. This test will identify which antibiotic will be most effective for treating the client's urinary tract infection. D. The nurse should insert a urinary catheter to collect urine when a client cannot empty his bladder.

A nurse is collecting a.data from a client who is postoperative following extracorporeal shockwave lithotripsy (ESWL). The nurse should identify that which of the following findings is the priority? a. Report of Palpitations b. bruising on the flank area c. stone fragments in the urine d. pink-tinged urine

A. Report of Palpitations The nurse should apply the ABC priority-setting framework. This framework emphasizes the basic core of human functioning - having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these can indicate a threat to life, and is the nurse's priority concern. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second-highest priority in the ABC priority-setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third-highest priority in the ABC priority-setting framework because delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. ESWL is the application of sound, laser, or dry shock wave energies to break a kidney stone into small pieces. The shock waves are initiated during the R wave of the ECG to prevent dysrhythmias. When using the airway, breathing, circulation approach to client care, the nurse should determine report of palpitations is a manifestation of dysrhythmias and is the priority finding

A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A. Infection B. Hemorrhage C. Hematuria D. Pain

A. The client is at risk for infection of the kidney because a biopsy is an invasive procedure. However, another complication is the priority. B. CORRECT: The greatest risk to the client following a kidney biopsy is hemorrhage due to a lack of clotting at the puncture site. The nurse should report this finding to the provider immediately. C. The client is at risk for hematuria, which is a common complication the first 48 to 72 hr after the biopsy. However, another complication is the priority. D. The client is at risk for pain after a kidney biopsy because blood in and around the kidney causes pressure on the nerves in the area; however, another complication is the priority.

A nurse is reviewing client laboratory data. The nurse should recognize that which of the following findings is expected for a client who has Stage 4 chronic kidney disease? A. Blood urea nitrogen (BUN) 15 mg/dL B. Glomerular ltration rate (GFR) 20 mL/min C. Serum creatinine 1.1 mg/dL D. Serum potassium 5.0 mEq/L

A. The nurse should expect the BUN to be above the expected reference range, about 10 to 20 times the BUN finding. B. CORRECT: The GFR is severely decreased to approximately 20 mL/min, which is indicative of stage 4 chronic kidney disease. C. In stage 4 chronic kidney disease, a creatinine level can be as high as 15 to 30 mg/dL. D. A client in stage 4 chronic kidney disease would have a potassium level greater than 5.0 mEq/L.

A nurse is preparing to administer fentanyl to a client who sustained deep partial‐thickness and full‐thickness burns over 60% of his body 24 hr ago. The nurse should plan to use which of the following routes to administer the medication? A. Subcutaneous B. Oral C. Intravenous D. Transdermal

A. The nurse should not give subcutaneous injections due to the difficulty of absorption from tissue during the resuscitation phase. B. The nurse should not give oral (including buccal, sublingual) medications due to decreased motility in the gastrointestinal tract during the resuscitation phase. C. CORRECT: The nurse should use the IV route to administer pain medication for rapid absorption and fast pain relief during the resuscitation phase. D. The nurse should not use the transdermal route of administration due to delays in absorption during the resuscitation phase.

A nurse is planning care for a client who has prerenal acute kidney injury (AKI) following abdominal aortic aneurysm repair. Urinary output is 60 mL in the past 2 hr, and blood pressure is 92/58 mm Hg. The nurse should anticipate which of the following interventions? A. Prepare the client for a CT scan with contrast dye. B. Plan to administer nitroprusside. C. Prepare to administer a fluid challenge. D. Plan to position the client in Trendelenburg.

A. The nurse should not plan for a CT scan. Contrast dye is contraindicated for a client who has possible acute kidney injury. B. Nitroprusside is a rapid‐acting vasodilator used to rapidly reduce blood pressure for clients who have hypertensive crisis. It is contraindicated for clients who have hypotension. C. CORRECT: The nurse should plan to administer a fluid challenge for hypovolemia, which is indicated by the client's low urinary output and blood pressure. D. The nurse should position the client in reverse Trendelenburg, with the head down and feet up, to treat hypotension.

A nurse in a provider's office is caring for a client who has a new diagnosis of herpes zoster. The nurse should anticipate a prescription for which of the following medications? Zoster vaccine Acyclovir Amoxicillin Infliximab

Acyclovir The nurse should anticipate a prescription for acyclovir, an antiviral medication, because it inhibits replication of the virus that causes herpes zoster.

A nurse is completing the admission assessment of a client who has renal calculi. Which of the following is an expected finding? A. Bradycardia B. Diaphoresis C. Nocturia D. Bradypnea

B. Diaphoresis is a clinical manifestation associated with a client who has a kidney stone.

A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make? a.Instruct the client to restrict movement of his left arm b.Avoid taking blood pressures on the client's left arm c. Check the fistula daily for a vibration d. Instruct the client to sleep on his left side.

B. Avoid Taking blood pressure's on the client's left arm. The nurse should avoid taking blood pressure measurements on the client's left arm, which can decrease blood flow and cause clotting.

A nurse is reinforcing teaching with a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statements indicates an understanding of the information. a. I will expect my urine to be cloudy after having this procedure b. I will feel the urge to urinate following this procedure. c. I will not need to have a urinary catheter following this procedure. d. At least I won't have leakage of urine after having this procedure.

B. I will feel the urge to urinate following this procedure. After a TURP, the client will feel the urge to urinate. The nurse should reassure him that he will receive analgesics to help relieve this discomfort.

A nurse is completing the admission assessment of a client who has renal calculi. Which of the following findings should the nurse expect? a. bradycardia b. diaphoresis c. nocturia d. bradypnea

B. diaphoresis

The nurse teaches the patient that has recurrent UTI's that she should : A. take baths with bubble baths B. urinate before and after sexual intercourse C. take prophylactic sulfonamides for the rest of her life D. restrict fluid intake to avoid the need for frequent voiding

B. urinate before and after sexual intercourse

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the dialysate output is less than the input, and the client's abdomen is distended. Which of the following actions should the nurse take? A.Administer pain medication to the client B.Change the client's position C. Place the drainage bag above the client's abdomen. D. Insert an indwelling urinary catheter.

B.Change the client's position The client is retaining the dialysate solution after the dwell time. The nurse should ensure that the clamp is open and the tubing is not kinked, and reposition the client to facilitate the drainage of the solution from the peritoneal cavity.

A nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect? (Select all that apply.) A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated serum creatinine E. Elevated serum calcium

C, D A manifestation of prerenal AKI is reduced urine output. A manifestation of prerenalAKI is elevated serum creatinine.

A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following assessment findings requires immediate intervention by the nurse? A. Flank pain that radiates to the lower abdomen B. Client report of nausea C. Absent urine output for 1 hr D. WBC count 15,000

C. When using the acute vs. chronic approach to care, no urine output for 1 hr requires immediate intervention by the nurse. This indicates kidney dysfunction, and the provider should be notified immediately.

A nurse is reinforcing teaching with a client prior to renal biopsy. Which of the following statements should the nurse make? A. "A creatinine clearance is needed prior to the procedure." B. "You will be NPO for 8 hours following the procedure." C. "You will need to be on bed rest following the procedure." D. "An allergy to shellfish is a contraindication for this procedure." .

C. "You will need to be on bed rest following the procedure." A renal biopsy involves a tissue biopsy through needle insertion into the lower lobe of the kidney. The client should maintain bed rest in a supine position with a back roll for support for 2 to 24 hr following the procedure to reduce the risk for bleeding. The nurse can elevate the head of the bed.

A nurse is caring for a client who is receiving peritoneal dialyisis. The nurse should monitor the client for which of the following adverse effects? a. Increased serum albumin b. Hypoglycemia c. Respiratory Distress d. Diarrhea

C. Respiratory Distress Respiratory Distress can occur during peritoneal dialysis due to fluid overload.

A nurse is reinforcing dietary teaching with a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to decrease in her diet? A. Phosphorous B. Calcium C. Sodium D. Potassium

C. Sodium A client who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium absorption. The client should supplement her diet with dietary calcium.

A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching? A. Hemodialysis restores kidney function. B. Hemodialysis replaces hormonal function of the renal system. C. Hemodialysis allows an unrestricted diet. D. Hemodialysis returns a balance to serum electrolytes.

D. The nurse should explain to the client that hemodialysis restores electrolyte balance by removing excess sodium, potassium, fluids, and waste products, and also restores acid‐base balance.

A nurse is caring for a client who has a urinary tract infection. Which of the following is the priority intervention by the nurse? A. Offer a warm sitz bath. B. Recommend drinking cranberry juice. C. Encourage increased fluids. D. Administer an antibiotic.

D. The greatest risk to the client is injury to the renal system from the UTI. Therefore, thepriority intervention is to administer antibiotics.

A nurse is assesing a client who is bedridden and was admitted from home. The nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse should document that the client has a pressure ulcer at which of the following stages? IV I III II

II With a stage II pressure ulcer, there is partial-thickness skin loss involving the epidermis and the dermis. The ulcer is visible and superficial and can appear as an abrasion, blister, or shallow crater. Edema persists, and the ulcer might become infected. The client might report pain, and there might be a small amount of drainage.

On reading the urinalysis results for a dehydrated patient, the nurse would expect to find: A. pH of 8.4 B RBC's of 4/hpf C. color: yellow, cloudy D. specific gravity of 1.035

D. specific gravity of 1.035

What is the normal range for creatinine clearance? (24 hour collection)

Dependent on CKD stages (INSERT VALUES HERE)

A nurse in the emergency department is caring for a client who has a snakebite on her arm. Which of the following interventions should the nurse implement? Immobilize the limb at the level of the heart. Apply a tourniquet to the affected limb. Use a sterile scapula to incise the wound. Apply ice to the skin over the snakebite wound.

Immobilize the limb at the level of the heart The emergency management of a client who has a snakebite focuses on limiting the spread of venom. Any constrictive clothing or jewelry should be removed before swelling worsens, and the affected limb should be immobilized at the level of the heart.

gentamicin

Impaired kidney function is an adverse effect of gentamicin.

A nurse is assessing a client who has a lesion on his skin. Which of the following findings is a clinical manifestation of a malignant melanoma? Rough, dry, scaly lesion Firm nodule with crust Pearly papule with ulcerated center Irregularly shaped lesion with blue tones

Irregularly shaped lesion with blue tones Malignant melanomas are irregularly shaped and can be blue, red, or white in tone. They often occur on the client's upper back and lower legs.

A nurse is caring for a client who has a prescription for silver sulfadiazine cream to be applied to her burn wounds. The nurse should evaluate the client for which of the following laboratory findings? Hyponatremia Leukopenia Hyperchloremia Elevated BUN

Leukopenia Transient leukopenia is an adverse effect of silver sulfadiazine.

A community health nurse is providing teaching about malignant melanoma to a group of clients. The nurse should inform the group that which of the following traits places a client at risk for developing malignant melanoma? Brown eyes Light skin Black hair Dark skin

Light skin Light skin and less pigmentation place a client at risk for developing malignant melanoma.

A nurse is caring for a client who has a lesion on the back of his right hand. The client asks the nurse which type of skin cancer is the most serious. Which of the following responses by the nurse is appropriate? Basal cell carcinomas Melanomas Actinic keratoses Squamous cell carcinomas

Melanomas

What is the functional unit of each kidney?

Nephron

A nurse in a provider's office is assessing a client's skin lesions. The nurse notes that the lesions are 0.5 cm (0.20 in) in size, elevated, and solid, with very distinct borders. The nurse should document the findings as which of the following skin lesions? Papules Macules Wheals Vesicles

Papules A papule is a small, solid, elevated lesion with distinct borders. It is usually smaller than 10 mm in diameter. Papules are common lesions of warts and elevated moles.

A nurse is caring for a client whose wounds are covered with a heterograft dressing. In response to the client's questions about the dressing, the nurse explains that it is obtained from which of the following sources? Cadaver skin Pig skin Amniotic membranes Beef collagen

Pig skin Heterografts are obtained from an animal, usually a pig.

A nurse is evaluating the laboratory values of a client who is in the resuscitation phase following a major burn. Which of the following laboratory findings should the nurse expect? Hemoglobin 10 g/dL Sodium 132 mEq/L Albumin 3.6 g/dL Potassium 4.0 mEq/dL

Sodium 132mEq/L This laboratory finding is below the expected reference range. The nurse should anticipate a low sodium level because sodium is trapped in interstitial space.

A nurse is planning care for a client who has been admitted for treatment of a malignant melanoma of the upper leg without metastasis. The nurse should plan to prepare the client for which of the following procedures? Curettage External radiation therapy Regional chemotherapy Surgical excision

Surgical excision

A nurse on a surgical unit is caring for four clients who have healing wounds. Which of the following wounds should the nurse expect to heal by primary intention? Partial-thickness burn Stage III pressure ulcer Surgical incision Dehisced sternal wound

Surgical incision With primary intention, a clean wound is closed mechanically, leaving well-approximated edges and minimal scarring. A surgical incision is an example of a wound that heals by primary intention.

A nurse is assessing a client who sustained superficial partial-thickness and deep partial-thickness burns 72 hr ago. Which of the following findings should the nurse report to the provider? Edema in the burned extremities Severe pain at the burn sites Urine output of 30 mL/hr Temperature of 39.1° C (102.4° F)

Temperature of 39.1° C (102.4° F) An elevated temperature is an indication of infection and the nurse should report this finding to the provider. Sepsis is a critical finding following a major burn injury. Initially, burn wounds are relatively pathogen-free. On approximately the third day following the injury, early colonization of the wound surface by gram-negative organisms changes to predominantly gram-positive opportunistic organisms.

A nurse is assessing the skin of a client who has frostbite. The client has small blisters that contain blood and the skin of the affected area does not blanch. The nurse should classify this injury as which of the following? First-degree frostbite Second-degree frostbite Third-degree frostbite Fourth-degree frostbite

Third-degree frostbite When a client has third-degree frostbite, the skin of the affected area has small blisters that are blood-filled and the skin does not blanch.

A nurse is providing discharge instructions to a client who is postoperative following a surgical excision of a basal cell carcinoma. Which of the following findings should the nurse include as an indication of a potential malignancy of a mole? Ulceration Blanching of surrounding skin Dimpling Fading of color

Ulceration Ulceration, bleeding, or exudation are indications of a mole's potential malignancy. Increasing size is also a warning sign. The nurse should emphasize the importance of lifetime follow-up evaluations and the proper techniques for self-examination of the skin every month.

A nurse is caring for a client who has a large wound healing by secondary intention. The nurse should inform the client that, in addition to protein, which of the following nutrients promotes wound healing? Vitamin B1 Calcium Vitamin C Potassium

Vitamin C A diet high in protein and vitamin C is recommended because these nutrients promote wound healing.

A nurse is reinforcing teaching with a client who has a history of urinary tract infections (UTIs). Which of the following statements should indicate to the nurse the need for additional instructions? a. "I will use a vaginal douche daily." b. "I will empty my bladder every 2 to 4 hours." c. "I will drink 2 liters of fluids per day." d. "I will wear cotton underwear."

a. "I will use a vaginal douche daily." The client should avoid vaginal douches, bubble baths, and any substances that can increase the risk for UTIs. The client should use mild soap and water to wash the perineal area.

A nurse is collecting data from a client who has an injury to the lower abdomen following a motor-vehicle crash. The nurse should identify that which of the following findings is a manifestations of bladder trauma? a. Hematuria b. Pyuria c. Fever d. Stress incontinence

a. Hematuria Manifestations of bladder trauma include hematuria, or blood in the urine; blood at the urinary meatus; pelvic pain; and anuria, or the absence of urine.

A nurse is caring for several clients. Which of the following clients are at risk for developing pyelonephritis? (Select all that apply) a. a client who is at 32 weeks gestation b. a client who has a kidney calculi c. a client who has a urine pH of 4.2 d. a client who has a neurogenic bladder e. a client who has diabetes mellitis

a. a client who is at 32 weeks gestation b. a client who has a kidney calculi d. a client who has a neurogenic bladder e. a client who has diabetes mellitis A: A client who is at 32 week of gestation is at risk for developing pyelonephritis because of increased pressure on the urinary system during pregnancy can cause reflux or retention of urine B: A client who has a kidney calculi is at risk for pyelonephritis because stones harbor bacteria D: The client who has a neurogenic bladder can retain urine, promoting bacterial growth and causing pyelonephritis. E: The client who has diabetes mellitus is at risk of pyelonephritis because glucose can be in the urine promotes bacterial growth

A nurse is preparing educational material to present to a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (select all that apply) a. avoid sitting in a wet bathing suit b. wipe the perineal area back to front following elimination c. empty the bladder when there is an urge to void d. wear synthetic fabric underwear e. take a shower daily

a. avoid sitting in a wet bathing suit c. empty the bladder when there is an urge to void e. take a shower daily A: The client should avoid sitting in a wet bathing suit, which can increase the risk for a UTI by colonization of bacteria in a moist, warm environment. C: The client should empty the bladder where there is an urge to void rather than retain urine for an extended period of time, which increases risk of UTI E: the client should take a shower daily to promote good body hygiene and decrease colonization of bacteria in the perineal area that can cause a UTI.

A nurse is reviewing discharge instructions with a client who had spontaneous passage of calcium phosphate renal calculus. Which of the following instructions should the nurse include in the teaching? (select all that apply) a. limit intake of food high in animal protein b. reduce sodium intake c. strain urine for 48 hours d. report burning with urination to the provider e. increase fluid intake to 3L/day

a. limit intake of food high in animal protein b. reduce sodium intake d. report burning with urination to the provider e. increase fluid intake to 3L/day A: The client should limit the intake of food high in animal protein, which contains calcium phosphate B: the client should limit intake of sodium, which affects the precipitation of calcium phosphate in the urine D: the client should report burning with urination to the provider because this can indicate a urinary tract infection. E: the client should increase fluid intake to 2 to 3L/day. A decrease in fluid intake can cause dehydration, which increases risk of calculi formation

A nurse is planning care for a client who has chronic pyelonephritis. Which of the following actions should the nurse plan to take? (Select all that apply) a. provide a referral for nutrition counseling b. encourage daily fluid intake of 1 L c. palpate the costovertebral angle d. monitor urinary output e. administer antibiotics

a. provide a referral for nutrition counseling c. palpate the costovertebral angle d. monitor urinary output e. administer antibiotics A: The client requires adequate nutrition to promote healing C: the nurse should gently palpate the costovertebral angle for flank tenderness, which can indicate inflammation/infection D: the nurse should monitor urinary output to determine that 1-3L of urine is excreted daily E: the nurse should administer antibiotics to treat the bacteriuria and decrease progressive damage to the kidneys

A nurse is reinforcing teaching with a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? a. "You should drink 1,000 milliliters of fluid per day." b. "You should complete the entire cycle of antibiotic therapy." c. "You should maintain complete bed rest until manifestations decrease." d. "You should avoid taking NSAIDs for pain."

b. "You should complete the entire cycle of antibiotic therapy." The client should complete the full prescription of the antibiotic therapy to decrease the chance of regrowth of the causative organism.

A nurse is completing discharge instructions with a client who has spontaneously passed a calcium oxalate calculus. To decrease the chance of recurrence, the nurse should instruct the client to avoid which of the following foods? (select all that apply) a. red meat b. black tea c. cheese d. whole grains e. spinach

b. black tea e. spinach

A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicates a urinary tract infection? a. positive for hyaline cysts b. positive for leukocyte esterase c. positive for ketones d. positive for crystals

b. positive for leukocyte esterase B: A positive leukocyte esterase indicates urinary tract infection

A nurse is reinforcing teaching about urinary tract infections (UTI) with a client. Which of the following manifestations should the nurse include? a. Vaginal discharge b. Weight gain c. Back pain d. Muscle cramps

c. Back pain Back pain and flank pain are manifestations of a UTI. Other manifestations include frequency, urgency, and cloudy, foul-smelling urine.

A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following assessment findings is the priority for the nurse to report to the provider? a. flank pain that radiates to the lower abdomen b. client reports of nausea c. absent urine output for 1 hr d. serum WBC count 15,000/mm3

c. absent urine output for 1 hr C: The greatest risk to this client is damage to the kidney resulting from obstruction of urine flow by the renal calculus. Therefore, the priority finding for the nurse to report to the provider is anuria.

A nurse is teaching a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements by the client indicates understanding of the teaching? a. "I will be fully awake during the procedure" b. "lithotripsy will reduce my chances of having stones in the future" c. "I will report any bruising that occurs to my doctor" d. "Straining my urine following the procedure is important"

d. "Straining my urine following the procedure is important" D: A client is instructed to strain urine following lithotripsy to verify that the calculi have passed

A nurse is reinforcing teaching about the prostate-specific antigen (PSA) test with a client. Which of the following statements should the nurse make? a. "Expected PSA values will decrease as you get older." b. "Annual PSA screening should begin at age 40." c. "You should not ejaculate for 24 hours after the PSA test." d. "You should fast for 8 hours prior to the PSA test."

d. "You should fast for 8 hours prior to the PSA test." PSA is a glycoprotein that is manufactured in the prostate and is used to screen for prostate cancer. The client should not eat for 8 hr prior to this procedure.

A nurse is collecting data from a client who is 1 week postoperative following a living donor kidney transplant. Which of the following findings should indicate to the nurse that the client is experiencing acute kidney rejection? a. Urinary output 100 mL/hr b. Sodium 137 mg/dL c. Creatinine 0.8 mg/dL d. Blood pressure 160/90 mm Hg

d. Blood pressure 160/90 mm Hg Due to the kidney's role in fluid and blood pressure regulation, a client who is experiencing rejection can have hypertension.

A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client report diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first? a. Administer an analgesic to the client. b. Measure the client's weight. c. Restrict the client's protein intake. d. Check the client's electrolyte values.

d. Check the client's electrolyte values. The nurse should apply the urgent versus non-urgent priority-setting framework when caring for the client. Using this framework, the nurse should consider urgent needs to be the priority because they pose a greater threat to the client. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. The nurse should check the client's most recent potassium value because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias; therefore, this is the priority action.

A nurse is reinforcing teaching with a client prior to a cystoscopy. Which of the following statements should the nurse make? a. Expect to be on bed rest for 24 hours after this procedure. -you will need to keep the sutures clean after this procedure -you will be placed on your left side for this procedure -expect to have pink-tinged urine after this procedure

d. Expect to have pink-tinged urine after this procedure. A cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Following this procedure, pink-tinged urine is expected.

A nurse is reinforcing teaching with a client who has chronic kidney disease (CKD). which of the following instructions should the nurse include? a. Eat a diet high in protein. b. Limit caloric intake c. Eat a diet high in phosphorus. d. Limit fluid intake.

d. Limit fluid intake. A client who has CKD should limit fluid intake to prevent hypervolemia, or excessive fluid overload.

A nurse is caring for a client who has diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action? a. Monitor the client's I&O. b. Strain the client's urine. c. Encourage the client to increase fluid intake. d. Relieve the client's pain.

d. Relieve the client's pain. The nurse should apply the urgent versus non-urgent priority-setting framework when caring for the client. Using this framework, the nurse should consider urgent needs to be the priority because they pose a greater threat to the client. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. The pain associated with renal calculi is severe and can lead to shock; therefore, this is the nurse's priority action.

A nurse is caring for a client who has a urinary tract infection (UTI). Which of the following is the priority intervention by the nurse? a. offer a warm sitz bath b. recommend drinking cranberry juice c. encourage increased fluids d. administer antibiotics

d. administer antibiotics D: The greatest risk to the client is injury to the renal system and sepsis from the UTI. The priority intervention is to administer antibiotics

Renin Angiotensin System (RAAS)

https://www.youtube.com/watch?v=M0vpn6YVwiI

What are the functions of the Kidney and Urinary system?

vUrine formation vExcretion of waste products vRegulation of electrolytes vRegulation of acid-base balance vControl of water balance vControl of blood pressure vRenal Clearance vGlomerular filtration rate vRegulation of red blood cell production vSynthesis of vitamin D to active form vSecretion of prostaglandins

What are the gerontological considerations for Renal/Urinary function?

•Older adults susceptible to kidney injury:(Sclerosis of the glomerulus and renal vasculature, Decreased GFR Altered acid-base balance) •Older adults may intentionally limit fluids •Diminished thirst, need reminding to drink, increased dehydration •Incomplete emptying of bladder •Decreased drug clearance = increased drug-drug interactions