Med/surg exam 3
Which term best describes a total urine output less than 500 mL in 24 hours? OR The term used to describe total urine output less than 0.5 mL/kg/hour is
Oliguria
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
The nurse is encouraging the client with recurrent urinary tract infections to increase fluid intake to 8 large glasses of fluids daily. Which beverage would the nurse discourage for this client?
Coffee in the morning
The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client be assessed for an allergy to iodine?
Computed tomography with contrast
Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?
Confusion and seizures
Which is a reversible cause of urinary incontinence in the older adult?
Constipation
A male client who is admitted with the diagnosis of urinary calculi complains of excruciating pain. The pain is suspected to be caused by increased pressure in the renal pelvis. Which measure would be most appropriate to provide pain relief?
Encourage frequent ambulation.
A client asks the nurse why a creatinine clearance test is an accurate indicator of kidney function. The nurse is most correct to reply which of the following?
"Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney."
A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?
"I should take at least 1,000 mg of vitamin C each day."
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
"My urine will be eliminated through a stoma."
A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?
"This medication will relieve your pain."
Name a hypotonic solution
0.45% NaCl
What is considered an isotonic solution?
0.9% NaCl
In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the client's residual urine must be less than which amount on two separate occasions (morning and evening)?
100 mL
Which value represents a normal BUN-to-creatinine ratio?
10:1
Convulsions or coma can occur with this serum sodium level:
130 mEq/L
The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be
155 mEq/L (155 mmol/L)
What serum bicarbonate level indicates metabolic alkalosis?
28 mEq/L
Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance?
A patient with a minimal urine output of 30 mL/hour
Hypertonic solution
A solution with an osmolarity higher than that of serum
Hypotonic solution
A solution with an osmolarity lower than that of serum
Isotonic solution
A solution with the same osmolarity is blood
Acidosis
Acid base imbalance characterized by an increase in H+ concentration parentheses decrease blood pH (a low arterial pH due to increased H+ concentration or reduced by carbonate. Concentration is called metabolic acidosis. A low arterial pH due to increased PCO2 is called respiratory acidosis)
A client with excess fluid volume and hyponatremia is in a comatose state. What are the nursing considerations concerning fluid replacement?
Administer small volumes of a hypertonic solution.
What is the most common cause of symptomatic hypomagnesemia?
Alcoholism
Which hormone causes the kidneys to reabsorb sodium?
Aldosterone
Glomerular Filtration Rate (GFR)
Amount of plasma filter through the glomeruli per unit of time
Urinary frequency
Avoiding more frequently than every three hours
What is one of the most important indications of an acid-base imbalance that is shown in an ABG?
Bicarbonate
The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?
Bleeding
The nurse understands that the most common route of a UTI is which of the following?
By ascending infection (transurethral)
What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?
Change in cognitive functioning
The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder?
Chronic kidney disease
What appearance of urine suggests a UTI?
Cloudy urine
A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection?
Creatinine
A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for?
Creatinine clearance level
Anuria
Decrease urine output of less than 50 mL in 24 hours
Diagnostic testing of an adult client reveals renal glycosuria. The nurse should recognize the need for the client to be assessed for what health problem?
Diabetes mellitus
A client has a full bladder. Which sound would the nurse expect to hear on percussion?
Dullness
Erythropoietin
Glycoprotein produced by kidney, stimulates bone mero to produce red blood cells
Antidiuretic hormone
Hormone secreted by the posterior pituitary gland, causes the kidneys to re-absorb more water. Synonym: vasopressin.
Aldosterone
Hormone synthesized in released by the adrenal cortex, causes the kidneys to reabsorb sodium
Which urinary diversion would the nurse select for a client diagnosed with bladder cancer and requiring a cystectomy?
Ileal conduit
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?
Increased serum creatinine
A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level?
Increases arterial pH
A client undergoes renal angiography. The nurse prepares the client for the test and provides postprocedure care. Which intervention should the nurse provide to the client after renal angiography?
Palpate the pulses in the legs and feet
The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance?
Presence of Trousseau sign
Alkalosis
Reduction in H+ or increase in bicarbonate. Increased blood pH. Can be metabolic or respsiratory.
A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?
Relieve the pain.
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?
Renin
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
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
Stress
The nurse is preparing the procedure room for a client who will undergo an intravenous pyelogram. Which item(s) should the nurse include?
Suction equipment
Which nursing intervention should the nurse caring for the client with pyelonephritis implement?
Teach client to increase fluid intake up to 3 liters per day.
A patient has a suprapubic catheter inserted postoperatively. What would be the advantages of the suprapubic catheter versus a urethral catheter?
The patient can void sooner than with a urethral catheter. The suprapubic catheter allows for more mobility. The suprapubic catheter permits measurement of residual urine without urethral instrumentation.
Which is the procedure of choice for men with recurrent or complicated UTIs?
Transrectal ultrasonography
"Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
Client states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?
Urinary calculi
Pyuria
White blood cells in the urine
Oliguria
You're an output less than 400 mL in 24 hours or less than 0.5 mL per kilogram per hour over six hours.
By what mechanism will the sodium-potassium pump move the excess body fluid?
active transport
sodium 137 mEq/L (137 mmol/L) potassium 4.6 mEq/L (4.6 mmol/L) chloride 94 mEq/L (94 mmol/L) calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is of highest concern to the nurse?
calcium
A client with emphysema is at a greater risk for developing which acid-base imbalance?
chronic respiratory acidosis
Early signs of hypervolemia include
increased breathing effort and weight gain
When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?
pH 7.48
Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?
pH, 7.25; PaCO2 50 mm Hg
A client is complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:
renal calculi
Which electrolytes is the primary determinant of extracellular fluid (ECF) osmolality?
sodium
Common symptom of hypocalcemia
tingling in the fingers
Excessive use of sodium bicarbonate can cause:
metabolic alkalosis
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
infection
Which fluid location which contains the most body water?
intracellular fluid
The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?
lungs and kidneys
Which is the preferred route of administration for potassium?
PO
When fluid intake is normal, the specific gravity of urine should be:
1.010 to 1.025
Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. Specific gravity compares the density of urine to the density of distilled water. Which is an example of how urine concentration is affected?
On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.
Renal calculi can form anywhere in the urinary tract. What is their most common formation site?
Kidney
A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer?
Lactated Ringer's solution
An older adult's most recent laboratory findings indicate a decrease in creatinine clearance. When performing an assessment related to potential causes, the nurse should:
confirm all of the medications and supplements normally taken.
Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
Anticholinergic
Creatinine
Endogenous waste product of muscle, energy metabolism
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D
specific gravity
Expression of the degree of concentration of the year in
Voiding Dysfunction
Failure of the bladder to store urine or failure of bladder to empty, urinary retention
The nurse observes that the client's urine is orange. Which additional assessment would be important for this client?
Intake of medication such as phenazopyridine hydrochloride
Common findings with respiratory alkalosis
Light headedness or paresthesia
A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder?
Metabolic acidosis
A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing?
Metabolic alkalosis
An arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?
Metabolic alkalosis
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?
Monitor the client for an allergy to iodine contrast material.
Which is an effect of aging on upper and lower urinary tract function?
More prone to develop hypernatremia
A client is experiencing some renal secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed in urine?
glucose
A client is having a blood urea nitrogen (BUN) test. BUN level is:
increased in renal disease and urinary obstruction.
