nursing care 1 exam 6

A client comes to the clinic for a follow-up visit. During the interview, the client states, "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

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?

Urinary calculi

A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing, and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing:

ureteral stones.

micturition

urination or voiding

oliguria

urine output less than 0.5mL/kg/hr

residual urine

urine that remains in the bladder after voiding

frequency

voiding more frequently than every 3 hours

urinary frequency

voiding more often than every 3 hours

glomerular filtration rate (GFR)

amount of plasma filtered through the glomeruli per unit of time

urethrovesical reflux

an obstruction to free-flowing urine leading to the reflux of urine from the urethra into the bladder

bacteriuria

bacteria in the urine

A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is:

"The glomerular filtration rate decreases as we age."

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

A low-purine diet

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?

Angiography

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?

Change the wafer and pouch.

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?

Detects calculi, cysts, or tumors

Which of the following is a cause of a calcium renal stone?

Excessive intake of vitamin D

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease?

Incontinence

Patients with urolithiasis need to be encouraged to:

Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.

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

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?

Ketoralac (Toradol)

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action?

Maintain skin and stomal integrity.

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 of the following is the most common symptom of bladder cancer?

Painless gross hematuria

Which medication may be ordered to relieve discomfort associated with a urinary tract infection?

Phenazopyridine

Which term refers to inflammation of the renal pelvis?

Pyelonephritis

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?

Pyridium

Sympathomimetics have which of the following effects on the body?

Relaxation of bladder wall

Which of the following hormones is secreted by the juxtaglomerular apparatus?

Renin

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?

The pouch faceplate doesn't fit the stoma.

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:

WBC 50

The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?

When the urine output is less than 30 mL/h

suprapubic catheter

a urinary catheter that is inserted through a suprapubic incision into the bladder

renal clearance

ability of the kidneys to clear solutes from the plasma

nocturia

awakening at night to urinate

ureterovesical or vesicoureteral reflux

backward flow of urine from the bladder into one or both ureters

neurogenic bladder

bladder dysfunction that results from a disorder or dysfunction of the nervous system and leads to urinary incontinence

hematuria

red blood cells in the urine

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.

urosepsis

spread of infection from the urinary tract to the bloodstream that results in a systemic infection

anuria

decreased urine output of less than 50 mL in 24 hours

urea nitrogen

end product of protein metabolism

creatinine

endogenous waste product of muscle energy metabolism

renal glycosuria

excretion of glucose in the urine

specific gravity

expression of the degree of concentration of the urine

nephron

structural and functional unit of the kidneys responsible for urine formation

cystectomy

surgical removal of the urinary bladder

hilum

the rounded outer convex of each kidney. penetrated with blood vessels, nerves, and the ureter

ureterosigmoidostomy

transplantation of the ureters into the sigmoid colon, allowing urine to flow through the colon and out the rectum

ileal conduit

transplantation of the ureters to an isolated section of the terminal ileum, with one end of the ureters brought to the abdominal wall

antidiuretic hormone (ADH)

hormone secreted by the posterior pituitary gland; causes the kidneys to reabsorb more water; also called vasopressin

aldosterone

hormone synthesized and released by the adrenal cortex; causes the kidneys to reabsorb sodium

diuresis

increased urine volume

interstitial cystitis

inflammation of the bladder wall that eventually causes disintegration of the lining and loss of bladder elasticity

prostatitis

inflammation of the prostate gland

pyelonephritis

inflammation of the renal pelvis

urethritis

inflammation of the urethra

cystitis

inflammation of the urinary bladder

urinary incontinence

involuntary or uncontrolled loss of urine from the bladder

overflow incontinence

involuntary urine loss associated with overdistention of the bladder

dysuria

painful or difficult urination

proteinuria

protein in the urine

glomerulus

tuft of capillaries forming part of the nephron through which filtration occurs

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?

Diabetes mellitus

An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:

Encourage high fluid intake.

pyuria

white blood cells in the urine