path prepU chapter 33

A child has been admitted to the pediatric unit with a tentative diagnosis of lipoid nephrosis. While taking the history, which items lead the nurse to suspect the diagnosis is accurate? Select all that apply. swimmer's ear recent routine vaccines vomiting and diarrhea recent upper respiratory infection a new tooth broke through the gums

recent routine vaccines recent upper respiratory infection

an older adult client has been hospitalized for the treatment of acute pyelonephritis. which characteristic of the client is most likely implicated in the etiology of this current health problem? has peripheral vascular disease recently has a urinary tract infection was diagnosed with type 2 diabetes several years earlier takes a diuretic and an ACE inhibitor each day for the treatment of hypertension

recently had a urinary tract infection

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy? increase dietary sodium intake DASH diet with limited caloric intake smoking cessation program walking program

smoking cessation program

which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate? ACE inhibitors should be used strictly in those clients who also have an underlying cardiac history the ACE inhibitors have been shown to shrink the size of the cysts inside the kidneys ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction the use of ACE inhibitors will increase the vasopressin levels

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction

which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? cloudy urine oliguria hematuria urinary urgency

hematuria

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as: a streptococcal infection 7 to 12 days prior to onset drug-induced damage to the renal glomeruli prolonged blockage of the ureter with a stone uncontrolled diabetes with increased proteinuria

a streptococcal infection 7 to 12 days prior to onset

which client is displaying manifestations of having a kidney stone? acute onset of colicky flank pain radiating to lower abdomen a visible abdominal pain in bilateral lower quadrants increased thirst and urinary output with warm, dry skin elevation in systemic blood pressure and frequent urination

acute onset of colicky flank pain radiating to lower abdomen

Acute pyelonephritis is a result of: bacterial infection viral infection renal failure chronic reflux

bacterial infection

a 9-yr-old child has been diagnosed with the nephrotic syndrome. Place the following stages in the development of this health problem in ascending order. Use all the options. decreased colloidal osmotic pressure increased glomerular membrane permeability accumulation of fluid in interstitial tissue (edema) proteins escape from plasma to glomerular filtrate hypoalbuminemia

hypoalbuminemia increased glomerular membrane permeability proteins escape from plasma to glomerular filtrate decreased colloidal osmotic pressure accumulation of fluid in interstitial tissue (edema)

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which type of kidney stones? uric acid stones calcium stones cystine stones magnesium ammonium phosphate stones

uric acid stones

several clients in clinic today are reporting urinary sings/symptoms. which reported manigestations(s) leads the health care provider to suspect acute pyelonephritis? select all that apply shortness of breath heart palpitations urinary urgency and frequency abrupt onset of fever and chills flank pain in the back

urinary urgency and frequency abrupt onset of fever and chills flank pain in the back

A cytotechnologist is performing genetic testing on a series of tissues. One tissue comes back with the WT1 mutation, and it's mapped to chromosome 11. What disease will the client most likely develop? wilms tumor pyelonephritis renal cell carcinoma alport syndrome

wilms tumor

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed: nephrotic syndrome kidney stones acute renal failure acute postinfectious glomerulonephritis

acute postinfectious glomerulonephritis

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for? calcium cystine uric acid magnesium ammonium

calcium

the nurse is assessing a client who has a unilateral obstruction of the urinary tract. which clinical finding by the nurse correlates to this diagnosis? inability to control urination increased urine output excretion of dilute urine increase in blood pressure

increase in blood pressure

unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation? decreased sodium retention decreased heart rate increased urinary output increased blood pressure

increased blood pressure

what is the usual cause of acute pyelonephritis? reflux autoimmunity obstruction infection

infection

if a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema? lower extremities abdomen eyelids hands

lower extremities

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome? hematuria and anemia proteinuria and generalized edema increased creatinine with normal blood urea nitrogen renal colic and increased serum sodium

proteinuria and generalized edema

A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager? taking antimicrobials to treat Escherichia coli while forcing fluids washing hands prior to inserting a tampon to minimize the risk of group B streptococcus proper handwashing to decrease amount of pseudomonas growing on the hands wearing gloves when wiping perineum after defecation to prevent staphylococcus aureus infection

taking antimicrobials to treat escherichia coli while forcing fluids

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)? ascending urinary tract infection and vomiting elevated systemic blood pressure and severe pain bilateral flank masses and impaired lung development gross hematuria and massive generalized edema

bilateral flank masses and impaired lung development

which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)? extracorporeal shock wave lithotripsy (ESWL) percutaneous nephrolithotomy retrograde uretroscopy percutaneous ureterolithotomy

extracorporeal shock wave lithotripsy (ESWL)

A client who has had recurrent urinary tract infections asks the nurse about the old wives' tale of drinking cranberry juice daily. Which response by the nurse is most accurate? studies on tis are based on a person drinking at least 1 gallon of juice per day research suggests cranberry juice will reduce bacterial adherence to the lining of the urinary tract there is no research on this topic, so I don't think it will help you beer is probably more effective at killing bacteria than cranberry juice

infection

A client with systemic lupus erythematosus (SLE) glomerulonephritis is experiencing a worsening of the disease and has progressed to the higher classes resulting in renal involvement. Which medication(s) will likely be prescribed by the health care provider to treat the deterioration of the renal function? Select all that apply. increase in ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) oral corticosteroid lisinopril, an angiotensin-converting enzyme (ACE) inhibitor intravenous antimicrobial combination drug trimethoprim and sulfamethoxazole spironolactone, a mineralocorticoid-receptor antagonist

oral corticosteroid lisinopril, an angiotensin-converting enzyme (ACE) inhibitor

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause? poor dietary intake of iron reduced production of erythropoietin low calcium levels hemorrhage

reduced production of erythropoietin