Patho exam 3 part 4
Which organism causes most UTIs?
Escherichia coli
The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection?
Foul odor pH of 8.2
A patient with altered cardiac function is being assessed by the nurse. When auscultating lung sounds, the nurse will assist this patient into a _____ position.
Fowler's
On admission, a patient with a history of cardiac insufficiency complains of shortness of breath. The nurse auscultates the lungs and notes bilateral crackles throughout both fields. In addition, there is bilateral +2 edema of the lower extremities. Which medication does the nurse anticipate that the health care provider will prescribe?
Furosemide [Lasix]
The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?
Furosemide [Lasix]
Which are common signs and symptoms of dehydration?
Furrowed tongue Decreased intake and output levels Mental confusion
What is the action of urinary antimicrobial agents?
Have an antiseptic effect on the urine and the urinary tract
The nurse is reviewing lab work received on a patient admitted with the diagnosis of dehydration. The nurse will notify the physician of which lab value?
Serum sodium level: 115 mEq/L
Which sign(s) and/or symptom(s) of dehydration may occur as a result of a diuretic?
Skin remains peaked on turgor assessment Soft, sunken eyeballs
Which medication is a potassium sparing diuretic?
Spironolactone [Aldactone]
The nurse is providing education to a patient with altered cardiac function. When instructing this patient the nurse will encourage:
regular, mild exercise. good skin care. stress reduction.
Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs?
tolterodine, darifenacin, and solifenacin
The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
"I will limit my fluid intake."
The nurse has provided patient teaching about potassium sparing diuretic therapy. Which statement by the patient indicates a need for further teaching?
"I will use a salt substitute because I limit my salt intake."
Which instruction by the nurse will be included when teaching an adult patient about digoxin [Lanoxin] for management of heart failure?
"Report nausea and vomiting to your health care provider."
The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?
"This medication reduces the resistance your heart has to pump against."
The nurse is to administer digoxin to an 18 month old patient who weighs 16.5 lb. Guidelines for administration read as follows: 0.0075-0.010 mg/kg/day. Which is a safe medication dosage?
0.074 mg
Which drug is used to obtain vasodilation in the treatment of chronic heart failure?
ACE inhibitors
Which action(s) will the nurse take when caring for a patient with heart failure?
Assess electrolyte levels. Report daily weight fluctuations. Maintain skin hygiene.
The nurse is caring for a 3-year-old girl who has a congenital heart anomaly. The patient's current medications include digoxin and furosemide [Lasix]. The apical pulse rate is 100 beats/min. Which action will the nurse take?
Administer the medication.
Which intervention(s) will help stimulate urination when a patient is experiencing postoperative urinary retention?
Administration of bethanechol chloride (Urecholine) Pouring warm water over the perineum
Which is the initial manifestation of digoxin toxicity in children?
Atrial dysrhythmia
Which nursing intervention(s) would be performed for a patient who is on diuretic therapy?
Auscultation of lung sounds Assessment of skin turgor Positioning techniques Monitoring of intake and output
Which medication, if administered with spironolactone (Aldactone), will alert the nurse to assess the patient for signs and symptoms of hyperkalemia?
Captopril [Capoten]
A patient with heart failure has been prescribed nesiritide (Natrecor). Which statement(s) is/are true regarding this medication?
Cardiac ventricles secrete this hormone in response to fluid overload. It suppresses aldosterone. It causes vasodilation.
A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells, and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the health care provider will order?
Ciprofloxacin (Cipro)
A patient has been taking an antimicrobial agent prescribed to treat a UTI for 2 days. She contacts the health care provider's office to report persistence of symptoms. In evaluating the medication effectiveness, which assessment(s) would be important?
Complete emptying of the bladder Amount of pain with urination as well as frequency Amount of daily fluid intake and output GI symptom complaints Bleeding with urination
Which nursing assessment is most important to determine fluid status for a patient with heart failure?
Daily weights
A 14-year-old male is taking tolterodine (Detrol). What is the action of this drug?
Decreases the urge to void
The nurse transcribes a new order for ethacrynic acid (Edecrin) on a patient with edema resulting from cirrhosis of the liver. Which currently prescribed medication(s) should the nurse report to the ordering health care provider?
Digoxin Prednisone Tobramycin
Which drug will be administered to a patient being admitted with severe digoxin intoxication?
Digoxin immune Fab [Digibind]
The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI). Which symptom(s) would the nurse observe in this patient with left ventricular systolic failure?
Diminished exercise tolerance Shortness of breath with activity
Individuals with which disorder(s) are particularly susceptible to the development of electrolyte disturbances during diuretic therapy?
History of cardiac disease History of renal disease History of hormonal disorders History of psychiatric illness Massive trauma Serious burns
Which contributing factor(s) to heart failure is/are modifiable?
Hypertension Addiction to smoking Exercise tolerance
Which medical condition(s) may contribute to fluid volume excess?
Hypertension Liver disease Pregnancy Use of corticosteroids
How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?
In a one-time dose
What would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic?
Increased blood sugar levels
Which condition warrants the use of acetazolamide [Diamox] as a diuretic?
Increased intraocular pressure
Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?
Inotropic
The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instruction(s) may facilitate management of incontinence?
Instruction of proper wiping techniques to prevent bacterial infection Education on bladder training and Kegel exercises Information on personal hygiene measures to prevent perianal breakdown Information of incontinence products and appliances Importance of establishing a regular toileting schedule
The nurse would expect to assess which serum potassium level in a patient who has severe vomiting and diarrhea?
Less than 3.5 mEq/L
A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms?
Phenazopyridine hydrochloride (Pyridium)
Which condition will neostigmine be used to treat?
Postoperative or postdelivery urinary retention
Which foods will the nurse recommend for a patient taking loop diuretics?
Potassium-rich foods such as raisins, figs, and bananas
A patient who has heart failure and difficulty breathing is being admitted. Which physical assessment(s) indicate(s) fluid volume excess?
Rapid, bounding, irregular pulse rate 3+ pitting ankle edema Neck vein engorgement Shortness of breath
An older adult male patient with long term heart failure has presented for an office visit. The nurse obtains information that he has recently begun taking St. John's wort. What results with the use of this herbal supplement?
Reduced therapeutic benefits of digoxin
Before administering digoxin (Lanoxin), the nurse takes the adult patient's apical pulse for 1 full minute. What additional nursing consideration(s) will be taken before administration of the medication?
Review of the digoxin blood level Review of serum electrolytes, liver, and kidney function studies Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight
What may become discolored by phenazopyridine (Pyridium) in addition to the urine?
Sclera
Which premedication assessment(s) would the nurse obtain prior to the initiation of bumetanide (Bumex)?
Serum potassium Lung sounds Orientation level Blood pressure
Which patient assessment would alert the nurse to withhold a loop diuretic?
Serum potassium of 2.6 mEq/L
Which statements about vasodilators is/are true?
They reduce systemic vascular resistance. They reduce preload. They decrease pulmonary congestion. They increase tissue perfusion to muscles and organs.
After undergoing prostate surgery, a patient is discharged on the medication phenazopyridine hydrochloride (Pyridium) to assist with urinary catheter discomfort. What information will the nurse include in the discharge teaching?
Urine will appear reddish orange.
How soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure?
Within 10 minutes
The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the health care provider?
Yellow sclera Increased pain and burning
A 37-year-old male presents at the emergency department reporting severe vomiting for the past 48 hours. When assessing skin turgor, the nurse will:
gently pinch the skin together over the sternum.
The nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure. The nurse will schedule this medication:
in the morning.
The nurse is preparing to administer a single dose packet of fosfomycin to a patient diagnosed with a UTI. When preparing this medication, the nurse will:
mix contents with 120 mL of water and administer by mouth.
When teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte?
potassium
When obtaining urine for analysis on a patient in the labor and birth unit, the nurse assesses the urine to appear frothy. The nurse interprets this as a sign of possible:
preeclampsia (toxemia).
