PrepU_MedSug_Genitourinary_Ch47,49
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? "Take your temperature every 4 hours." "Increase your fluid intake to 2 to 3 L per day." "Apply an antibacterial dressing to the incision daily." "Be aware that your urine will be cherry-red for 5 to 7 days."
Correct response: "Increase your fluid intake to 2 to 3 L per day." Explanation: The nurse should instruct the client to increase fluid intake. Increasing fluid intake flushes the renal calculi fragments through — and prevents obstruction of — the urinary system. Measuring temperature every 4 hours isn't needed. Lithotripsy doesn't require an incision. Hematuria may occur for a few hours after lithotripsy but should then disappear.
A nurse is about to admit a client to the medical surgical unit directly from the healthcare provider's office. Upon assessment, the nurse notes that the client has significant periorbital edema. Laboratory values indicate the presence of proteinuria and hypoproteinemia. Which action is the nurse's priority? Strict intake and output assessment and documentation Monitoring of hemoglobin and hematocrit Frequent ambulation Ensuring client compliance with a low-protein diet
Correct response: Strict intake and output assessment and documentation Explanation: Symptoms are highly suggestive of glomerulonephritis. Clients require strict intake and output are generally placed on a high protein diet. Monitoring of laboratory values is good nursing practice overall, but not the priority with this diagnosis. Ambulation is not the priority, as client requires rest.
Urinary tract infection (UTI) is a potential problem after spinal cord injury. To prevent an UTI, the nurse should encourage the client to: drink a glass of citrus fruit juice at every meal. drink at least 2,000 mL of fluid daily. add extra protein to the daily diet. wash hands frequently.
Correct response: drink at least 2,000 mL of fluid daily. Explanation: As soon as the client's vasomotor status stabilizes and is not susceptible to fluid volume overload, it is essential to drink at least 2,000 mL of fluid daily. Increased fluid intake helps flush out bacteria and prevents urinary stasis. Citrus juices are not encouraged. They can promote a urinary tract infection because they are alkaline-forming. Most citrus fruits are not metabolized as acids in the body. Extra protein does not decrease the potential for a urinary tract infection. While washing hands frequently is an appropriate health habit, UTIs in clients with spinal cord injuries primarily are caused by urinary stasis, and not prevented by handwashing.
A client is receiving hemodialysis for chronic kidney failure. The nurse understands the client is at an increased risk for which condition? development of peritonitis during dialysis renal calculi due to the increased urine output bladder infections serum hepatitis
Correct response: serum hepatitis Explanation: Serum hepatitis (hepatitis B) is transmitted by blood or blood products. The hemodialysis and routine transfusions needed for a client in renal failure constitute a great risk of exposure. Other answers are incorrect because dialysis is done through a dialysis catheter, not peritoneum. There is no reason for increased calculi or infection based on urine output.
To prevent recurrence of cystitis, the nurse should plan to encourage the female client to include which measure in her daily routine? wearing cotton underpants increasing citrus juice intake douching regularly with 0.25% acetic acid using vaginal sprays
Correct response: wearing cotton underpants Explanation: A woman can adopt several health-promotion measures to prevent the recurrence of cystitis, including avoiding too-tight pants, noncotton underpants, and irritating substances, such as bubble baths and vaginal soaps and sprays. Increasing citrus juice intake can be a bladder irritant. Regular douching is not recommended; it can alter the pH of the vagina, increasing the risk of infection.
