renal questions
Following a renal biopsy, the client complains of pain at the biopsy site, which radiates to the front of the abdomen. Based on this complaint, the nurse further monitors the client for: 1. Bleeding 2. Infection 3. Renal colic 4. Normal, expected pain
1. a renal biopsy patient experiencing pain at the biopsy site, radiates to the front of the abdomen usually indicates bleeding. X-ray determines the bleeding. other s/s of bleeding are: hypotension, hematuria, decreased hematocrite; signs and symptoms of infection occurs later.
A client is diagnosed with polycystic kidney disease and the nurse provides information to the client about the treatment plan. The nurse determines that the client needs additional information if the client states that which of the following is a component of the treatment plan? 1 Sodium restriction 2. Genetic counseling 3. Increased water intake 4. Antihypertensive medications
1. polycystic kidney causes sodium waste rather than sodium accumulation; therefore, more sodium is needed for polycystic kidney patients. Patients are encouraged to increase sodium and water intake, also their blood pressure is aggressively controlled. numerous fluid filled cysts on uni or bilateral kidney; genetic; able to spread to liver, pancreas, heart, brain; life threatening.
A female client is admitted to the mergence room following a fall from a horse. The physician orders insertion of a Foley catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. The nurse should: 1. Notify the physician 2. use a smaller catheter 3. Administer pain medication before inserting the catheter 4. use extra povidone-iodine solution in cleansing the meatus.
1. notify physician. the catheter should not be inserted until the cause of the blood is determined by a diagnostic testing.
A nurse is assessing te latency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent ? 1. palpation of a thrill over the fistula 2. Presence of a radial pulse in the left wrist 3. Absence of a bruit on auscultation of the fistula 4. Capillary refill less than 3 second in the nail beds of the fingers onto left hand
1. palpating for a thrill or auscultate for a bruit.
The nurse monitoring a client receiving peritoneal dialysis notes that the client' outflow is less than the inflow. Select all nurse actions in this situation. 1. contact the physician 2. check the level of the drainage bag 3. Reposition the client to his or her side 4. Place the client in good body alignment 5. check the peritoneal dialysis system for kinks 6. Increase the flow rate of the peritoneal dialysis solution
2, 3, 4, 5 position the client, good body alignment, check the level of the drainage bag, check the peritoneal dialysis system for kinks, clamp open.
A nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder , if noted on the client's record, would the nurse identify as a risk factor for this disorder? 1. Hypoglycemia 2. Diabetes mellitus 3. Coronary artery disease 4. Orthostatic hypotension
2. DM is a risk factor for HTN and kidney diseases. other risk factors are hypertension, chronic renal calculi, chronic cystitis, structural abnormalities of the urinary tract, presence of urinary stones, and indwelling or frequent urinary catheterization.
A client has epididymititis as a complication of urinary tract infection (UTI). The nurse is giving the client instructions to prevent a recurrence. The nurse determines that the client needs further instruction if the client states the intention to: 1. Drink increased amounts of fluids 2. Limit the force of the stream during voiding 3.Continue to take antibiotics until all symptoms are gone 4. Use condoms to eliminate risk from chlamydia and gonorrhea
3. the client should increase intake of fluids to flush the urinary system. Because organisms can be forced into the vas deferens and epididymis from strain or pressure during voiding, the client should limit the force of the stream. Condom use can help prevent urethritis and epididymititis from sexually transmitted infections. Antibiotics are always taken until the full course of therapy is completed.
A nurse is monitoring an 88-year-old woman suspected of having a urinary tract infection (UTI) for signs of the infection. Which of the following would alert the nurse to the possibility of the presence of a UTI? 1. Fever 2. Urgency 3. Confusion 4. Frequency
3. confusion is the most frequent symptom of UTI in elderly patients. other symptoms are usually related to aging or other illnesses.
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. the nurse tells the client that it is important to maintain the dwell time for the dialyzes at the prescribed time because of the risk of: 1. infection 2. fluid overload 3. hyperglycemia 4. disequilibrium syndrome
3. due to the absorption of dialysate and electrolyte imbalances, glucose is absorbed. If dwell time is extended, DM patient may become hyperglycemia, they need extra insulin. *dwell time - the time the solution remains in the abdomen between exchange is called the dwell time.
A nurse is caring for a client with epididymitis. The nurse anticipates noting which of the following findings on data collection? 1. Diarrhea, groin pain, and scrotal edema 2. fever, diarrhea, groin pain, and ecchymosis 3. fever nausea and vomiting, and painful scrotal edema 4. Nausea, vomiting and scrotal edema with ecchymosis
3. the s/s of epididymitis: pain and scrotal edema, n/v, fever and chill. these usually are caused by infection sometimes trauma.
A nurse is caring for the client with epididymitis. The nurse would avoid using which of the flowing treatment modalities in the care of the client? 1. Bedrest 2. Sitz bath 3. Heating pad 4.Scrotal elevation
3. treatment modalities for epididymitis are: bed rest, sitz bath, scrotal elevation, analgesic, antibiotics,
A nurse is performing an admission assessment on a client with a diagnosis of bladder cancer. Which of the following would the nurse most likely expect to note on data collection of this client? 1. Urgency 2. Frequency 3. Hematuria 4. Burning on urination
3. gross, painless hematuria is usually the first sign of bladder cancer. Later, as the disease progresses, patient experience urgency, frequency, or burning.
A client is scheduled for intravenous pyelography (IVP). Before the test, the priority nursing action would be to: 1. Restrict fluids 2. Administer a sedative 3. Determine a history of allergies 4. Administer an oral preparation of radiopaque dye
3. iodine based dye is used in IVP allergy needs to be checked.
A client with prostatitis resulting fro kidney infection has received instructions on management of the condition at home and prevention of recurrence. The nurse determines that the client understood the instructions if the client has verbalized that he will: 1. Stop antibiotic therapy when pain subsides 2. Exercise as much as possible to stimulate circulation. 3. Use warm sits baths and analgesics to increase comfort. 4. Keep fluid intake to a minimum to decrease the need to void.
3. treatment of prostatitis: analgesics, antibiotics, increase fluid intake, stool softener, sitz bath.
A male client has a tentative diagnosis of urethritis. The nurse collects data from the client, knowing that which of the following are manifestations of the disorder? 1. Hematuria and pyuria 2. Dysuria and proteinuria 3. Dysuria and penile discharge 4. Hematuria and penile discharge
3. urethritis in male is usually caused by chlamydia. The signs are dysuria and clear to mucopurulent discharge.
A male client who is hospitalized is diagnosed with urethritis caused by chlamydial infection. The nursing assistant assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care. The nurse tells the assistant that: 1. Enteric precautions should be instituted for the client. 2. Gloves and mask should be used when in the client's room. 3. Contact isolation should be initiated, because the disease is highly contagious 4. Standard precautions are sufficient, because the infection is transmitted sexually.
4.
A nurse is reviewing the client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following? 1. Decreased hemoglobin level 2. Decreased red blood cell (RBC) count 3. Decreased white blood cell (WBC) count 4. Elevated blood urea nitrogen (BUN) level
4.
A client newly diagnosed with chronic renal failure has recently begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse monitors the client during dialysis for: 1. Hypertension, tachycardia, and fever 2. Hypotension, bradycardia, and hypothermia 3. Restlessness, irritability, and generalized weakness 4. Headache, deteriorating level of consciousness, and twitching
4. for hemodialysis beginners, because the fast removal of the waste in the body and brain tissue, osmotic pressure changes, fluid goes into cerebral cells causes brain swelling, n/v, deteriorating level of consciousness, and twitting, seizure.
A client with chronic renal failure has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate binding agent. The client now has mental cloudiness, dementia, an com plaits of bone pain. The nurse interprets that these data are compatible with: 1. Advancing uremia 2. Phosphate overdose 3. Folic acid deficiency 4. Aluminum intoxication
4. phosphate binding agents usually contains aluminum. aluminum accumulation causes aluminum intoxication. The symptoms are: mental cloudiness, dementia, and bone pain from infiltration of the bone with aluminum. This condition was formerly known as dialysis dementia. It may be treated with aluminum-chelating agents, which make aluminum available to be dialyzed from the body. It could be prevented by avoiding or limiting the use of phosphate-binding agents that contain aluminum.
The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to a minister this medication: 1. during dialysis 2. Just prior to dialysis 3. The day after dialysis 4. On return from dialysis
4. antihypertensives, enalapril, should be taken after dialysis to prevent hypotension or medication being washed out. don't need to wait after dialysis to take antihypertensives.
A nurse is collecting data for a client who has had benign prostatic hyperplasia (BPH) in the past. To determine if the client is currently experiencing exacerbation of BPH, the nurse asks the client about the presence of which early symptom? 1. Nocturia 2. Urinary retention 3. Urge incontinence 4. Decreased force in the stream of urine
4. decreased force in the stream of urine is an early symptom of BPH; the client later develops urinary frequency, urgency, incontinence, hematuria; if untreated, complete obstruction would occur, and also urinary retention.
A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. The nurse monitors the client for signs of transurethral resection (TUR) syndrome. Which of the following data would indicate the onset of this syndrome? 1. Tachycardia and diarrhea 2. Bradycardia and confusion 3. Increased urinary output and anemia 4. Decreased urinary output and bladder spasms
4. RUR syndrome is caused by over absorption of non electrolyte irrigation to the cerebral cells during surgery, which causes cerebral edema. This causes, disorientation, confusion, hypertension, bradycardia, n/v, muscle twitching, blurred vision.
A nurse is caring for the client who had a renal biopsy. Which intervention would the nurse avoid in the care of the client after this procedure? 1. Administering pain medication as prescribed 2. Encouraging fluids to at least 3L in the first 24 hours 3. Testing serial urine samples with dipsticks for occult blood 4. Ambulating the client in the room and hall for short distances.
4. ensure the patient remains in bed for the first 24 hours; monitor vital signs and biopsy site; Patient should drink lots of water to prevent possible clot formation in the kidney and urinary tract; a hematest is done on serial urine samples with urine dipsticks to evaluate bleeding. Analgesics are needed.
A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate? 1. stop the dialysis 2. slow the infusion 3. decrease the amount to be infused 4. Explain that the pan will subside after the first few exchanges.
4. pain during the inflow and first 1 or 2 weeks of the dialysis is expected. This is due to peritoneal irritation.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which manifestation of this disorder? 1. Warmth, redness, and pain in the left hand 2. Aching pain, pallor, and edema of the left arm 3. Edema and purplish discoloration of the left arm 4. pallor, diminished pulse, and pain in the left hand
4. steal syndrome is the vascular insufficiency results from fistula. the symptoms: pallor, diminished pulse distal to the fistula, pain distal to the fistula. This is caused by tissue ischemia.