Urinary Disorders

T/F - Klebsiella is the most common causative agent for urinary tract infecitons

False

T/F - Serum blood urea nitrogen (BUN) is a much more accurate indicator of renal function than is serum creatinine

False

T/F - Voiding is generally a painful process for clients with interstitial cystitis

False

A client is scheduled for cystoscopy to determine which of her kidneys is diseased. Which should the nurse consider when caring for this client?

Help the client with sitz baths to ease voiding

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medicaiton?

Hematocrit of 33% (0.33)

A nurse is reinforcing teaching with a client who has chronic kidney disease and is to being hemodialysis. Which of the following information should the nurse include?

Hemodialysis returns a balance to serum electrolytes

A nurse is caring for a client who has a urinary tract infection (UTI). Which of the following is the priority intervention by the nurse?

Administer an antibiotic

T/F - Biofeedback is used if Kegel exercises are ineffective in controlling the urine flow

True

A nurse is reinforcing teaching with a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements by the client indicates understanding of the teaching?

"Straining my urine following the procedure is important"

A nurse is reinforcing teaching with a client who will have an x-ray of the kidneys, ureters, and bladder (KUB). Which of the following statements should the nurse include?

"The procedure determines whether you have a kidney stone."

A sulfonamide is prescribed for a client with a urinary tract infection. During review of the client's record, the nurse notes that the client is taking warfarin sodium daily. Which prescription should the nurse anticipate for this client?

A decrease in the warfarin sodium dosage

Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. Which should the nurse reinforce to the client?

A reddish-orange discoloration of the urine may occur - Phenazopyridine hydrochloride: Analgesic It can relieve symptoms caused by urinary tract infections and other urinary problems.

A routine urinalysis is performed on a 59-year-old female client diagnosed with kidney disease and electrolye imbalances. Which abnormality would the nruse suspect to be documented?

Abnormal specific gravity

A nurse is caring for a client who reports frequent urination. When assessing the urinalysis report, the nurse should look for what component to confirm a normal urinalysis?

Absence of glucose in the urine

A nurse is caring for a client who has left renal calculus and an indwelling urinary catheter. Which of the following findings is the priority for the nurse to report to the provider?

Absent urine output for 1 hr

A nurse is contributing to the plan of care for a client who has prerenal acute kidney injury (AKI) folliwng abdominal aortic aneurysm repair. Urinary output is 60 mL in the past 2 hr, and blood pressure is 92/58 mm Hg. The nurse should anticipate which of the following interventions?

Adminsiter a fluid challenge

A client with chronic kidney disease 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, and complaints of bone pain. Which does this data indicate?

Aluminum intoxication

Following kidney transplantation, cyclosporine (Sandimmune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L)

The nurse is checking the laboratory results of a 76-year-old woman who had a urinalysis performed. The nurse notes that there is calcium in her urine. What condition does this abnormal substance in the urine signify?

Bone degeneration

The nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The nurse should check the client for which sign of toxicity?

Bradycardia - Bethanechol chloride: Saliva production stimulator and Urinary retention medication It can treat urinary and bladder problems by emptying the bladder and increasing urination.

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome?

Bradycardia and confusion

A nurse is reviewing the medical record of a client who has intrarenal acute kidney injury (AKI). Which of the following factors should the nurse identify as the cause of this form of AKI?

Cocaine use disorder

The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/ symptom is likely to present first?

Confusion

A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which action?

Continue to take antibiotics until all symptoms are gone

A nurse is assisting with the admission assessment of a client who has renal calculi. Which of the following findings should the nurse expect?

Diaphoresis

A nurse is preparing to begin a 24-hr urine collection for a client. Which of the following actions should the nurse take?

Discard the first voiding when beginning the test.

A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder?

Dysuria and penile discharge

The nurse is reinforcing discharge instructions to a client receiving sulfadiazine. Which should be included in the list of instructions?

Maintain a high fluid intake. - Sulfadiazine: Antibiotics It can treat urinary tract infections, malaria, ear infections, and toxoplasmosis. It can also help prevent rheumatic fever and meningitis.

___________ is the common early phase of acute renal failure characterized by urine production of less than 400 mL in 24 hours

Oliguria

A nurse is collecting data from a client who has returned to the medical-surgical unit following a CT scan of the kidneys with IV contrast. Which of the following findings should the nurse identify as an indication the client is experiencing an allergic reaction to the contrast material?

Pruritus

Oxybutynin chloride is prescribed for a client with neurogenic bladder. Which sign would inidcate a possible toxic effect related to this medicaiton?

Restlessness - Oxybutynin: Bladder relaxant It can treat overactive bladder.

A nurse is checking a client's laboratory findings. Which of the following findings is expected for a client who has stage 3 chronic kidney disease?

Serum potassium 6.0 mEq/L

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse rim-should instruct the client to report which symptom if it developed during the course of this medication therapy?

Sore throat - Trimethoprim-sulfamethoxazole: Antibiotics It can treat or prevent infections.

A nurse is caring for a client experiencing urge incontinence. What should the nurse include in the client educaiton?

Tell the client to perform Kegel exercises daily.

A voiding _______ is a fluoroscopic test performed to diagnose vesicoureteral reflux.

cystourethrogram

A nurse is caring for several clients. Which of the following clients are at risk for developing pyelonephritis? (Select all that apply) (4)

1. A client who is at 32 weeks of gestation 2. A client who has kidney calculi 3. A client who has a neurogenic bladder 4. A client who has diabetes mellitus

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply (4)

1. Check the level of the drainage bag 2. Reposition the client to his or her side 3. Place the client in good body alignment 4. Check the peritoneal dialysis system for kinks

A nurse is contributing to the plan of care for a client who has chronic pyelonephritis. Which of the following actions should the nurse recommend? (Select all that apply) (4)

1. Assist with a referral for nutrition counseling 2. Palpate the costovertebral angle 3. Monitor urinary output 4. Administer antibiotics

A nurse is assiting in the planning of care for a client who has chronic kidney disease. Which of the following actions should the nurse include in the plan of care? (Select all that apply) (4)

1. Auscultate lungs for pulmonary edema 2. Provide frequent mouth rinses 3. Restrict fluids based on urinary output 4. Monitor for weight gain trends

A nurse is reviewing information with a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (Select all that apply) (3)

1. Avoid sitting in a wet bathing suit 2. Empty the bladder when there is an urge to void 3. Take a shower daily

The nurse is caring for the client with epididymitis. Which treatment modalities should be implemented? Select all that apply (4)

1. Bed rest 2. Sitz bath 3. Antibiotics 4. Scrotal elevation

A nurse reinforcing discharge teaching with a client who has spontaneously passed a calcium oxalate calculus. To decrease the chance of recurrence, the client should avoid which of the following foods? (Select all that apply) (3)

1. Black tea 2. Peanuts 3. Spinach

A nurse is contributing to the plan of care for a client who received hemodialysis. Which of the following interventions should the nurse recommend? (Select all that apply) (4)

1. Check BUN and serum creatinine 2. Administer medications the nurse withheld prior to dialysis 3. Observe for manisfestations of hypovolemia 4. Monitor the access site for bleeding

The nurse is reviewing the client's record and notes that the primary health care provider (PHCP) has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal funciton? Select all that apply

1. Elevated serum creatinine level 2. Decreased red blood cell (RBC) count 3. Elevated blood urea nitrogen (BUN) level

A nurse is caring for a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? (Select all that apply) (4)

1. Identify an allergy to seafood 2. Withhold metformin for 24 hr. 3. Administer an enema 4. Check for asthma

A nurse is reinforcing discharge instructions with a client who had spontaneous passage of a calcium phosphate renal calculus. Which of the following instructions should the nurse include in the teahcing? (Select all that apply). (4)

1. Limit intake of food high in animal protein 2. Reduce sodium intake 3. Report burning with urination to the provider 4. Increase fluid intake to 3 L/day

A nurse is caring for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse plan to take? (Select all that apply) (4)

1. Monitor serum glucose levels 2. Report cloudly dialysate return 3. Monitor for shortness of breath 4. Check the access site dressing for wetness

A nurse is contributing to the plan of care for a client who has postrenal AKI due to metastatic cancer. The client has a serum creatinine of 5 mg/dL. Which of the following interventions should the nurse recommend? (Select all that apply) (3)

1. Provide a high-protein diet 2. Check the urine for blood 3. Monitor for intermittent anuria

A nurse is caring for a client who has acute kidney injury and is scheduled for hemodialysis. Which of the following actions should the nurse take? (Select all that apply) (4)

1. Review the medications the client currently takes 2. Check the AV fistula for a bruit 3. Measure the client's weight 4. Check serum electrolytes

After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate?

Bleeding

A nurse is carinf for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take?

Check level of consciousness

The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which class of medicaitons?

Decongestants

The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom?

Decreased force in the stream of urine

A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take?

Determine if there is a history of allergies

A nurse is preparing a client for an intervenous pyelogram (IVP). What intervention should the nurse be prepared to implement?

Determine whether the client is allergic to shellfish

The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identigy as a risk factor for this diagnosis?

Diabetes mellitus

A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client?

Hemorrhage

]The nurse is reviewing the laboratory results of a client being evaluated for urinary functioning and notes that bilirubin is present in the urine. What condition would the nurse suspect?

Hepatitis - Bilirubin is a product of red blood cell breakdown. Normally, bilirubin is carried in the blood and passes into your liver, where it's removed and becomes part of bile. Bilirubin in your urine may indicate liver damage or disease. - Hepatitis is an inflammation of the liver

The nurse is instructing a client with diabetes mellitis about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?

Hyperglycemia

A postoperative client is prescribed morphine to control pain related to knee replacement. The medication causes the client to be confused and agitated with attempts to get out of bed on her own. Restraints are ordered, which cause the client to be incontinent. What type of incontinence is this client experiencing?

Iatrogenic incontinence - Iatrogenic incontinence is drug-induced incontinence. Some drugs, such as muscle relaxants and nervous system blockers, may result in weakening the sphincter muscle. Other drugs, such as antihistamines, may block the normal transmission of nerve impulses to and from the bladder.

A 37-year-old male client presents at the emergency department reporting excruciating pain that comes in waves, along with nausea, vomiting, and chills. The nurse suspects the client has kidney stones. What test would be ordered to confirm or rule out this condition?

KUB (Kidney Ureter Bladder) flat plate of the abdomen

T/F - Chronic glomerulonephritis is a more serious condition than acute glomerulonephritis

True

Bethanechol chloride is prescribed for a client with urinary retention. Which disorder should be a contraindication to the administration of this medicaiton?

Urinary strictures - Bethanechol chloride: Saliva production stimulator and Urinary retention medication It can treat urinary and bladder problems by emptying the bladder and increasing urination.

A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instrucitons?

Use warm sitz baths and analgesics to increase comfort

Clients should be placed in a ________ position for 24 hours following a renal biopsy

supine

Following identification of a mass by imaging studies, a client undergoes a needle biopsy of the kidney for a specific diagnosis. Which should the nurse consider for this procedure?

Apply pressure to the site to minimize bleeding

A hemodialysis client with a left arm fisutla is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder?

Pallor, diminished pulse, and pain in the left hand

A nurse is checking urinalysis results for four clients. Which of the following urinalysis results indicates a urinary tract infection?

Positive for leukocyte esterase

_______ incontinence refers to incontinence that can be reversed with diagnosis and treatment of the precipitating cause

Transient