Urinary System (2 of 2)

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

painless hematuria

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?

urinary urgency

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse?

"Even a perfect match does not guarantee organ success."

The nurse is caring for a 13-year-old female client diagnosed with urethritis. Which of the following assessment answers would indicate that further instruction is needed? Select all that apply.

"I change my sanitary napkin when it is full." "I take a bubble bath a couple of times per week." "I clean my private area with soap and water."

Following ureteroscopy, for the removal of ureteral calculus, a stent is temporarily left in place. The client asks what purpose the stent provides. Which is the best response from the nurse?

"Inflammation from the stone can block the flow of urine."

An investment banker, with chronic renal failure, informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?

"This type of dialysis will provide more independence."

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?

"Very few symptoms are associated with renal cancer."

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

Need to urinate after engaging in sexual intercourse

The nurse evaluates the client as experiencing symptoms of disequilibrium syndrome, following an initial hemodialysis treatment. Which is the best action to be taken by the nurse?

Slow the dialysis process during future treatment.

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?

SpO2 at 90% with fine crackles in the lung bases

The nurse is caring for a client diagnosed with bladder stones. The client is scheduled for a litholapaxy. Which nursing action is most important to complete prior to the procedure?

Strain all urine

The nurse is caring for a 37-year-old female client with potential interstitial cystitis. Which question, asked by the nurse, is helpful in suggesting the disease?

"When was your last menstrual period?"

The nurse is caring for a client with chronic bladder infections and inflammation. The physician has ruled out several medical diagnoses and is considering interstitial cystitis. The nurse is most correct to anticipate which diagnostic test to confirm the disorder?

A bladder biopsy

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

A low-purine diet

The nurse is employed in an urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

Anticholinergic

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

The nurse is providing instruction in stoma care with temporary bag following an ileal conduit surgery. Which of the following instructions are accurate? Select all that apply.

Ascorbic acid suppresses urine odors. Change the pouch every 4 to 7 days if it is a two-piece pouch. Apply an appliance deodorant to decrease odors.

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?

Brief, hot daily showers

As the nurse comes from morning report, the nurse is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention?

Client voided 300 mL with 250 mL residual volume

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively?

Client's manual dexterity and vision

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?

Decrease in the blood flow through the kidneys

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?

Coffee in the morning

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?

Diminished erythropoietin production

The nurse is caring for a client with cystitis. Which adjunct therapy is the nurse most correct to suggest to keep bacteria from adhering to the wall of the bladder?

Drinking cranberry juice

An older adult male client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises him to wear barrier garments, such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity?

Exposing the affected area to air

A chronic renal failure client complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

Hyperphosphatemia

The nurse is caring for a male client who has a significant urinary narrowing secondary to an enlarged prostate. Which nursing action is best to relieve his urinary retention?

Insert a coudé catheter to remove urine from the bladder.

A nephrostomy tube is inserted in a client with a large ureteral calculus. Which is the most important consideration in providing nursing care for this client?

Maintain free, continuous urine drainage.

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client's history prior to administering care, which is of most concern?

New diagnosis of urosepsis

The licensed practical nurse is employed as a charge nurse at a long-term care facility. A resident is ordered a catheterization schedule of every 6 hours due to chronic urinary retention. The LPN reports daily catheterization amounts from the previous day ranging from 450 to 800 mL. Which nursing action is most correct?

Obtain an order to increase the frequency of the catheterizations.

The office nurse is providing information to a client who has experienced recurrent renal calculi. Which of the following jobs would place a client at greatest risk for calculi formation?

Over-the-road truck driver

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

Permanent drainage with a urethral catheter

The nurse is caring for a client who is following a treatment plan to decrease urinary tract infections. Which of the following indicates the need to change the treatment plan?

The client exhibits continued symptoms.

The nurse is caring for four clients on a urinary medical unit. For which client does the nurse need no further medical interventions?

The client has a residual urine of 90 mL on a bedside ultrasound bladder scan.

The nurse is caring for several clients on a urinary medical unit. Which client is at an increased risk for bladder stones?

The client who is paraplegic

The nurse is completing a plan of care for a client with chronic urinary incontinence. Which of the following outcomes is a priority?

The client will maintain perineal skin integrity.

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action, made by the nursing assistant, would require instruction?

The nursing assistant places the drainage bag on the client's abdomen for transport.

A client with several calculi in the ureter is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which teaching statement by the nurse best describes the procedure?

The stone is identified via fluoroscopy and then shock waves are used to shatter the stones.

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections?

The urethra

The nurse is caring for a client with a urinary tract infection and a urethral stricture. Which complication of the condition is the primary cause of infection?

There is a backflow of urine causing a diverticulum.

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?

Urge

The nurse is assessing a client brought to the emergency department for systemic complications after a traumatic event. Which assessment finding is most suggestive of an intact urinary tract?

Urine output is pink and noted at 300 mL.

The nurse is caring for a client who has chronic urinary retention and discussing the options. When discussing care, which intervention is considered first?

Using the Credé's maneuver

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important?

catheterize the client immediately after the client voids.

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

hematuria

A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values?

hyperkalemia

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select?

ileal conduit

The hemodialysis client is scheduled to receive weekly injections of epoetin. Which is the most important consideration to be taken by the nurse in the administration of this medication?

Schedule injection on nondialysis day.

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

Low purine

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?

The kidneys can improve over a period of months.

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands which of the following reasons that this drug is an effective treatment? Select all that apply.

Increases bladder neck resistance Decreases involuntary bladder contractions