renal gu nclex

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"Do you have any pain when you urinate?"

When reading a patient's chart, the nurse notes that the patient has dysuria. To assess whether there is any improvement, which question will the nurse ask?

check which medications the patient is currently taking.

A patient's urine dipstick indicates a small amount of protein in the urine. The next action by the nurse should be to ______________

Large container for urine

A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which equipment will the nurse need to obtain?

bladder cancer.

A 26-year-old patient who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for ________________

ibuprofen (Motrin)

During assessment of a patient with decreased renal function, which of these medications taken by the patient at home will be of most concern to the nurse?

Leave a light on in the bathroom during the night.

An 82-year-old man has been admitted with benign prostatic hyperplasia. Which of the following is most appropriate to include in the nursing plan of care?

Document the information on the assessment form.

While assessing a patient's urinary system, the nurse cannot palpate either kidney. Which action should the nurse take next?

Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist.

How will the nurse assess the flank area of a patient with pyelonephritis for tenderness?

60, The creatinine clearance approximates the GFR.

The result of a patient's creatinine clearance test is 60 mL/min. The nurse equates this finding to a glomerular filtration rate (GFR) of _____ mL/min.

identify renal artery or aortic bruits.

The nurse uses auscultation during assessment of the urinary system to __________________

The patient describes allergies to shellfish and penicillin.

A patient who is scheduled for an intravenous pyelogram (IVP) gives the nurse the following information. Which information has the most immediate implications for the patient's care?

"Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."

When teaching a patient scheduled for a cystogram via a cystoscope about the procedure, the nurse tells the patient, ________________

may experience blood-tinged urine and urinary frequency.

The nurse informs the patient undergoing cystoscopy that following the procedure, the patient _________________

a Fleet enema.

A patient with an elevated blood urea nitrogen (BUN) and serum creatinine is scheduled for a renal arteriogram. The nurse should question an order from radiology for bowel preparation with the use of

teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.

The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a patient with a suspected urinary tract infection (UTI). To obtain the specimen, the nurse will plan to

Monitor the urine output after the procedure.

A hospitalized patient with a decreased glomerular filtration rate is scheduled to have an intravenous pyelogram (IVP). Which action will be included in the plan of care?

Apply a pressure dressing and keep the patient on the affected side for 30 to 60 minutes.

A patient with diabetic nephropathy is admitted for a right renal biopsy. Immediately after the biopsy, which of these is an essential nursing action?

Ask the patient about use of any medications.

A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is a red-orange color. Which action should the nurse take first?

Ask about the usual urinary pattern and any measures used for bladder control.

Which of the following actions will the nurse plan to take first when admitting a patient who has a history of neurogenic bladder as a result of a spinal cord injury?

WBC: 20-26/hpf

When reviewing the results of a patient's urinalysis, which information indicates that the nurse should notify the health care provider?

The respiratory rate is 38 breaths/minute.

Following an intravenous pyelogram (IVP), all of the following assessment data are obtained. Which one requires immediate action by the nurse?

Obtain a midstream urine specimen for culture and sensitivity testing.

A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?

"I will empty my bladder every 3 to 4 hours during the day."

The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) for a patient with cystitis has been effective when the patient states, ___________________

The urine may turn a reddish-orange color.

Which information will the nurse include when teaching the patient with a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)?

Costovertebral tenderness

A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital with chills, fever, and vomiting. Which finding by the nurse will be most helpful in determining whether the patient has an upper urinary tract infection (UTI)?

"I should start taking a high potency multiple vitamin every morning."

After teaching a patient with interstitial cystitis about management of the condition, the nurse determines that further instruction is needed when the patient says, __________________

recent sore throat and fever.

When admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the patient about ________________

Peripheral and periorbital edema is resolved.

Which finding by the nurse for a patient admitted with glomerulonephritis indicates that treatment has been effective?

anticoagulants.

A patient with nephrotic syndrome develops flank pain. The nurse will anticipate teaching the patient about treatment with ______________

Recent weight gain

A patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect to find related to this illness?

organ meats and sardines.

A patient's renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, the nurse teaches the patient to avoid eating __________________

have 2000 to 3000 mL of fluid a day.

To prevent the recurrence of renal calculi, the nurse teaches the patient to _____________

monitoring and recording blood pressure.

When planning teaching for a patient with benign nephrosclerosis the nurse should include instructions regarding ________________

Importance of genetic counseling

A 32-year-old patient is diagnosed with polycystic kidney disease. Which information is most appropriate for the nurse to include in teaching at this time?

gonococcal urethritis.

When assessing a 30-year-old man who complains of a feeling of incomplete bladder emptying and a split, spraying urine stream, the nurse asks about a history of ______________

bladder cancer.

After obtaining the health history for a 25-year-old who smokes two packs of cigarettes daily, the nurse will plan to do teaching about the increased risk for __________

Assist the patient to the bathroom every 2 hours during the day.

A 78-year-old who has been admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action will be best to include in the plan of care?

Teach the patient how to perform Kegel exercises.

A 62-year-old asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is most appropriate to include in the care plan?

Use an ultrasound scanner to check the postvoiding residual.

Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes. Which nursing action is most appropriate?

Place a bedside commode near the patient's bed.

A patient in the hospital has a history of functional urinary incontinence. Which nursing action will be included in the plan of care?

"I will clean the catheter carefully before and after each catheterization."

After the home health nurse teaches a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying, which patient statement indicates that the teaching has been effective?

Call the health care provider if the ureteral catheter output drops suddenly.

Which action will the nurse include in the plan of care for a patient who has had a ureterolithotomy and has a left ureteral catheter and a urethral catheter in place?

Catheterization technique and schedule

A patient who has bladder cancer had a cystectomy with creation of an Indiana pouch. Which topic will be included in patient teaching?

disturbed body image related to change in body function.

Two days after surgery for an ileal conduit, the patient will not look at the stoma or participate in care. The patient insists that no one but the ostomy nurse specialist care for the stoma. The nurse identifies a nursing diagnosis of __________

The patient has noticed clots in the urine.

A patient who has had a transurethral resection with fulguration for bladder cancer 3 days previously calls the nurse at the urology clinic. Which information given by the patient is most important to report to the health care provider?

the need to empty the bladder before treatment.

A patient with bladder cancer is scheduled for intravesical chemotherapy. In preparation for the treatment the nurse will teach the patient about ______________

Avoid unnecessary catheterizations.

Which nursing action will be most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in patients admitted to the hospital?

pain with urination.

When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask about _____________

Blood pressure 88/45 mm Hg

Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?

Excess fluid volume related to low serum protein levels

A patient who is diagnosed with nephrotic syndrome has 3+ ankle and leg edema and ascites. Which nursing diagnosis is a priority for the patient?

Insert a urinary retention catheter.

An 88-year-old with benign prostatic hyperplasia (BPH) has a markedly distended bladder and is agitated and confused. Which of the following interventions prescribed by the health care provider should the nurse implement first?

Administer prescribed analgesics.

A patient with renal calculi is hospitalized with gross hematuria and severe colicky left flank pain. Which nursing action will be of highest priority at this time?

Change the ostomy appliance.

Which nursing action should the nurse who is caring for a patient who has had an ileal conduit for several years delegate to nursing assistive personnel (NAP)?

Drop in urine output

When the nurse is caring for a patient who has had left-sided extracorporeal shock wave lithotripsy, which assessment finding is most important to report to the health care provider?

Assist the patient to take a 15-minute sitz bath.

Following an open loop resection and fulguration of the bladder, a patient is unable to void. Which nursing action should be implemented first?

Disconnecting the catheter from the drainage tube to obtain a specimen

The nurse observes nursing assistive personnel (NAP) taking the following actions when caring for a patient with a retention catheter. Which action requires that the nurse intervene?

Urine output is 20 mL/hr for 2 hours.

A patient undergoes a nephrectomy after having massive trauma to the kidney. Which assessment finding obtained postoperatively is most important to communicate to the surgeon?

Heart rate 102 beats/minute

Which assessment finding for a patient who has had a cystectomy with an ileal conduit the previous day is most important for the nurse to communicate to the physician?

Give ketorolac (Toradol) 10 mg PO PRN for pain.

A 26-year-old patient with a history of polycystic kidney disease is admitted to the surgical unit after having knee surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider?

Left-sided flank pain

Which information noted by the nurse when caring for a patient with a bladder infection is most important to report to the health care provider?

Report the patient's symptoms to the health care provider.

After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains of pain and coldness of the right fingers. Which action should the nurse take?

rapid respirations.

A patient with acute kidney injury (AKI) has an arterial blood pH of 7.30. The nurse will assess the patient for _________________

maintaining cardiac output.

A patient with severe heart failure develops elevated blood urea nitrogen (BUN) and creatinine levels. The nurse will plan care to meet the goal of __________________

Cardiac rhythm

A patient who has acute glomerulonephritis is hospitalized with acute kidney injury (AKI) and hyperkalemia. Which information will the nurse obtain to evaluate the effectiveness of the prescribed calcium gluconate IV?

Ibuprofen (Advil) 400 mg PO PRN for pain

A patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which of these orders for the patient will the nurse question?

"I will measure my urinary output each day to help calculate the amount I can drink."

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

Phosphate level

Which patient information will the nurse plan to obtain in order to determine the effectiveness of the prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)?

patient's bowel sounds.

Before administering sodium polystyrene sulfonate (Kayexalate) to a patient with hyperkalemia, the nurse should assess the ______________

Scrambled eggs, English muffin, and apple juice

The nurse has instructed a patient who is receiving hemodialysis about appropriate dietary choices. Which menu choice by the patient indicates that the teaching has been successful?

serum phosphate.

Before administration of calcium carbonate (Caltrate) to a patient with chronic kidney disease (CKD), the nurse should check the laboratory value for _______________

Calculated glomerular filtration rate (GFR)

Which information will be most useful to the nurse in evaluating improvement in kidney function for a patient who is hospitalized with acute kidney injury (AKI)?

is much less likely to clot.

A patient needing vascular access for hemodialysis asks the nurse what the differences are between an arteriovenous (AV) fistula and a graft. The nurse explains that one advantage of the fistula is that it

Check the fistula site for a bruit and thrill.

When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula?

More protein will be allowed because of the removal of urea and creatinine by dialysis.

When a patient who has had progressive chronic kidney disease (CKD) for several years is started on hemodialysis, which information about diet will the nurse include in patient teaching?

The patient cleans the catheter while taking a bath every day.

Which action by a patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD?

The patient has metastatic lung cancer.

When the nurse is taking a history for a patient who is a possible candidate for a kidney transplant, which information about the patient indicates that the patient is not an appropriate candidate for transplantation?

Joint pain

The nurse is caring for a patient who had kidney transplantation several years ago. Which assessment finding may indicate that the patient is experiencing adverse effects to the prescribed corticosteroid?

There is a nontender lump in the axilla.

Which data obtained when assessing a patient who had a kidney transplant 8 years ago and who is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone (Deltasone) will be of most concern to the nurse?

Milk of magnesia 30 mL

A patient with chronic kidney disease (CKD) brings all home medications to the clinic to be reviewed by the nurse. Which medication being used by the patient indicates that patient teaching is required?

potassium.

A patient with hypertension and stage 2 chronic kidney disease (CKD) is receiving captopril (Capoten). Before administration of the medication, the nurse will check the patient's ___________________

blood urea nitrogen (BUN) and creatinine.

A new order for IV gentamicin (Garamycin) 60 mg BID is received for a patient with diabetes who has pneumonia. When evaluating for adverse effects of the medication, the nurse will plan to monitor the patient's _______________

Hemoglobin level 13 g/dL

Which of the following information obtained by the nurse who is caring for a patient with end-stage renal disease (ESRD) indicates the nurse should consult with the health care provider before giving the prescribed epoetin alfa (Procrit)?

Place the patient on bed rest.

In a patient with acute kidney injury (AKI) who requires hemodialysis, a temporary vascular access is obtained by placing a catheter in the left femoral vein. Which intervention will be included in the plan of care?

Serum potassium level 6.5 mEq/L

When the nurse is caring for a patient who has been admitted with a severe crushing injury after an industrial accident, which laboratory result will be most important to report to the health care provider?

Insert retention catheter.

A patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and an elevated blood urea nitrogen (BUN) and creatinine. Which of these prescribed therapies should the nurse implement first?

Urine output over an 8-hour period is 2500 mL.

Which information about a patient who was admitted 10 days previously with acute kidney injury (AKI) caused by dehydration will be most important for the nurse to report to the health care provider?

Check the chart for the most recent blood potassium level.

After noting lengthening QRS intervals in a patient with acute kidney injury (AKI), which action should the nurse take first?

Place the patient on a cardiac monitor.

When caring for a dehydrated patient with acute kidney injury who is oliguric, anemic, and hyperkalemic, which of the following prescribed actions should the nurse take first?

Check blood pressure before starting dialysis.

Which nursing action for a patient who has arrived for a scheduled hemodialysis session is most appropriate for the RN to delegate to a dialysis technician?

The LPN/LVN gives the iron supplement and phosphate binder with lunch.

The RN observes an LPN/LVN carrying out all of the following actions while caring for a patient with stage 2 chronic kidney disease. Which action requires the RN to intervene?

The patient's peritoneal effluent appears cloudy.

The nurse is assessing a patient who is receiving peritoneal dialysis with 2 L inflows. Which information should be reported immediately to the health care provider?

The patient's central venous pressure (CVP) is decreased.

Two hours after a kidney transplant, the nurse obtains all of the following data when assessing the patient. Which information is most important to communicate to the health care provider?

1000

A patient in the oliguric phase of acute renal failure has a 24-hour fluid output of 150 mL emesis and 250 mL urine. The nurse plans a fluid replacement for the following day of ___ mL.

Check the patient's blood pressure.

During hemodialysis, a patient complains of nausea and dizziness. Which action should the nurse take first?

Urine output

Which parameter will be most important for the nurse to consider when titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation?

infuse a bolus of normal saline.

A patient complains of leg cramps during hemodialysis. The nurse should first _____________

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