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urinary system and disorders and meds MS 33, 34 pharm 41
Terms in this set (83)
An 85-year-old patient was held NPO since midnight last night for diagnostic testing. The procedure is now complete at 10:00 AM. The nurse should:
offer 4 ounces of water or juice every hour.
The nurse cautions the diabetic patient that ultimately the disease will affect the blood flow through the kidney due to:
scleroses of renal vessels.
. The nurse explains that when the kidney suffers an autoimmune inflammatory reaction, the glomeruli lose their ability to function effectively, which leads to:
The nurse understands that most often tumors occur in the bladder because the bladder wall is exposed most frequently to:
When the patient asks why he has so many urinary tract infections (UTIs), the nurse points out that UTIs can result from:
bacteria that have colonized in the kidney.
The nurse clarifies that nephrotoxic drugs such as doxycycline and rifampin can cause kidney damage by:
chemical alterations of glomeruli.
The nurse recommends that, in order to keep optimum flow through the urinary system, a person should have a minimum intake of _____ mL/day.
2000 to 2500
When a patient is put on a sulfa drug, the nurse adds interventions to the nursing care plan to increase the daily fluid intake to a minimum of _____ mL/day.
The nurse reviewing laboratory reports on kidney function identifies a result that suggests decreased renal function, which is:
creatinine, 2.0 mg/dL.
A patient is scheduled to have a cystometrography performed. Which statement by the patient indicates an understanding of the planned test?
The test will measure my urine flow volume and muscle function.
The nurse is caring for a woman suspected of having a vaginal fistula. Which finding will support the proposed diagnosis?
When the patient reports he has blood in his urine the moment he starts to void that disappears until the next time he voids, the nurse is aware that the source of the bleeding is most probably:
in the urethra.
The nurse is collecting data from a patient who complains of having urinary frequency. When reviewing the patients health history, the nurse would be prompted to inquire about the patients intake of:
The student nurse is attempting to irrigate an indwelling catheter. Which action by the student nurse best indicates an understanding of the correct procedure to employ?
The student nurse uses steady gentle pressure.
The patient confides that sneezing makes her wet her pants. The nurse recognizes that this is a cardinal sign of ______ incontinence.
A frustrated patient reports that, after two surgeries to correct incontinence, she is still involuntarily voiding. Which suggestion by the nurse would be most helpful to the patient at this time?
Keep a voiding diary.
In instructing the patient in the use of vaginal weight training, the nurse coaches the patient to insert the smallest of the cones in the vagina and:
hold it in place with muscle tightening for 15 minutes and remove it.
A patient has just returned to the nursing unit after having a renal biopsy. When planning the patients care, which instruction will most likely be included?
The patient should remain flat in bed for at least 6 hours after the procedure.
The nurse is caring for a patient who recently had abdominal surgery. When evaluating the patients output, the nurse correctly recognizes that urinary output less than ________ mL/hr is considered inadequate.
A patient has had diagnostic tests to assess uric acid levels. The tests reveal that levels are elevated. The nurse should consider the patients intake of what to potentially explain excessive levels?
The nurse lists the functions of the kidney, which include: (Select all that apply.)
regulation of electrolytes.
elimination of metabolic waste.
regulation of fluid volume.
regulation of blood pressure.
secretion of erythropoietin.
The nurse outlines the age-related changes that occur in the urinary system, which include: (Select all that apply.)
hypertrophy of the prostate.
decrease in secretion of renin.
decrease in muscle tone of bladder.
The nurse is discussing bladder health with a patient. During the discussion, the nurse has emphasized the need to void in a timely manner. Which statement by a patient indicates understanding of the rationale behind the recommendations? (Select all that apply.)
Urinating regularly will prevent prolonged exposure of the bladder wall to harmful wastes.
Allowing my bladder to overfill causes the walls to overstretch.
A full bladder can cause undue strain on the urinary sphincters.
While caring for a patient with an indwelling catheter, the nurse will include in the daily care the interventions of: (Select all that apply.)
observing tube placement and level of urine in collection bag.
keeping the drainage bag below the level of the bed.
cleaning the meatus and catheter with soap and water.
When the patient complains of urinary retention, the nurse can help the patient to void by: (Select all that apply.)
offering caffeine or carbonated drinks.
providing a warm bath.
instructing in the double void technique.
running water in the lavatory to stimulate urination.
The basic functional unit of the kidney is the ________.
The nurse explains that the urge to void occurs when the bladder contain as little as ______ mL of urine.
Blood in the urine
Urination at night
High urinary output
Absence of urine
When a 90-year-old resident in a long-term care facility becomes progressively confused and irritable, the nurse should:
request an order for a urinalysis
During the review of the medications to be administered, the nurse notes that a patient has been prescribed liquid nitrofurantoin (Furadantin). The nurse will add an intervention to the nursing care plan to:
rinse the mouth after administration.
When a 25-year-old woman comes to the emergency department with nonspecific urethritis, the nurse is prompted to inquire about the patients use of:
A 25-year-old man comes to the college clinic with fever of 101 F and pain in the flank radiating into the thigh and genitals. He complains of nausea. The nurse recognizes these complaints as being indicative of:
The nurse cautions a young man who is taking ciprofloxacin (Cipro) for pyelonephritis to take all the prescription as directed in order to prevent recurrence, which can cause:
scarring of the renal pelvis.
The nurse is reviewing the history and physical examination of a 22-year-old man hospitalized for acute glomerulonephritis. The nurse recognizes the significant information of the probable etiology of this disease as:
a recent strep throat infection.
. The nurse evaluates a need for further instruction about a sodium-restricted diet when the patient with glomerulonephritis says:
Im glad I can still drink carbonated drinks.
Plasmapheresis has been ordered for the patient diagnosed with glomerulonephritis. Before the procedure, the patient correctly reports that the procedure will help her when she states that it will:
Identify specific organisms causing my disease.
The nurse is caring for a patient diagnosed with glomerulonephritis. The nurse notes that the patient is feeling confined with reports of feeling bored and caged. During the interaction, the patient asks when he can resume his normal activities. The nurse clarifies that bed rest is enforced until:
hypertension and hematuria are gone.
The nurse explains that as chronic glomerulonephritis develops, the kidney:
When the patient enters into nephrotic syndrome after an exacerbation of glomerulonephritis, the nurse would expect to see:
decreased serum albumin.
A patient who has a kidney stone lodged in the ureter questions why it must be removed. What response by the nurse is most appropriate?
You may experience a condition known as hydronephrosis, which will result in increased pressure in your renal structures above the stone.
To relieve hydronephrosis, the patient has undergone a right nephrostomy. The nursing responsibility in this condition is:
assessing urinary output from the left kidney.
The nurse assessing a 50-year-old woman who was involved in a car accident 2 hours ago finds marked tenderness and spasm in the suprapubic area and a nonpulsating mass. The nurse interprets these findings as indication of:
A patient who had a bladder repair following an injury from an automobile accident complains of pain. Which action would be considered an independent nursing intervention that does not require a physicians order?
Apply a cold compress to the surgical site.
After an instillation of doxorubicin (Adriamycin) into the bladder for treatment of cancer in situ, the patient is then:
moved from side to side and from prone to supine.
Before hemodialysis, the nurse will withhold:
The nurse is discussing alternative therapies with a patient who has had repeated urinary tract infections (UTIs) over the past year. The patient asks the nurse if there are any foods that might help her to potentially avoid developing more infections. What response by the nurse is most appropriate?
Studies show support for including vitamin C in the diet to help avoid urinary tract infections.
The nurse is caring for a patient who is being treated for acute pyelonephritis. When performing the assessment, the nurse correctly recognizes that which symptom is consistent with the early stages of the disease?
The nurse is caring for a child suspected of having acute glomerulonephritis. When reviewing the data collected, the nurse is most likely to note what in the health history?
Recent upper respiratory infection
The nurse would question an order for carbenicillin for a patient with a urinary infection if the patient is: (Select all that apply.)
allergic to penicillin.
taking oral contraceptives.
When a patient with a urinary tract infection (UTI) is placed on cefazolin (Ancef), the nurse will monitor for: (Select all that apply.)
A patient has been admitted to the acute care facility to rule out glomerulonephritis. Assessment findings that are supportive of the potential diagnosis include: (Select all that apply.)
. While the patient is on plasmapheresis, the nurse should monitor for: (Select all that apply.)
bleeding at the puncture site.
a bruit at the shunt site.
decreasing blood pressure.
signs of hyperkalemia.
The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation. Which findings place the patient at an increased risk for the development of the renal calculi? (Select all that apply.)
Uric acid crystals in urine
Frequent bacterial urinary infections
Inadequate fluid intake
Prolonged bed rest
Tumor of parathyroid gland
The home health nurse recognizes uremic signs in a patient with chronic renal failure, which include: (Select all that apply.)
restless legs syndrome.
dry, scaly skin.
urea crystals in eyebrows.
The nurse caring for a patient who has just had an arteriovenous (AV) access created in his right forearm this morning should assess: (Select all that apply.)
for a bruit on auscultation of the AV site.
capillary refill in the left hand.
adequate elevation of the right arm.
clotting of the AV access.
The nurse is aware that 80% of urinary tract infections (UTIs) in females are the result of contamination from __________.
Vascular changes related to diabetes mellitus
. Ureteral obstruction
. Prostate hypertrophy
What is the action of urinary antimicrobial agents?
Have an antiseptic effect on the urine and the urinary tract
A patient is complaining of moderate bladder pain and spasms secondary to a UTI. Which drug would assist in relieving symptoms?
Phenazopyridine hydrochloride (Pyridium)
A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells, and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the health care provider will order?
How often is fosfomycin (Monurol) usually administered when used in the treatment of UTIs?
In a one-time dose
After undergoing prostate surgery, a patient is discharged on the medication phenazopyridine hydrochloride (Pyridium) to assist with urinary catheter discomfort. What information will the nurse include in the discharge teaching?
Urine will appear reddish orange.
A 14-year-old male is taking tolterodine (Detrol). What is the action of this drug?
Decreases the urge to void
Which condition will neostigmine be used to treat?
Postoperative or postdelivery urinary retention
Which organism causes most UTIs?
What may become discolored by phenazopyridine (Pyridium) in addition to the urine?
The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
I will limit my fluid intake.
The nurse is preparing to administer a single dose packet of fosfomycin to a patient diagnosed with a UTI. When preparing this medication, the nurse will:
mix contents with 120 mL of water and administer by mouth.
When obtaining urine for analysis on a patient in the labor and birth unit, the nurse assesses the urine to appear frothy. The nurse interprets this as a sign of possible:
A patient has been taking an antimicrobial agent prescribed to treat a UTI for 2 days. She contacts the health care providers office to report persistence of symptoms. In evaluating the medication effectiveness, which assessment(s) would be important?(Select all that apply.)
Complete emptying of the bladder
Amount of pain with urination as well as frequency
Amount of daily fluid intake and output
GI symptom complaints
Bleeding with urination
The nurse is assisting with postpartum care for a mother who has given birth to her fourth child. She reports a moderate amount of urinary incontinence since the birth of the third child and is concerned that this problem will worsen. Which instruction(s) may facilitate management of incontinence? (Select all that apply.)
Instruction of proper wiping techniques to prevent bacterial infection
Education on bladder training and Kegel exercises
Information on personal hygiene measures to prevent perianal breakdown
Information of incontinence products and appliances
Importance of establishing a regular toileting schedule
The nurse is reviewing the urinalysis results of an older adult patient admitted with elevated temperature and incontinence. Which urinalysis properties are indicative of an infection? (Select all that apply.)
pH of 8.2
Which intervention(s) will help stimulate urination when a patient is experiencing postoperative urinary retention? (Select all that apply.)
Administration of bethanechol chloride (Urecholine)
Pouring warm water over the perineum
Fluoxetine, erythromycin, clarithromycin, ketoconazole, itraconazole, miconazole, vinblastine, ritonavir, and nefazodone may inhibit the metabolism of which drugs? (Select all that apply.)
The nurse is caring for a patient taking Pyridium for the diagnosis of UTI. What should the nurse report to the health care provider? (Select all that apply.)
Increased pain and burning
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