Exam 2: Renal/Urologic Disorders

Question 1

What is the main clinical manifestation of a urinary tract infection?

Answer 1

Costovertebral tenderness (pain over the area where the kidney is) indicating an upper UTI, which can be more serious/difficult to treat

Question 2

What should female patients be encouraged to do to prevent a UTI?

Answer 2

Wiping from the front to back

Question 3

What is one way to prevent a CAUTI?

Answer 3

Removing the catheter as soon as possible (ex: 24 hrs after surgery)

Question 4

Nursing care for UTI?

Answer 4

Patient should increase fluid intake and empty the bladder every 2-3 hrs while awake to decrease the likelihood of bacteria building up

Question 5

What lab findings will be seen in a patient with nephrotic syndrome?

Answer 5

Decreased serum albumin which is a common cause of edema

Question 6

What is expected to be seen in a patient with a new onset of nephrotic syndrome?

Answer 6

Recent weight gain

Question 7

What are risk factors for developing urinary tract calculi (kidney stones) (4)

Answer 7

• warm climate changes
• metabolic changes
• genetic factors
• excessive amts of food that contain uric acid (sardines, meats/organ meats/red meats, cheeses, wine)

Question 8

What is the highest priority treatment for a urinary calculi/kidney stone?

Answer 8

Treatment of pain due to the patient possibly passing the stones through their urine without surgery

Question 9

Care for a patient with renal calculi or kidney stone?

Answer 9

Administer prescribed analgesics and opioids to relieve renal colic pain

Question 10

What should the nurse teach the patient to expect after a shock wave procedure to break down the kidney stone?

Answer 10

First few times that the patient voids after this procedure may be bright red (hematuria), which is normal and expected

Question 11

What should be done to avoid the recurrence of renal calculi?

Answer 11

Drinking 2000-3000 mL of fluids/day

Question 12

What type of exercises should be promoted to a patient who has urinary incontinence?

Answer 12

Kegal pelvic exercises

Question 13

What are the goals of treatment for urinary incontinence?

Answer 13

Frequent urination every 2-3 hrs and identifying the factors that led to incontinence

Question 14

A 55- year- old woman who is admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing and coughing causes leakage of urine. What is an intervention that the nurse can do?

Answer 14

Teach the patient how to perform Kegal exercises

Question 15

What lab result is expected to find in a patient with acute kidney injury (AKI)?

Answer 15

Increase in serum creatinine levels (indicates that the kidneys are not functioning at the highest capacity)

Question 16

Causes of?

• prerenal
• intrarenal
• postrenal

Answer 16

Prerenal: reduction of renal blood flow
Intrarenal: direct damage to the kidney tissue
Postrenal: obstruction to the outflow of urine causing backflow into renal pelvis

Question 17

Clinical manifestations/phases (3) of an AKI?

Answer 17

Oliguric phase: patient is not urinating
Diuretic phase: urine output 1-3 liters but may reach 5 liters (concerns over deydration)
Recovery phase: GFR increases, allowing BUN and creatinine levels to decrease

Question 18

Main diagnostic study for an AKI?

Answer 18

Increase in serum creatinine and BUN testing

Question 19

What indicates to the nurse that the patient with AKI is in the recovery phase?

Answer 19

Decrease in BUN and creatinine levels

Question 20

Clinical manifestations of chronic kidney disease (CKD) and what is its main form of treatment (2)

Answer 20

Anuria: inability to urinate
Treat anuria by:
- placing on immediate dialysis
- strict I&Os

Question 21

One of the systemic manifestation of CKD is musculoskeletal issues, which serum level is likely to be seen with this?

Answer 21

Decrease in calcium levels because less vitamin D is converted to its active form (patient should not limit calcium intake)

Question 22

Which serum level (2) should be monitored routinely in patients with CKD and why?

Answer 22

• potassium and sodium levels
• because medications for blood pressure such as beta-blockers, ace inhibitors, and diuretics can greatly affect electrolyte levels

Question 23

Stages of CKD are based on?

Answer 23

GFR

Question 24

Which lab value indicates that CKD is getting worse?

Answer 24

GFR

Question 25

Dialysis removes and re-establishes? (3)

Answer 25

• removes metabolic waste

- re-establishes normal fluid vol and electrolyte imbalance

Question 26

What complication is the patient at high risk for when undergoing peritoneal dialysis?

Answer 26

Risk for infection is very high at the site of the peritoneal wall of the abdomen

Question 27

To prevent the most common serious complication of PD, what is the most important for the nurse to do?

Answer 27

Use strict aseptic technique

Question 28

What 2 indicators show a very serious issue that can indicate occlusion in a patient receiving hemodialysis?

Answer 28

Lack of thrill and bruit

Question 29

What foods should be limited for a patient with a high risk of renal calculi?

Answer 29

Anchovies and shellfish