Exam 3 Flashcards
what are some findings from a urinalysis that may indicate a possible UTI?
foul odor and presence or nitrites and leukocyte esterase
what does an elevated urine specific gravity indicate?
dehydration
The nurse is caring for a client who complains of recurrent flank pain and N/V for the past 24 hr. What action is the nurses priority?
administer pain medication
What measures can be taken to prevent UTIs?
- wipe front to back
- empty bladder regularly and completely
- drink apple cider vinegar daily
- drink 2-3 L/day
what would be a contraindication for a kidney biopsy?
bleeding tendencies
what are 2 actions the nurse could take if they suspect their client has a UTI?
check urine and culture sensitivity and request an antispasmodic agent
which pathogen is the most common cause of pyelonephritis?
e. coli
what education about pyelonephritis should the nurse include?
pyelonephritis increases a pregnant woman’s risk of preterm labor
what are some expected findings with PKD (polycystic kidney disease)?
- flank pain
- HTN
- polyuria
What should the client avoid doing during a creatinine clearance test?
rigorous exercise, as this may increase values
What should the nurse ensure for a traction device used on a patient?
that the weights are free hanging at all times
What is indicated by a positive Phalen’s sign?
carpal tunnel
What is seen in a positive Phalen test?
tingling/numbness over median nerve, palmar surface of thumb, index finger, middle finger, and part of ring finger
What are some qualities of a fiber glass cast that differ from plaster?
weighs less, less restrictive, lighter in weight, and requires less drying time
what type of fractures would be classified as the bone being splintered into several pieces?
comminuted
what is true about the postoperative process of placing a prosthesis?
physical therapy will teach exercises to strengthen muscle for prosthesis use
The patient tells the nurse, “I’ve been peeing so much this week, i always feel like I need to go, and it hurts when i try to pee.” what order should the nurse expect?
culture and sensitivity, as these are the trademarks or a UTI
what urinalysis lab findings can be expected with a UTI?
leukocytes esterase, nitrites, and bacteria
what may recurrent flank pain, nausea, and recent vomiting indicate?
kidney stones
what postoperative complication would pose the greatest risk to the client?
hemorrhage
a client’s urinalysis is positive for leukocyte esterase and nitrites, what action should the nurse take?
obtain a clean-catch culture and sensitivity
What actions should a nurse take for a client who has chronic pyelonephritis?
- referral for nutrition counseling
- palpate CVA
- monitor urinary output
- administer abx
what is priority intervention for a client who has a UTI?
administer antibiotics
what education can be provided to a female who has frequent UTIs?
avoid sitting in wet bathing suit, empty bladder when you have urge to pee, shower daily, wipe front to back, wear cotton underwear
what are some expected findings for an admission assessment of a client with renal calculi?
tachycardia, diaphoresis, oliguria, tachypnea
what education should the nurse give to a client who has had spontaneous passage of calcium phosphate renal calculi?
- limit high animal proteins
- reduce sodium intake
- report burning to provider
- increase to 3L/day
what foods can be avoided to prevent the recurrence of calcium oxalate calculus?
black tea and spinach
what intervention should the nurse implement for a client with phantom pain?
administer antileptic medication
how can flexion contractures be prevented with amputations?
position the client prone several times a say (20-30 min each time) and ROM exercises w/residual limb
what indicates proper understanding of external fixation device care?
- clean pins (increase frequency if drainage increases)
- separate cotton swab for each pin
- report loosening of pins
- report increasing redness at pin sites
what long bone injury complication is trademarked by red-brown petechiae around the neck, upper arms, and chest?
fat embolism
what causes a fat embolism?
fat globules released from a long bone
what are the treatment measures for fat embolisms?
bed rest, oxygen, IVF, and fracture immobilization
what 4 steps should be taken first if a person in the community experiences a traumatic amputation?
- call 911
- assess ABCs
- gauze/clean cloth over wound
- elevate above heart
how should an amputated body part be preserved? (3 steps)
- wrap in clean gauze
- place in a water tight bag
- place bag into a bag of ice water
what may a TENS (transcutaneous electrical nerve stimulation) unit be ordered for treatment of?
phantom limb pain
should anything be applied to the stump following amputation?
NO, alcohol dries and lotion makes skin too soft (breakdown)
How can flexion contractures be prevented following an amputation?
- turn every 2 hr
- use firm mattress
- lay prone for 20-30 min every 3-4 hr
Though red-brown petechiae is only seen with fat embolism, what signs are seen in both PE and fat embolism?
- AMS
- increased RR, HR
- chest pain
- dyspnea/crackles
- decreased SpO2
when is a fat embolism most likely to occur?
24-48 hr after the injury
what is a fasciotomy and when is it used?
surgical procedure where incision is made through the fascia to relieve pressure as is seen in compartment syndrome
what should be avoided with care of a patient with compartment syndrome?
do NOT ice or elevate
what is likely to cause fatigue/stress fractures?
excessive strain
what can a KUB x-ray be utilized to determine?
if you have a stone
what is the biggest risk following a kidney biopsy?
hemorrhage
if a patient was admitted to the ER with knee pain and swelling after playing baseball, what should the nurse do?
- assess quality/severity (pain)
- neurovascular assessment
- elevate extremity
- immobilize injured joint
if a patient had right leg pain, numbness, and tingling following an ORIF of the right tibia, what should the nurse do?
perform neurovascular assessment
what pt teaching should be given for care for 24 hrs after ORIF on right wrist?
- ice pack first 24 hr
- report coolness/discoloration
- move fingers frequently (blood flow)
what are normal age-related musculoskeletal changes?
atrophy
slowed movement
kyphosis
arthritis
widened gait
decreased ROM
what is an early manifestation of fat embolus?
AMS
what action should a patient take if they see increased redness at the pin site of an external fixator?
report provider
what are some findings with acute pyelonephritis?
frequency
dysuria
tachycardia
CVA tenderness
what finding 1 hr after a kidney biopsy would require the nurse to take immediate action?
pink-tinged urine
what foods to avoid with calcium oxalate stones?
black tea
spinach
What is the priority nursing action for glomerular nephritis?
Admin ABX (commonly caused be streptococcus)
What is sometimes done in terms of fluid for pts with glomerular nephritis?
fluid restrictions (prevent edema: crackles and all that)
