Exam 3

Question 1

what are some findings from a urinalysis that may indicate a possible UTI?

Answer 1

foul odor and presence or nitrites and leukocyte esterase

Question 2

what does an elevated urine specific gravity indicate?

Answer 2

dehydration

Question 3

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?

Answer 3

administer pain medication

Question 4

What measures can be taken to prevent UTIs?

Answer 4

• wipe front to back
• empty bladder regularly and completely
• drink apple cider vinegar daily
• drink 2-3 L/day

Question 5

what would be a contraindication for a kidney biopsy?

Answer 5

bleeding tendencies

Question 6

what are 2 actions the nurse could take if they suspect their client has a UTI?

Answer 6

check urine and culture sensitivity and request an antispasmodic agent

Question 7

which pathogen is the most common cause of pyelonephritis?

Answer 7

e. coli

Question 8

what education about pyelonephritis should the nurse include?

Answer 8

pyelonephritis increases a pregnant woman’s risk of preterm labor

Question 9

what are some expected findings with PKD (polycystic kidney disease)?

Answer 9

• flank pain
• HTN
• polyuria

Question 10

What should the client avoid doing during a creatinine clearance test?

Answer 10

rigorous exercise, as this may increase values

Question 11

What should the nurse ensure for a traction device used on a patient?

Answer 11

that the weights are free hanging at all times

Question 12

What is indicated by a positive Phalen’s sign?

Answer 12

carpal tunnel

Question 13

What is seen in a positive Phalen test?

Answer 13

tingling/numbness over median nerve, palmar surface of thumb, index finger, middle finger, and part of ring finger

Question 14

What are some qualities of a fiber glass cast that differ from plaster?

Answer 14

weighs less, less restrictive, lighter in weight, and requires less drying time

Question 15

what type of fractures would be classified as the bone being splintered into several pieces?

Answer 15

comminuted

Question 16

what is true about the postoperative process of placing a prosthesis?

Answer 16

physical therapy will teach exercises to strengthen muscle for prosthesis use

Question 17

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?

Answer 17

culture and sensitivity, as these are the trademarks or a UTI

Question 18

what urinalysis lab findings can be expected with a UTI?

Answer 18

leukocytes esterase, nitrites, and bacteria

Question 19

what may recurrent flank pain, nausea, and recent vomiting indicate?

Answer 19

kidney stones

Question 20

what postoperative complication would pose the greatest risk to the client?

Answer 20

hemorrhage

Question 21

a client’s urinalysis is positive for leukocyte esterase and nitrites, what action should the nurse take?

Answer 21

obtain a clean-catch culture and sensitivity

Question 22

What actions should a nurse take for a client who has chronic pyelonephritis?

Answer 22

• referral for nutrition counseling
• palpate CVA
• monitor urinary output
• administer abx

Question 23

what is priority intervention for a client who has a UTI?

Answer 23

administer antibiotics

Question 24

what education can be provided to a female who has frequent UTIs?

Answer 24

avoid sitting in wet bathing suit, empty bladder when you have urge to pee, shower daily, wipe front to back, wear cotton underwear

Question 25

what are some expected findings for an admission assessment of a client with renal calculi?

Answer 25

tachycardia, diaphoresis, oliguria, tachypnea

Question 26

what education should the nurse give to a client who has had spontaneous passage of calcium phosphate renal calculi?

Answer 26

- limit high animal proteins - reduce sodium intake - report burning to provider - increase to 3L/day

Question 27

what foods can be avoided to prevent the recurrence of calcium oxalate calculus?

Answer 27

black tea and spinach

Question 28

what intervention should the nurse implement for a client with phantom pain?

Answer 28

administer antileptic medication

Question 29

how can flexion contractures be prevented with amputations?

Answer 29

position the client prone several times a say (20-30 min each time) and ROM exercises w/residual limb

Question 30

what indicates proper understanding of external fixation device care?

Answer 30

- clean pins (increase frequency if drainage increases) - separate cotton swab for each pin - report loosening of pins - report increasing redness at pin sites

Question 31

what long bone injury complication is trademarked by red-brown petechiae around the neck, upper arms, and chest?

Answer 31

fat embolism

Question 32

what causes a fat embolism?

Answer 32

fat globules released from a long bone

Question 33

what are the treatment measures for fat embolisms?

Answer 33

bed rest, oxygen, IVF, and fracture immobilization

Question 34

what 4 steps should be taken first if a person in the community experiences a traumatic amputation?

Answer 34

1. call 911 2. assess ABCs 3. gauze/clean cloth over wound 4. elevate above heart

Question 35

how should an amputated body part be preserved? (3 steps)

Answer 35

1. wrap in clean gauze 2. place in a water tight bag 3. place bag into a bag of ice water

Question 36

what may a TENS (transcutaneous electrical nerve stimulation) unit be ordered for treatment of?

Answer 36

phantom limb pain

Question 37

should anything be applied to the stump following amputation?

Answer 37

NO, alcohol dries and lotion makes skin too soft (breakdown)

Question 38

How can flexion contractures be prevented following an amputation?

Answer 38

- turn every 2 hr - use firm mattress - lay prone for 20-30 min every 3-4 hr

Question 39

Though red-brown petechiae is only seen with fat embolism, what signs are seen in both PE and fat embolism?

Answer 39

- AMS - increased RR, HR - chest pain - dyspnea/crackles - decreased SpO2

Question 40

when is a fat embolism most likely to occur?

Answer 40

24-48 hr after the injury

Question 41

what is a fasciotomy and when is it used?

Answer 41

surgical procedure where incision is made through the fascia to relieve pressure as is seen in compartment syndrome

Question 42

what should be avoided with care of a patient with compartment syndrome?

Answer 42

do NOT ice or elevate

Question 43

what is likely to cause fatigue/stress fractures?

Answer 43

excessive strain

Question 44

what can a KUB x-ray be utilized to determine?

Answer 44

if you have a stone

Question 45

what is the biggest risk following a kidney biopsy?

Answer 45

hemorrhage

Question 46

if a patient was admitted to the ER with knee pain and swelling after playing baseball, what should the nurse do?

Answer 46

- assess quality/severity (pain) - neurovascular assessment - elevate extremity - immobilize injured joint

Question 47

if a patient had right leg pain, numbness, and tingling following an ORIF of the right tibia, what should the nurse do?

Answer 47

perform neurovascular assessment

Question 48

what pt teaching should be given for care for 24 hrs after ORIF on right wrist?

Answer 48

- ice pack first 24 hr - report coolness/discoloration - move fingers frequently (blood flow)

Question 49

what are normal age-related musculoskeletal changes?

Answer 49

atrophy slowed movement kyphosis arthritis widened gait decreased ROM

Question 50

what is an early manifestation of fat embolus?

Answer 50

AMS

Question 51

what action should a patient take if they see increased redness at the pin site of an external fixator?

Answer 51

report provider

Question 52

what are some findings with acute pyelonephritis?

Answer 52

frequency dysuria tachycardia CVA tenderness

Question 53

what finding 1 hr after a kidney biopsy would require the nurse to take immediate action?

Answer 53

pink-tinged urine

Question 54

what foods to avoid with calcium oxalate stones?

Answer 54

black tea spinach

Question 55

What is the priority nursing action for glomerular nephritis?

Answer 55

Admin ABX (commonly caused be streptococcus)

Question 56

What is sometimes done in terms of fluid for pts with glomerular nephritis?

Answer 56

fluid restrictions (prevent edema: crackles and all that)