GU/Renal Flashcards
A nurse is assessing a client who has chronic kidney disease and has completed the third peritoneal dialysis (PD) treatment. Which of the following findings should the nurse report to the provider?
A. Greater outflow of dialysate than inflow
B. Weight loss
C. Cloudy dialysate effluent
D. Report of pain during inflow
C. Cloudy dialysate effluent
Cloudy or opaque drainage is an early manifestation of peritonitis. The nurse should notify the provider immediately because infection can be a life-threatening complication.
Hemodialysis
a treatment to filter wastes and water from your blood, as your kidneys did when they were healthy;
helps control blood pressure and balance important minerals, such as potassium, sodium, and calcium, in your blood
can help you feel better and live longer, but it’s not a cure for kidney failure
A nurse is planning care for a client who has chronic kidney disease and a potassium level of 7.3 mEq/L. Which of the following interventions should the nurse plan to take?
A. Initiate an IV infusion of lactated Ringer’s solution.
B. Give spironolactone 50 mg PO BID.
C. Infuse regular insulin in dextrose 10% in water.
D. Administer supplemental phosphorus.
C. Infuse regular insulin in dextrose 10% in water.
The nurses should infuse regular insulin in dextrose 10% to 20% in water to a client who has hyperkalemia. The administration of insulin will drive the potassium from the extracellular fluid into the intracellular fluid to decrease the serum potassium level. The dextrose in the solution will counter the insulin to prevent hypoglycemia from occurring.
A nurse is obtaining a urine specimen for culture and sensitivity from a client who has manifestations of a urinary tract infection. Which of the following actions should the nurse take?
A. Collect the client’s urine in a clean specimen container.
B. Instruct the client to start urinating then pass the container into the stream.
C. Obtain the client’s first morning urine on the following day.
D. Place the client’s urine specimen in a container with a preservative.
B. Instruct the client to start urinating then pass the container into the stream.
The nurse should instruct the client to start urinating, then pass the container into the stream, and collect 30 to 60 mL of urine in the container.
A nurse is providing discharge teaching to a client who has chronic kidney disease (CKD). Which of the following statements by the client indicates an understanding of the teaching?
“I will…
A. consume foods that are high in protein.”
B. decrease my intake of foods that are high in phosphorus.”
C. limit my intake of foods that are high in iron.”
D. add salt to the foods I consume.”
B. decrease my intake of foods that are high in phosphorus.”
A client who has CKD should limit their intake of foods that are high in phosphorus to prevent bone damage.
Expected Reference Range: BUN
10-20 mg/dL
Hct
Male 42-50%
Female 37-47%
A nurse is providing teaching to a client who has chronic kidney disease (CKD). Which of the following statements by the client indicates an understanding of the teaching?
“I will…
A. check my blood pressure once per week.”
B. take a magnesium antacid if I get constipated.”
C. weigh myself every morning.”
D. use a salt substitute in my diet.”
C. weigh myself every morning.”
Clients who have CKD should weigh themselves every morning at the same time to monitor fluid balance. The client should void prior to weighing if able, wear similar clothing when obtaining weight, and use the same set of scales each time.
A nurse is monitoring a client following hemodialysis. The nurse should recognize that which of the following factors places the client at risk for seizures?
A. Hypokalemia
B. A rapid increase of catecholamines
C. A rapid decrease in fluid
D. Hypercalcemia
C. A rapid decrease in fluid and electrolytes during hemodialysis can result in cerebral edema and increased intracranial pressure, placing the client at risk for seizures. This complication is called dialysis disequilibrium syndrome.
A nurse is caring for a postoperative client following arteriovenous (AV) fistula creation in the left arm. Which of the following actions should the nurse take?
A. Measure blood pressure in the client’s left arm every 4 hr.
B. Keep the client’s left arm in a dependent position.
C. Auscultate for bruits in the client’s fistula every 4 hr.
D. Instruct the client to sleep on the affected side.
C. Auscultate for bruits in the client’s fistula every 4 hr.
The nurse should auscultate for a bruit and palpate for a thrill every 4 hr to verify that the AV fistula is patent.
A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make?
a. Instruct the client to restrict movement of his left arm
b. Avoid taking blood pressures on the client’s left arm
c. Check the fistula daily for a vibration
d. Instruct the client to sleep on his left side.
B. Avoid Taking blood pressure’s on the client’s left arm.
The nurse should avoid taking blood pressure measurements on the client’s left arm, which can decrease blood flow and cause clotting.
A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client’s urinary catheter, which of the following findings should the nurse report to the provider?
a. Decreased urine output
b. Report of burning upon urination
c. Pink-tinged urine
d. Stress incontinence
A. Decreased urine output
A decreased urine output after a TURP indicates obstruction to urine flow by a clot or residual prostatic tissue and should be reported to the provider.
A nurse is reinforcing teaching with a client prior to a cystoscopy. Which of the following statements should the nurse make?
a. Expect to be on bed rest for 24 hours after this procedure.
b. you will need to keep the sutures clean after this procedure
c. you will be placed on your left side for this procedure
d. expect to have pink-tinged urine after this procedure
d. Expect to have pink-tinged urine after this procedure.
A cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Following this procedure, pink-tinged urine is expected.
A nurse is caring for a client who is receiving peritoneal dialyisis. The nurse should monitor the client for which of the following adverse effects?
a. Increased serum albumin
b. Hypoglycemia
c. Respiratory Distress
d. Diarrhea
c. Respiratory Distress
A nurse is collecting data from a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider?
a. Cloudy, yellow drainage
b. WBC 6,000
c. Potassium 4.0 mEq/L
d. Report of abdominal fullness
a. Cloudy, yellow drainage
A nurse is reinforcing teaching about collecting a 24-hour urine specimen for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse include
a. Place signs in the bathroom as a reminder about the test in progress
b. Discard the last voided specimen at the end of the collection period.
c. Instruct the client to increase exercise during 24-hour period.
d. Include the first voided specimen at the start of the collection period.
A. Place signs in the bathroom as a reminder about the test in progress
The nurse should place signs in the bathroom and alert family members of the test in progress so that everyone saves the specimens appropriately throughout the test.
A nurse is reinforcing dietary teaching with a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet?
A. Phosphorous
B. Calcium
C. Sodium
D. Potassium
B. Calcium
A client who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium absorption. The client should supplement her diet with dietary calcium.
A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the dialysate output is less than the input, and the client’s abdomen is distended. Which of the following actions should the nurse take?
A.Administer pain medication to the client
B.Change the client’s position
C. Place the drainage bag above the client’s abdomen.
D. Insert an indwelling urinary catheter.
B.Change the client’s position
