MS 1 Final Exam Review - GU Flashcards
Which precipitating factor is a common cause of pyelonephritis in patients admitted to the medical unit from a long-term care facility?
1 Fever
2 Gram-negative bacilli
3 Urinary tract catheterization
4 Urethral trauma from childbearing
3 Urinary tract catheterization
For residents of long-term care facilities, urinary tract catheterization is a common cause of pyelonephritis. Fever is a symptom of pyelonephritis but does not cause the pyelonephritis. Gram-negative bacilli cause urinary tract infections, not pyelonephritis. Urethral trauma from childbearing can cause urethral diverticula, not pyelonephritis.
Which instructions would the nurse provide the patient who has a diagnosis of acute pyelonephritis? Select all that apply.
1 “Avoid using vaginal deodorant sprays.”
2 “Drink at least eight glasses of fluid every day.”
3 “Avoid clothing that creates suprapubic pressure.”
4 “Avoid sexual intercourse until symptoms subside.”
5 “Take the full course of antibiotics to ensure that the bacteria are eradicated.”
2 “Drink at least eight glasses of fluid every day.”
5 “Take the full course of antibiotics to ensure that the bacteria are eradicated.”
The nurse should encourage the patient to drink at least eight glasses of fluid every day during and after treatment of acute pyelonephritis. A full course of antibiotics should be taken to ensure that the bacteria are eradicated. Avoiding the use of vaginal deodorant sprays is one of the interventions to be followed in patients with urethritis. The patient with interstitial cystitis should avoid clothing that creates suprapubic pressure, including pants with tight belts. Sexual intercourse should be avoided until symptoms subside in patients with urethritis.
Which intervention would the nurse include as a priority when developing a plan of care for the patient admitted with acute pyelonephritis?
1 Schedule a follow-up urine culture for seven days post discharge.
2 Assist the patient with identifying foods to help prevent future infections.
3 Administer parenteral antibiotics as prescribed by the health care provider.
4 Teach the patient the importance of taking all doses of the prescribed medications.
3 Administer parenteral antibiotics as prescribed by the health care provider.
Administration of the antibiotic is going to help counter the infectious process. Education and identifying the source is important, but it is not the priority, nor is scheduling the follow-up urine culture test.
The nurse is assessing the stomas of four patients who have undergone an ileostomy. Which patient’s findings indicate necrosis?
A brown-black stoma indicates necrosis. Patient D would be diagnosed with necrosis of the stoma. Patient A has a pale stoma, which is a sign of anemia. Patient B’s purple stoma indicates an inadequate blood supply to the bowel. Patient C’s brick-red stoma indicates viable stoma mucosa with adequate blood supply.
Which action would the nurse implement when preparing a patient for a scheduled IV pyelogram (IVP)?
1 Administer a cathartic or enema the morning of the procedure.
2 Assess the patient for allergies to penicillin prior to obtaining permission.
3 Advise the patient that a metallic taste may occur during the procedure.
4 Keep the patient NPO for four hours prior to procedure.
1 Administer a cathartic or enema the morning of the procedure.
Nursing responsibilities in caring for a patient undergoing an IVP include administration of a cathartic or enema to empty the colon of feces and gas. The nurse will also assess the patient for iodine sensitivity, keep the patient NPO for eight hours prior to the procedure, and advise the patient that warmth, a flushed face, and a salty taste during injection of contrast material may occur.
The nurse is caring for a patient who was transferred to the emergency department with severe burns. The laboratory values reveal a serum creatinine level of 5.2 mg/dL, and the glomerular filtration rate (GFR) has decreased by 75%. Which stage of acute kidney failure is the patient exhibiting?
1 Risk
2 Injury
3 Failure
4 Loss
3 Failure
As per the RIFLE (Risk, Injury, Failure, Loss, and End-stage) classification for staging acute kidney injury, this patient is at the failure stage. The criterion for failure is that serum creatinine increased by three times or GFR decreased by 75% or a serum creatinine >4 mg/dL with acute rise ≥0.5 mg/dL. When the GFR has decreased by 25%, the patient is at the risk stage. The patient with a GFR that has decreased by 50% is at the injury stage. The patient with persistent acute kidney failure experiences a complete loss of kidney function and is at the loss stage.
Which clinical manifestations would the nurse associate with acute pyelonephritis?
1 Chills and flank pain
2 Hemoptysis and rhonchi
3 Hematuria and proteinuria
4 Pain and lower urinary tract symptoms (LUTS)
1 Chills and flank pain
The clinical manifestations of acute pyelonephritis vary from mild fatigue to the sudden onset of chills and flank pain. Hemoptysis and rhonchi are pulmonary symptoms of Goodpasture syndrome. Hematuria and proteinuria are clinical manifestations of acute glomerulonephritis. Pain and LUTS are the two primary clinical manifestations of interstitial cystitis, or pain bladder syndrome.
A patient’s laboratory report reveals the glomerular filtration rate (GFR) is decreased by 75%. The nurse determines that the patient is experiencing which stage of acute kidney injury?
1 Kidney injury
2 Kidney failure
3 Risk of kidney injury
4 Loss of kidney function
2 Kidney failure
The RIFLE (Risk, Injury, Failure, Loss, and End-stage) classification for staging of acute kidney injury utilizes percentages of loss of GFR to define stages of kidney injury. Kidney failure is defined by a GFR decrease by 75%. Kidney injury is defined by a GFR decrease by 50%. Risk of kidney injury is defined by a GFR decrease by 25%. Loss of kidney function is defined as complete loss of kidney function for greater than four weeks.
During an IV pyelogram, development of which clinical manifestation would prompt the nurse to report the patient’s status to the health care provider?
1 Flushing of the face
2 Salty taste in the mouth
3 Tight sensation in the throat
4 Feeling of warmth over the entire body
3 Tight sensation in the throat
A tight feeling in the throat indicates the possible development of a severe allergic reaction to the dye used during IV pyelography, resulting in edema of the larynx and difficulty breathing. Flushing of the face, a salty taste in the mouth, and a feeling of warmth over the body are all possible and expected side effects during this procedure. They are usually transient and nondistressing.
The nurse assesses the stoma of a patient who has undergone ostomy surgery and identifies that which finding indicates ischemia?
1 Pale stoma
2 Dark-pink stoma
3 Dusky-blue stoma
4 Brown-black stoma
3 Dusky-blue stoma
Dusky-blue stoma indicates ischemia. Ischemia occurs due to an inadequate blood supply to the stoma. Pale stoma indicates anemia. Dark-pink stoma is a normal finding. Brown-black stoma indicates necrosis.
