Renal Flashcards
What is the glomerulus?
A series of specialized capillary loops
True or false ADH is also known as vasopressin
True
What acts on distal tubule and collecting ducts to increased sodium and water excretion
Prostaglandin E
What is bradykinin?
Small hormone that dilates the afferent arterial and increases capillary membrane permeability to some solutes
The patient has sustained a minor kidney injury. Which structure must remain functional in order for urine to be removed from the blood?
The nephron
Blood flows into ….., and through the specialized capillaries, water and small particles are filtered from the blood to make urine
Glomerulus
Renin is a hormone that helps regulate which functions?
- Bloodflow,
- glomerular filtration rate,
- blood pressure
Which substance increases kidney reabsorption of sodium and water?
Aldosterone
…….. Is a hormone produced in the kidneys parenchyma that stimulates the bone marrow to make red blood cells
Erythropoietin
Which hormone is released from the posterior pituitary and makes the distal convoluted tubule and the collecting duct permeable to water to maximize reabsorption and produce a concentrated urine?
Vasopressin
Based on the knowledge of the normal function of the kidney, which large particles are not found in the urine because they’re too large to filter through the glomerular capillary walls?
- Blood cells
- albumen
- other proteins
What is the average urine output of a healthy adult for a 24 hour period?
1500 to 2000 mL a day
Kidney function, in particular the GFR, is compromised when systolic blood pressure drops below what reading?
70 mm HG
Damage to which renal structure or tissues can change the actual production of urine?
Convoluted tubule’s
The patient has been in my life for several days after motor vehicle accident the nurse encourages ambulation to stimulate the movement of urine through the ureter by what phenomenon?
Peristalsis
Which renal changes associated with aging does the nurse expect an older adult patients report ?
Nocturnal polyuria
An older male patient has a history of an enlarged prostate. The patient is most likely to report which symptom associated with this condition?
Difficulty starting the urine stream
Impairment in the thirst mechanism associated with aging makes an older adult patient more vulnerable to which disorder?
Hypovolemia
The nurses talking to a group of older women about changes in the urinary system related to aging what symptom is likely to be the common concern for this group?
Incontincence
True or false
The most important role of the kidneys are to maintain body fluid volume and composition, and to filter waste products for elimination
True
The kidneys help regulate blood pressure and acid-base balance
True
True or false
The kidneys have a rich blood supply and receive 20 to 25% of the total cardiac output
True
Normal GFR average is 125 mL a minutes
True
GFR is controlled by blood pressure and blood flow
True
ADH increases tubular permeability to water, allowing water to leave the tube and be reabsorbed in the capillaries
True
During watery absorption, the membrane of the distal convoluted tubule is more permeable to water due to the influence of ADH
True
The nurses taking a history on a 55-year-old patient denies any serious chronic health problems. With sudden onset sign or symptom suggests possible kidney disease in a patient
Hypertension
Which patient narrative describes the symptom of dysuria?
It burns when I pee
The nurse and nutritionist are evaluating the diet and nutritional therapies for patient with kidney problems. Blood urea nitrogen levels for this patient are tracked because of the direct relationship to the intake and metabolism of which substance?
Protein
The nurses taking a history of a patient with a change and urinary patterns. In addition to the medical and surgical history, what is the nurse application about to complete the assessment?
- Occupational exposure to toxins
- Use of illicit substances such as cocaine
- Potential exposure to sexually-transmitted disease
The nurse is determining whether patient has a history of hypertension because of the potential for kidney problems. Which question is best to illicit this information?
Have you ever been told that your blood pressure was high
Patient appears very uncomfortable with the nurses questions about your night functions and patterns. What is the best technique for the nurse to use to elicit relevant information and decrease the patients discomfort?
Use the patients own terminology
The nurses taking a nutritional history on a patient. The patient states I really don’t drink as much water as I should what is the nurses that’s response?
What would encourage you to drink the recommended 3 L per day
When patients having problems with the kidneys or urinary tract, what is common symptom the prompt them to seek medical attention?
Pain in the flank or abdomen or pain when urinating
Which ethnic group have the highest risk for end-stage kidney disease secondary to diabetes mellitus and hypertension?
African Americans
Which over-the-counter product use that patient is a nurse explore further the potential impact on kidney function?
NSAIDs
The nurses performing assessment of the renal system. What is the first step in the assessment process?
Observe the flank region for asymmetry or discoloration
The patient has anorexia, nausea and vomiting, muscle cramping, and pruritus. How does the nurse interpret these findings?
Uremia
The nurse is auscultating the renal artery and here’s the bruit. What does this finding indicates?
Renal artery stenosis
The patient is diagnosed with renal artery stenosis. Which sound does the nurse expect to hear by auscultation when a bruit is present in renal artery?
Swishing sound
Which line of year and designers expect to find documented for patient who is oliguria.
Between 100 and 400 mL in a 24 hour.
The nurses assessing a patient for bladder distention. What technique is the nurse use
Gently palpate for the outline of the bladder, percuss the lower abdomen, continue toward the umbilicus until dull sounds or no longer produce
Patient reports flank pain or tenderness. What technique does the nurse used to assess for costovertebral tenderness?
Place one hand flat over the CVA, thump with other fist
The nurses preparing to assess a female patients urethra prior to insertion fully catheter. In addition just arrow gloves, which equipment to the nurse obtained to perform the initial assessment?
Good light source
Ketones in the urine may indicate which occurrence or process?
- Incomplete metabolism of fatty acid
2. Bodies is a fat and set of glucose for cellular energy
The nurses caring for patient with dehydration. Which lab test results does the nurse anticipate to see if this patient?
B UN rises faster than creatinine level
Which patients most likely to have a decreased calcium level?
Patient with nephritis
The nurse performs a dipstick urine test for a patient being evaluated for kidney problems. Glucose is present in the urine. How does the nurse and interpret this results?
Blood glucose level is greater than 220 mg
In addition to the kidney disease which patient condition causes the bun to rise above the normal range?
Infection
The community health nurses talking to group of African-American adults about Reno house. The nurse encourages the participants to have which type of yearly exam to screen for kidney problems
Urinalysis and microalbuminuria
Which test is the best indicator of kidney function?
Serum creatinine
In relation to kidney problems, what does an increase in the ratio of BUN to serum creatine indicate?
Suggests non-kidney factors causing an elevation in BUN
Which urine characteristic listed on the urinalysis report arouses the nurses station of a problem in the urinary tract?
Cloudiness
The patient has a urinalysis ordered. When is the best time for the nurse to collect a specimen?
In the morning
During the day of the nursing students measuring urine output and observing for your hearing characteristics capacious. Which of normal finding in the most urgent finding that must be reported to the supervising nurse
Output is decreased
24 hour urine specimen is required from the patient which strategy is best to ensure that all the urine collected for the full 24 hour period?
Place a sign in the bathroom reminding the patient to save the urine
The patient is scheduled for an IV urography. Which medication is discontinued at the time of the procedure and for at least 48 hours until kidney function has been reevaluated?
Glucophage (metformin)
Several patients are scheduled for testing today most potential kidney problems. Which test requires a patient to have a urinary catheter inserted before the test?
Cystography
The patient has had an IV urography What is included in the post procedural care for the patient?
IV or oral fluid hydration
Wish diagnostic test incorporates contrast dye, but does not place a patient at risk for nephrotoxicity
Voiding cystourethrogrAm
The nurses reviewing the results of the patients ultrasound of the kidney. The report reveals an large kidney we should just switch possible problem?
Polystitic kidney
Patient returns to be in after a kidney scan which instruction about the patient’s urine does the nurse give to the UAP caring for the patient
It does not please anyone at risk because of the small amount of radioactive material
The nurses alerted by the radiology department to the patient had a catch up real renal scan. What does the nurse monitor for when the patient returns from the procedure
Orthostatic hypotension
The nurses teaching a patient scheduled for an ultrasonography. What preprocedure all instruction does the nurse give the patient?
Drink a lot of water
The patient had a cystoscopy. After the procedure which is a nurse expect to see in this patient
Pink tinged urine
Patient is scheduled for retrograde urethrography. Post procedural care is similar to post procedural care given for which test
IV urography
Patient has undergone a kidney biopsy. What is the nurse monitor for the patient related to this procedure?
Hemorrhage
A patient has undergone a kidney biopsy. In the immediate post procedure period, the nurse notifies a healthcare provider about which findings?
- Hematuria
- Decreasing urine output
- Flank pain
Decreasing BP
The nurse is counseling the woman who had recurrent urinary tract infections. What should the nurse explained if the reason why women are at greater risk than men for contracting a urinary tract infection?
Proximity of the urethra to the anus
A routine urinalysis is ordered for a client. What should the nurse do with the specimen cannot be sent immediately to the laboratory?
Refrigerate the specimen
The client experiences difficulty in voiding after an indwelling urinary catheter is removed. To what does the nurse determined that this is most probably related?
Interruption in previous voiding habits
Which nursing action can best prevent infection from a urinary retention catheter question
Cleansing around the meatus routinely
The nurses providing client teaching tool woman who has recurrent urinary tract infections. Which information should the nurse include concerning the reason why women are more susceptible to urinary tract infections then men?
The length of the urethra
Client nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating antibiotic therapy prescribed by the healthcare provider?
Obtain a urine specimen for culture and sensitivity
A nurse is assessing the Urine of a client with a urinary tract infection. For which characteristics of the nurse assessed each specimen of urine?
Clarity
Macrobid 0.1 mg is prescriber client with a urinary tract infection. Each tablet contains 50 mg. How many tablets should the nurse administered?
2 tabs
A nurses caring for a client with a diagnosis of renal calculi of calcium phosphate composition. Which type of diet should the nurse explore the client when providing discharge information?
Low calcium
A pathology report states that the client urinary calculus is composed of uric acid. Which should the nurse instruct the client to avoid ?
Liver
A client have a heminephrectomy and returns from the postanesthesia care unit with the nephrostomy tube and an indwelling urinary catheter. The client urinary output is 50 mL an hour what is the nurses next action?
Record the findings
Client is diagnosed with bladder cancer, and a cystectomy and in ilio conduit are scheduled. What should the nurse plan to do preoperatively?
Administer cleansing enemas and laxatives
A nurses caring for a client after surgical creation of a conduit diversion. What is the major disadvantage of a conduit to version but the nurse should consider when caring for this client?
Urine continuously drains from it
A nurses caring for a client who is admitted with ureteral colic and hematuria. The client also has stage one hypertension and it’s overweight. The decrease of which clinical indicator associated with this client status should the nurse be most concerned about this time?
Pain
A nurses caring for a client with uretral calculus. Which are the most important nursing actions?
- Monitoring intake and output
- Straining the urine at each voiding
- Administering the prescribed analgesic
The pathology report states at a clients urinary calculus is composed of uric acid. Which nutrients of the nurse instruct the client to avoid?
Organ meats and meat extracts
A lithotripsy to break up Renal calculi is unsuccessful, and nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the healthcare provider?
Urine output of 20 to 30 mL an hour
Client is admitted to the hospital from the emergency department with a diagnosis of urolithiasis. The nurse reviews the clients clinical record and performs an administration assessment. What is the priority nursing action?
Administer the prescribed morphine
A client with urge incontinence is receiving ditropan 30 mg orally. Each tablet contains 5 mg. How many tablets so the nurse administered?
6 tabs
- You are providing nursing care for a 24-year old female patient admitted to the unit with a diagnosis of cystitis. Which intervention should you delegate to the nursing assistant?
- providing the pt with a clean-catch urine sample container
- What laboratory result is of most concern to you for an adult pt with cystitis?
- urine bacteria count of 100,000 colonies per milliliter
- as charge nurse, you would assign the nursing care of which pt to an LPN/LVN, working under the supervision of an RN
- a 48-year-old with cystitis who is taking oral antibiotics
- you are admitting a 66-year-old male pt suspected of having urinary tract infection. Which piece of the pts medical history supports this diagnosis?
The patient has been followed for prostate disease for two years
you are supervising a new RN graduate who is on orientation to the unit. The new RN asks you why the pt with uncomplicated cystitis is being discharged with orders for ciprofloxacin (cipro) 250mg twice a day for only 3 days. What is your best response?
research has shown that with a 3-day course of ciprogloxacin there is increased pt adherence to the plan of care
. a 28-year old married female pt with cystitis requires instruction about how to prevent future UTIs, and you have delegated this teaching to a newly graduated RN. Which statement by the new nurse requires that you intervene?
its ok to soak in the tub with bubble bath because it will keep you clean
you are creating a nursing care plan for older adult pts with incontinence. For which pt will a bladder-training program be an appropriate intervention?
a pt with urge incontinence and abnormal detrusor muscle contractions
. a pt with incontinence will be taking oxybutynin chloride (Ditropan) 5mg by mouth three times a day after discharge. Which information would you be sure to teach this pt before discharge?
drink fluids or use hard candy when you experience a dry mouth
you are providing care for a pt with reflux urinary incontinence. Which action could be appropriately delegated to a new LPN/LVN>
reinforcing the importance of proper hand washing to prevent infection
. a pt has urolithiasis and is passing the stones into the lower urinary tract. What is the priority nursing diagnosis for the pt at this time?
Acute pain
the nursing diagnosis of constipation related to compression of the interstitial tract has been identified in a pt with polycystic kidney disease. Which nursing care action should you delegate to a newly trained LPN/LVN
administering docusate sodium (Colace) 100mg by mouth BID
you are supervising a nurse on orientation to the unit who is discharging a pt admitted with kidney stones who underwent lithotripsy. Which statement by the nurse requires that you intervene
- report any signs of bruising to your physician immediately since this indicated bleeding
you are admitting nurse for a pt with nephrotic syndrome. Which assessment finding supports this diagnosis?
edema formation
a pt has renal cell carcinoma (adenocarcinoma of the kidney) you are providing orientation to a new nurse on the unit who asks why this pt is not receiving chemotherapy. What is your best response?
chemotherapy has been shown to have only limited effectiveness against this type of cancer
