Nokea
A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which of the following equipment will the nurse need to obtain?
- A. Sterile specimen cup
- B. Large container for urine
- C. Foley catheter and drainage bag
- D. Towelettes for perineal cleaning
Correct Answer: B
Rationale: Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes, and a sterile specimen cup are not needed for this test.
You may also like to solve these questions
The nurse is caring for a patient following an intravenous pyelogram (IVP) and obtains all of the following assessment data. Which of the following findings require immediate action by the nurse?
- A. The heart rate is 58 beats/minute.
- B. The respiratory rate is 38 breaths/minute.
- C. The patient complains of a dry mouth.
- D. The urine output is 400 mL in the first 2 hours.
Correct Answer: B
Rationale: The increased respiratory rate indicates that the patient may be experiencing an allergic reaction (anaphylactic reaction) to the contrast medium used during the procedure. The nurse should immediately assess the patient's oxygen saturation and breath sounds. The other data are not unusual findings following an IVP.
The nurse is preparing a patient for a cystoscopy. Which of the following information should the nurse include in patient teaching about the procedure?
- A. NPO for 8 hours to prevent nausea and vomiting.
- B. Strict bed rest for about 4-6 hours.
- C. Request prescribed opioids as necessary for pain.
- D. May experience blood-tinged urine and urinary frequency.
Correct Answer: D
Rationale: Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.
The nurse is assessing a patient's urinary system and is unable to palpate either kidney. Which of the following actions should the nurse take next?
- A. Obtain a urine specimen to check for hematuria
- B. Document the information on the assessment form.
- C. Ask the patient about any history of recent sore throat.
- D. Ask the health care provider about scheduling a renal ultrasound.
Correct Answer: B
Rationale: The kidneys are protected by the abdominal organs, ribs, and muscles of the back and may not be palpable under normal circumstances, so no action except to document the assessment information is needed. Asking about a recent sore throat, checking for hematuria, or obtaining a renal ultrasound may be appropriate when assessing for renal problems for some patients, but there is nothing in the question stem to indicate that they are appropriate for this patient.
The nurse is preparing a patient with a decreased glomerular filtration rate for an intravenous pyelogram (IVP). Which of the following actions should be included in the plan of care?
- A. Monitor the urine output after the procedure.
- B. Assist with monitored anesthesia care (MAC).
- C. Give oral contrast solution before the procedure.
- D. Insert a large size urinary catheter before the IVP.
Correct Answer: A
Rationale: Patients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the patient's urine output. MAC sedation and retention catheterization are not required for the procedure. The contrast medium is given intravenously, not orally.
The nurse is caring for a patient with an elevated blood urea nitrogen (BUN) and serum creatinine who is scheduled for a renal arteriogram. Which of the following bowel preparation prescriptions should the nurse question?
- A. Fleet enema
- B. Tap-water enema
- C. Bisacodyl tablets
- D. Castor oil
Correct Answer: A
Rationale: High-phosphate enemas, such as Fleet enemas, should be avoided in patients with elevated BUN and creatinine because phosphate cannot be excreted by patients with renal failure. The other medications for bowel evacuation are more appropriate.