Nokea
A nurse cares for a client who has kidney stones from secondary hyperoxaluria. Which medication should the nurse anticipate administering?
- A. Phenazopyridine (Pyridium)
- B. Propatudeline (Pro-Banthine)
- C. Tolterodine (Detrol)
- D. Allopurinol (Zyloprim)
Correct Answer: D
Rationale: Stones caused by secondary hyperoxaluria respond to allopurinol (Zyloprim). Phenazopyridine is given to clients with urinary tract infections. Propatudeline is an anticholinergic. Tolterodine is an anticholinergic with smooth muscle relaxant properties.
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A nurse assesses a client who has had two episodes of bacterial cystitis in the last 6 months. Which questions should the nurse ask?
- A. How much water do you drink every day?
- B. Do you take estrogen replacement therapy?
- C. Does anyone in your family have a history of cystitis?
- D. Do you take any immune-suppressing drugs?
- E. Do you drink grapefruit juice or orange juice daily?
Correct Answer: A,B,D
Rationale: Fluid intake, estrogen levels, and immune suppression all can increase the chance of recurrent cystitis. Family history is usually insignificant, and cranberry juice, not grapefruit or orange juice, has been found to increase the acidity and reduce the risk for bacterial cystitis.
A nurse teaches a client about self-care after experiencing a urinary calculus treated by lithotripsy. Which statements should the nurse include in this client's discharge teaching?
- A. Finish the prescribed antibiotic even if you are feeling better.
- B. Drink at least 3 liters of fluid daily.
- C. The bruising on your back may take several weeks to resolve.
- D. Report any blood present in your urine.
- E. It is normal to experience pain and difficulty urinating.
Correct Answer: A,B,C
Rationale: The client should be taught to finish the prescribed antibiotic to ensure that he or she does not get a urinary tract infection. The client should drink at least 3 liters of fluid daily to dilute potential stone-forming crystals, prevent dehydration, and promote urine flow. After lithotripsy, the client should expect bruising that may take several weeks to resolve.
A nurse provides phone triage to a pregnant client. The client states, 'I am experiencing a burning pain when I urinate.' How should the nurse respond?
- A. This means labor will start soon. Prepare to go to the hospital.
- B. You probably have a urinary tract infection. Drink more cranberry juice.
- C. Make an appointment with your provider to have your infection treated.
- D. Your pelvic wall is weakening. Pelvic muscle exercises should help.
Correct Answer: C
Rationale: Pregnant clients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the client to make an appointment and have the infection treated.
A nurse teaches a client with a history of calcium phosphate urinary stones. Which statements should the nurse include in this client's dietary teaching?
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. Avoid spinach, black tea, and rhubarb.
- D. Drink white wine or beer instead of red wine.
- E. Reduce your intake of milk and other dairy products.
Correct Answer: A,B,E
Rationale: Clients with calcium phosphate urinary stones should be taught to limit the intake of foods high in animal protein, sodium, and calcium. Clients with calcium oxalate stones should avoid spinach, black tea, and rhubarb.
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of bacterial cystitis?
- A. A 36-year-old female who has never been pregnant
- B. A 42-year-old male who is prescribed cephalophamide
- C. A 34-year-old female who is not using estrogen replacement
- D. A 77-year-old male with mild congestive heart failure
Correct Answer: C
Rationale: Females at any age are more susceptible to cystitis than men because of the shorter urethra in women. Postmenopausal women who are not on hormone replacement therapy are at increased risk for bacterial cystitis because of changes in the cells of the urethra and vagina. The middle-aged woman who has never been pregnant would not have a risk potential as high as the older woman who is not using hormone replacement therapy.