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A nurse cares for a middle-aged female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The client asks, 'What can I do to help prevent these infections?' How should the nurse respond?
- A. Test your urine daily for the presence of ketone bodies and proteins.
- B. Use tampons rather than sanitary napkins during your menstrual period.
- C. Drink more water and empty your bladder more frequently during the day.
- D. Keep your hemoglobin A1C under 9% by keeping your blood sugar controlled.
Correct Answer: C
Rationale: Increasing fluid intake (especially water) and frequent voiding help flush bacteria from the urinary tract, reducing the risk of pyelonephritis. Chronically elevated blood glucose in diabetes can promote bacterial growth, but frequent voiding is the most direct preventive measure. Testing urine for ketones/proteins, using tampons, or controlling hemoglobin A1C are not as directly related to preventing urinary tract infections.
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A nurse teaches a client with polycystic kidney disease (PKD). Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
- A. Take your blood pressure every morning.
- B. Weigh yourself at the same time each day.
- C. Adjust your diet to prevent diarrhea.
- D. Contact your provider if you have visual disturbances.
- E. Assess your urine for renal stones.
Correct Answer: A,B,D
Rationale: Clients with PKD should monitor blood pressure and weight daily to track hypertension and fluid status, and report visual disturbances, which may indicate a berry aneurysm. Adjusting diet to prevent constipation, not diarrhea, is appropriate, and renal stones are not a primary concern in PKD.
After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take a laxative every night before going to bed.
- B. I must increase my intake of dietary fiber and fluids.
- C. I only use salt when I am cooking my own food.
- D. I can eat white bread to minimize gastrointestinal gas.
Correct Answer: B
Rationale: Clients with PKD often experience constipation, which can be managed by increasing dietary fiber and fluid intake. Laxatives should be used cautiously, salt intake should be restricted, and white bread is low in fiber, making it inappropriate for a high-fiber diet.
A nurse reviews laboratory results for a client with glomerulonephritis. The client's glomerular filtration rate (GFR) is 40 ml/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
- A. Excessive GFR
- B. Normal GFR
- C. Reduced GFR
- D. Potential for fluid overload
- E. Potential for dehydration
Correct Answer: C,D
Rationale: A GFR of 40 ml/min is significantly reduced compared to the normal range of 100-120 ml/min, indicating impaired kidney function. This reduction increases the risk of fluid overload, leading to hypertension and pulmonary edema, rather than dehydration.
A nurse assesses a client with nephrotic syndrome. For which clinical manifestations should the nurse assess? (Select all that apply.)
- A. Proteinuria
- B. Hypoalbuminemia
- C. Dehydration
- D. Lipiduria
- E. Dysuria
- F. Costovertebral angle (CVA) tenderness
Correct Answer: A,B,D
Rationale: Nephrotic syndrome is characterized by proteinuria (>3.5 g/24 hr), hypoalbuminemia, and lipiduria due to glomerular damage. Dehydration is unlikely due to fluid overload, and dysuria and CVA tenderness are associated with infections like cystitis or pyelonephritis, not nephrotic syndrome.
An emergency department nurse cares for a client who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate should the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.)
- A. 100 ml/hr
- B. 250 ml/hr
- C. 500 ml/hr
- D. 750 ml/hr
Correct Answer: C
Rationale: To deliver 3 L (3000 ml) over 6 hours, the infusion rate is calculated as 3000 ml ÷ 6 hours = 500 ml/hr. This rate ensures the prescribed volume is administered within the specified time frame.