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A patient is complaining of genitourinary pain shortly after returning to the unit from a scheduled cystoscopy. What intervention should the nurse perform?
- A. Encourage mobilization.
- B. Apply topical lidocaine to the patients meatus, as ordered.
- C. Apply moist heat to the patients lower abdomen.
- D. Apply an ice pack to the patients perineum.
Correct Answer: C
Rationale: Following cystoscopy, moist heat to the lower abdomen and warm sitz baths are helpful in relieving pain and relaxing the muscles. Ice, lidocaine, and mobilization are not recommended interventions.
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The nurse is caring for a patient who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the physician?
- A. Scant hematuria
- B. Renal colic
- C. Temperature100.2 \mathrm{~F}$ orally
- D. Infiltration of the patients intravenous catheter
Correct Answer: C
Rationale: Hematuria and renal colic are common and expected findings after the performance of a renal brush biopsy. The physician should be notified of the patients body temperature, which likely indicates the onset of an infectious process. IV infiltration does not warrant notification of the primary care physician.
Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem?
- A. Diabetes insipidus
- B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- C. Diabetes mellitus
- D. Renal carcinoma
Correct Answer: C
Rationale: Renal glycosuria can occur on its own as a benign condition. It also occurs in poorly controlled diabetes, the most common condition that causes the blood glucose level to exceed the kidneys reabsorption capacity. Glycosuria is not associated with SIADH, diabetes insipidus, or renal carcinoma.
A patient with recurrent urinary tract infections has just undergone a cystoscopy and complains of slight hematuria during the first void after the procedure. What is the nurses most appropriate action?
- A. Administer a STAT dose of vitamin\mathrm{K}$, as ordered.
- B. Reassure the patient that this is not unexpected and then monitor the patient for further bleeding.
- C. Promptly inform the physician of this assessment finding.
- D. Position the patient supine and insert a Foley catheter, as ordered.
Correct Answer: B
Rationale: Some burning on voiding, blood-tinged urine, and urinary frequency from trauma to the mucous membranes can be expected after cystoscopy. The nurse should explain this to the patient and ensure that the bleeding resolves. No clear need exists to report this finding and it does not warrant insertion of a Foley catheter or vitamin\mathrm{K}$ administration.
A nurse is caring for a 73-year-old patient with a urethral obstruction related to prostatic enlargement. When planning this patients care, the nurse should be aware of the consequent risk of what complication?
- A. Urinary tract infection
- B. Enuresis
- C. Polyuria
- D. Proteinuria
Correct Answer: A
Rationale: An obstruction of the bladder outlet, such as in advanced benign prostatic hyperplasia, results in abnormally high voiding pressure with a slow, prolonged flow of urine. The urine may remain in the bladder, which increases the potential of a urinary tract infection. Older male patients are at risk for prostatic enlargement, which causes urethral obstruction and can result in hydronephrosis, renal failure, and urinary tract infections.
Results of a patients 24 -hour urine sample indicate osmolality of510 \mathrm{mOsm} / \mathrm{kg}$, which is within reference range. What conclusion can the nurse draw from this assessment finding?
- A. The patients kidneys are capable of maintaining acidbase balance.
- B. The patients kidneys reabsorb most of the potassium that the patient ingests.
- C. The patients kidneys can produce sufficiently concentrated urine.
- D. The patients kidneys are producing sufficient erythropoietin.
Correct Answer: C
Rationale: Osmolality is the most accurate measurement of the kidneys ability to dilute and concentrate urine. Osmolality is not a direct indicator of renal function as it relates to erythropoietin synthesis or maintenance of acidbase balance. It does not indicate the maintenance of healthy levels of potassium, the vast majority of which is excreted.