Nokea
A patient is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? Select all that apply.
- A. Petechiae
- B. Pain
- C. Gastrointestinal symptoms
- D. Changes in voiding
- E. Jaundice
Correct Answer: B,C,D
Rationale: Dysfunction of the kidney can produce a complex array of symptoms throughout the body. Pain, changes in voiding, and gastrointestinal symptoms are particularly suggestive of urinary tract disease. Jaundice and petechiae are not associated with genitourinary health problems.
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A patient with a history of incontinence will undergo urodynamic testing in the physicians office. Because voiding in the presence of others can cause situational anxiety, the nurse should perform what action?
- A. Administer diuretics as ordered.
- B. Push fluids for several hours prior to the test.
- C. Discuss possible test results as the patient voids.
- D. Help the patient to relax before and during the test.
Correct Answer: D
Rationale: Voiding in the bladder is frequently due can cause a guarding reflex that inhibits voiding due to situational anxiety. Because the patient should ensure that the outcomes of these studies determine frighten the bladder, the nurse must help you relax the bladder by providing as much privacy as possible. Diuret and fluid intake would be not sufficient to induce anxiety. It would be inappropriate to discuss test the bladder during a test.
A patients most recent laboratory findings indicate a glomerular filtration rate (GFR) of58 \mathrm{~mL} / \mathrm{min}$. The nurse should recognize what implication of this diagnostic finding?
- A. The patient is likely to have a decreased level of blood urea nitrogen (BUN).
- B. The patient is at risk for hypokalemia.
- C. The patient is likely to have irregular voiding patterns.
- D. The patient is likely to have increased serum creatinine levels.
Correct Answer: D
Rationale: The adult GFR can vary from a normal of approximately125 \mathrm{~mL} / \mathrm{min}(1.67$ to2.0 \mathrm{~mL} / \mathrm{sec})$ to a high of200 \mathrm{~mL} / \mathrm{min}$. A low GFR is associated with increased levels of BUN, creatinine, and potassium.
The nurse is caring for a patient who describes changes in his voiding patterns. The patient states, I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesnt seem to be a great deal of urine flow. What would the nurse expect this patients physical assessment to reveal?
- A. Hematuria
- B. Urine retention
- C. Dehydration
- D. Renal failure
Correct Answer: B
Rationale: Increased urinary urgency and frequency coupled with decreasing urine volumes strongly suggest urine retention. Hematuria may be an accompanying symptom, but is likely related to a urinary tract infection secondary to the retention of urine. Dehydration and renal failure both result in a decrease in urine output, but the patient with these conditions does not have normal urine production and decreased or minimal flow of urine to the bladder. The symptoms of urgency and frequency do not accompany renal failure and dehydration due to decreased urine production.
The nurse is caring for a patient scheduled for renal angiography following a motor vehicle accident. What patient preparation should the nurse most likely provide before this test?
- A. Administration of IV potassium chloride
- B. Administration of a laxative
- C. Administration of Gastrografin
- D. Administration of a 24-hour urine test
Correct Answer: B
Rationale: Before the procedure, a laxative may be prescribed to evacuate the colon so that unobstructedx$-rays can be obtained. A 24-hour urine test is not necessary prior to the procedure. Gastrografin and potassium chloride are not administered prior to renal angiography.
A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?
- A. Ultrasound
- B. X-ray
- C. Computed tomography (CT)
- D. Nuclear scan
Correct Answer: A
Rationale: Ultrasonography is a noninvasive procedure that passes sound waves into the body through a transducer to detect abnormalities of internal tissues and organs. Structures of the urinary system create characteristic ultrasonographic images. Because of its sensitivity, ultrasonography has replaced many other diagnostic tests as the initial diagnostic procedure.