Nokea
An intravenous pyelogram confirms the presence of a large renal calculus in the proximal left ureter of a newly admitted patient. The patient is not a candidate for conservative measures, so surgical correction is recommended. In addition to observing the patient for hemorrhage, which aspect of care will be the nurse's postsurgical interventions included for this patient?
- A. Encouraging fluid intake
- B. Addressing anxiety related to unclear outcome of condition
- C. Monitoring the patient for signs of prostatic hypertrophy
- D. Recommending appropriate oral analgesics to the health care provider
Correct Answer: A
Rationale: After surgery, encourage fluid intake to prevent infection and to prevent further stones from developing.
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Which aspect of self care will the nurse encourage, barring any other contraindication, when teaching a patient how to decrease the chance of further problems with urolithiasis?
- A. Increase his fluid intake.
- B. Increase intake of dairy products.
- C. Restrict his protein intake.
- D. Take one baby aspirin daily.
Correct Answer: A
Rationale: Fluid intake should be encouraged to at least 2000 mL of fluid in 24 hours, unless contraindicated.
A patient has nephrotic syndrome. Which statement made by the patient indicates understanding of the necessary diet modifications?
- A. I will need to increase protein and decrease sodium intake.'
- B. I will need to drink more milk to get my calcium.'
- C. Carbohydrate restriction will be difficult.'
- D. Potassium restriction won't be hard since I don't like fruit.'
Correct Answer: A
Rationale: Medical management for nephrotic syndrome depends on the extent of tissue involvement and may include the use of corticosteroids and a low-sodium, high-protein diet.
A male patient, age 71, is recovering from a trans-urethral prostatic resection (TURP). The health care provider requests removal of the indwelling catheter 2 days after the TURP procedure. Which occurrence might the patient experience after the catheter is removed?
- A. Burning on urination
- B. Passing of blood clots in the urine
- C. Dribbling of urine
- D. Coffee-colored urine
Correct Answer: C
Rationale: The patient is informed that initially he may experience frequency and voiding small amounts with some dribbling. There should be no hematuria or clots after 2 days.
The nurse is aware that as a person ages there is a loss of which mechanism of the kidney due to a decrease in blood supply to the kidneys and loss of nephrons?
- A. filtering
- B. reabsorption
- C. sterile water
- D. concentrating
Correct Answer: A
Rationale: The filtering mechanism is most affected with aging.
The nurse notes the amount and color of the urine the patient with urolithiasis has voided. While using Standard Precautions, which action will be the nurse's next action?
- A. Discard the urine.
- B. Add the urine to a 24-hour collector.
- C. Send the urine to the laboratory.
- D. Strain the urine.
Correct Answer: D
Rationale: All urine should be strained. Because stones may be any size, even the smallest speck must be saved for assessment by the laboratory.