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During the physical examination of a client, the nurse monitors for signs that may indicate a urinary tract disorder. Which of the following would suggest that the client may have a urinary tract disorder?
- A. Light-headedness
- B. Malaise
- C. Periorbital edema
- D. Flank pain
Correct Answer: C
Rationale: Periorbital edema, among other signs, such as edema of the extremities, cardiac failure, and mental changes may indicate a urinary tract disorder. Light-headedness and flank pain may suggest urinary bleeding. Malaise is a sign of systemic infection. Flank pain and malaise could occur after a biopsy, and if they occur, the physician is to be notified immediately.
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The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?
- A. Encourage voiding following the procedure.
- B. Assess renal blood work.
- C. Assess cognitive status
- D. Complete a pulse assessment of the legs and feet.
Correct Answer: D
Rationale: A renal angiography provides details about the arterial blood supply to the kidney. A catheter is passed up the femoral artery into the aorta in the area of the renal artery. After the procedure, a pressure dressing remains in place for several hours. It is essential that the nurse palpate pulses in the legs and feet at least every 1 to 2 hours for signs of arterial occlusion. Reviewing lab work is completed in the preoperative period. Voiding assessment and cognitive status provide additional data in the post-procedural period. Assessing cognitive status is completed due to the sedative that is administered in the preprocedural period.
Which diagnostic test would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?
- A. Radiography
- B. Angiography
- C. Computed tomography (CT scan)
- D. Cystoscopy
Correct Answer: B
Rationale: Angiography provides the details of the arterial supply to the kidneys, specifically the number and location of renal arteries. Radiography shows the size and position of the kidneys, ureters, and bladder. A CT scan is useful in identifying calculi, congenital abnormalities, obstruction, infections, and polycystic diseases. Cystoscopy is used for providing a visual examination of the internal bladder.
The nurse is assisting the physician in completing a cystoscopy. In which position would the nurse place the client when preparing for the procedure?
- A. On the client's back with knees to the side
- B. On the client's back with feet in the stirrups
- C. On the client's right side with a pillow behind the back
- D. On the client's left side with a pillow behind the back
Correct Answer: B
Rationale: The client who is undergoing a cystoscopy will be positioned on the back with the feet in stirrups. The client is also to have an empty bladder and may be sedated for the procedure.
The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated?
- A. The specific gravity will be relatively constant
- B. The specific gravity will equal to one
- C. The specific gravity will be high
- D. The specific gravity will be low
Correct Answer: C
Rationale: The nurse assesses all of the data to make an informed decision on client status. On a hot day, the client found outside will be perspiring. When dehydration occurs, a client will have low urine output and increased specific gravity of urine. In kidney disease, the specific gravity may remain relatively constant. The density of distilled water is one. A low specific gravity is noted in a client with high fluid intake and who is not losing systemic fluid.
The nurse is instructing a health class of high school seniors on the function of the kidney. The nurse is correct to highlight which information?
- A. Regulates estrogen and progesterone
- B. Excretes waste products
- C. Controls blood pressure
- D. Regulate calcium and the synthesis of vitamin D
- E. Activates growth hormone
- F. Regulates red blood cell production
Correct Answer: B,C,D,F
Rationale: The nurse is correct to highlight all of the options except regulates estrogen and progesterone. The pituitary gland controls hormone secretion.