Nokea
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.
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A client asks the nurse why a creatinine clearance test is an accurate indicator of kidney function. The nurse is most correct to reply which of the following?
- A. Creatinine is broken down at a constant rate, and the total amount is excreted by the kidney.
- B. Creatinine is metabolized in the liver and excreted by the kidney at a regular rate.
- C. Creatinine is a stress-related response that is excreted by the kidney.
- D. Creatinine is found in the urine to make the urine acidic and can be measured.
Correct Answer: A
Rationale: A creatinine clearance test is used to determine kidney function and creatinine excretion. Creatinine results from a breakdown of phosphocreatine. It is filtered by the glomeruli and excreted at a consistent rate by the kidney.
The nurse is instructing a 3-year-old's parent regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
- A. Dysuria
- B. Enuresis
- C. Hematuria
- D. Anuria
Correct Answer: B
Rationale: The nurse would be most correct to document that enuresis, the involuntary voiding during sleep or commonly called 'wetting the bed,' is a normal finding in a pediatric client younger than 5 years old. Dysuria (pain on urination), hematuria (red blood cell in urine), and anuria (urine output less than 50 mL/day) are all abnormal findings needing further investigation.
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify what as part of the upper urinary tract?
- A. Bladder
- B. Urethra
- C. Ureters
- D. Pelvic floor muscles
Correct Answer: C
Rationale: The upper urinary tract is composed of the kidneys, renal pelvis, and ureters. The lower urinary tract consists of the bladder, urethra, and pelvic floor muscles.
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.
A client is scheduled for a renal angiography. What would be appropriate for the nurse to do before the test?
- A. Monitor the client for signs of electrolyte and water imbalance.
- B. Monitor the client for an allergy to iodine contrast material.
- C. Assess the client's mental changes.
- D. Evaluate the client for periorbital edema.
Correct Answer: B
Rationale: A renal angiography procedure will be contraindicated if the client is allergic to iodine contrast material. Therefore, it is important for the nurse to monitor the client for an allergy to iodine contrast material. The nurse monitors the client for the signs of electrolyte and water imbalance, mental changes, and periorbital edema at any time regardless of the test being done.