Nokea
The nurse is admitting a patient with acute glomerulonephritis. Which of the following assessments is most important for the nurse to include?
- A. Recent sore throat and fever
- B. History of high blood pressure
- C. Frequency of bladder infections
- D. Family history of kidney stones
Correct Answer: A
Rationale: Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is not caused by hypertension, urinary tract infection (UTI), or kidney stones.
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The nurse is preparing a patient with bladder cancer for intravesical chemotherapy. Which of the following information should the nurse teach the patient about in preparation for the treatment?
- A. Premedicating to prevent nausea
- B. Where to obtain wigs and scarves
- C. The importance of oral care during treatment
- D. The need to empty the bladder before treatment
Correct Answer: D
Rationale: Intravesical chemotherapy is the instillation of the agent directly into the bladder, therefore the patient needs to have an empty bladder before the instillation of the chemotherapy. Systemic adverse effects are not experienced with intravesical chemotherapy.
The nurse is caring for a patient with nephrotic syndrome who develops flank pain. Which of the following medication classifications should the nurse anticipate including in the patient teaching plan?
- A. Antibiotics
- B. Anticoagulants
- C. Corticosteroids
- D. Antihypertensives
Correct Answer: B
Rationale: Flank pain in a patient with nephrosis suggests a renal vein thrombosis, and anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by pyelonephritis. Antihypertensives are used if the patient has high blood pressure. Corticosteroids may be used to treat nephrotic syndrome but will not resolve a thrombosis.
The nurse is caring for a patient following rectal surgery who voids about 50 mL of urine every 30-60 minutes. Which of the following nursing actions is best?
- A. Use a bladder scan device to check the postvoiding residual.
- B. Monitor the patient's intake and output over the next few hours.
- C. Have the patient take small amounts of fluid frequently throughout the day.
- D. Reassure the patient that this is normal after rectal surgery because of anesthesia.
Correct Answer: A
Rationale: A bladder scan device can be used to check for residual urine after the patient voids. Because the patient's history and clinical manifestations are consistent with overflow incontinence, it is not appropriate to have the patient drink small amounts. Although overflow incontinence is not unusual after surgery, the nurse should intervene to correct the physiological problem, not just reassure the patient. The patient may develop reflux into the renal pelvis as well as discomfort from a full bladder if the nurse waits to address the problem for several hours.
The nurse is providing teaching to a patient with impaired urinary elimination related to an UTI who weighs 70 kg. Which of the following daily fluid intake amounts should the nurse include in the teaching plan?
- A. 650 mL
- B. 1250 mL
- C. 1800 mL
- D. 2450 mL
Correct Answer: C
Rationale: The recommended daily liquid intake for the ambulatory adult is approximately 30 mL/kg body weight per day. Thus, a 70-kg person would require approximately 2100 mL each day. Among the options, 1800 mL is the closest appropriate amount to promote adequate urine output and prevent UTI recurrence.
The nurse is teaching a patient with interstitial cystitis about management of the condition. Which of the following patient statements indicate that further instruction is required?
- A. I will have to stop having coffee and orange juice for breakfast.
- B. I should start taking a high potency multiple vitamin every morning.
- C. I will buy some calcium glycerophosphate (Prelief) at the pharmacy.
- D. I should call the doctor about increased bladder pain or odorous urine.
Correct Answer: B
Rationale: High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.