Nokea
The nurse is caring for a client who is admitted to the nursing unit for a biopsy of the urinary tract tissue. When planning nursing care for the postoperative period, which nursing intervention documents the prescribed activity level?
- A. Maintain the client on bedrest
- B. Assist the client for bathroom privileges
- C. Ambulate the client in the hall
- D. Activity as tolerated
Correct Answer: A
Rationale: Following a urinary tract biopsy, the client is typically maintained on bedrest to minimize the risk of bleeding, given the high vascularity of the renal system. Assisting with bathroom privileges, ambulating in the hall, or allowing activity as tolerated may increase the risk of complications such as bleeding and are not typically prescribed immediately post-procedure.
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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.
The nurse is caring for a client about to undergo urologic testing. Which nursing action is best to comfort the client?
- A. Reassure the client the nurses are here to help and all will be fine.
- B. Allow for client's family to be present during testing.
- C. Provide for privacy and allow verbalization of concerns.
- D. Allow the client to determine the care to be provided.
Correct Answer: C
Rationale: Clients undergoing diagnostic testing are often anxious and worried. Clients having urologic testing may also feel embarrassed. Telling the client that all will be well dismisses the client's concerns. Provide privacy, reassurance, and information and maintain professional and empathic attitude. Allowing families to be present during testing and the client to determine care is not appropriate and may be distracting to the client.
The nurse has received morning lab work on a client with chronic renal disease. Which finding indicates renal disease?
- A. Urine pH of 6.5
- B. Urine nitrate: negative
- C. Protein level of 400 mg/dL
- D. Specific gravity: 1.0.2
Correct Answer: C
Rationale: The nurse must analyze components of a urinalysis to determine abnormal results. Protein at a level of 400 mg/dL is high and indicates renal disease. The other results are normal.
The nurse is teaching a client with oliguria about the steps that occur during the process of urine formation in the order in which they occur. Place the steps in the order the nurse should review them.
- A. Entrance into the Bowman capsule
- B. Drainage from the collecting tubules
- C. Filtration of plasma by glomerulus
- D. Movement through the nephrons to be absorbed or excreted
- E. Flowing into the renal pelvis and down the ureter
- F. Drainage into the bladder then out the urethra
Correct Answer: C,A,D,B,E,F
Rationale: There are three main steps with sub-steps in the complex process of forming urine. The glomerular filtration begins with filtering of the blood plasma by the glomerulus. Next, the filtrate enters Bowman capsule and moves through the tubular system of the nephron and is either absorbed into circulation or excreted as urine. The formed urine drains from the collecting tubules into the renal pelvis and down each ureter to the bladder and out through the urethra.
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.