Nokea
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.
You may also like to solve these questions
The nurse is caring for a client who has a history of urine reflux. To assess the client for this urinary complication, which nursing action is best?
- A. Ask the client if voiding sufficient quantities has been a problem.
- B. Monitor the client's intake and output for inconsistency.
- C. Have the client void into a collection device.
- D. Palpate the client's bladder for distension.
Correct Answer: D
Rationale: Normally, urine flows in one direction because of peristaltic action and because the ureters enter the bladder at an oblique angle. The reflux of urine (urine that flows backward) can occur secondary to a distended bladder. By palpating for bladder distension, the nurse is able to determine that reflux urine traveled back to the bladder instead of traveling from the bladder down the urethra. All of the other options provide data that can be helpful, but actually feeling for the distension is best. Using a bladder scanner would also provide an amount of urine in the bladder.
A client who is suspected of urinary tract infection is asked to collect a 24-hour urine specimen for culture. Which measure can the nurse suggest to the client that may help prevent the entire urine specimen from becoming contaminated?
- A. Collect the voided urine sample primarily before 5 AM.
- B. Refrigerate the specimen until it is taken to the laboratory.
- C. Use the same receptacle for voiding and defecation.
- D. Store the collected urine away from sunlight.
Correct Answer: B
Rationale: To prevent the entire urine specimen from becoming contaminated, the urine specimen should be refrigerated until it can be taken to the laboratory. The nurse should ask the client to use separate receptacles for voiding and defecation to prevent any part of the specimen from being lost or contaminated. Urinating and collecting the urine sample only before 5 AM and collecting and storing the urine away from sunlight will not help prevent the urine specimen from becoming contaminated.
When describing the functions of the kidney to a client, which would the nurse include?
- A. Regulation of white blood cell production
- B. Synthesis of vitamin K
- C. Control of water balance
- D. Secretion of the enzyme renin
- E. Management of blood pressure
Correct Answer: C,D,E
Rationale: Functions of the kidneys include control of water balance and blood pressure, regulation of red blood cell production, synthesis of vitamin D to active form, and secretion of prostaglandins. They also produce the enzyme renin.
A gerontologic consideration of aging is the decreased ability to concentrate urine. This consideration leads to an increased susceptibility to dehydration further complicated by a deficit in thirst. Which nursing action would be most appropriate to address this concern?
- A. Encourage the client to decrease fluid intake.
- B. Instruct the client to double void.
- C. Offer the client use of the bathroom.
- D. Monitor the client for signs of drug toxicity.
Correct Answer: C
Rationale: A dull sound when percussing over the bladder indicates a full bladder. Because the bladder is full, the nurse would offer the client use of the bathroom. Tenderness over the kidney can indicate an infection or stones. Bruits are an abnormal vascular sound that does not indicate the need to use the bathroom. Ingesting water does not mean that the client has to void at this time.
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.