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The nurse is caring for a patient who is going to have an open renal biopsy. What would be an important nursing action in preparing this patient for the procedure?
- A. Discuss the patients diagnosis with the family.
- B. Bathe the patient before the procedure with antiseptic skin wash.
- C. Administer antivirals before sending the patient for the procedure.
- D. Keep the patient NPO prior to the procedure.
Correct Answer: D
Rationale: Preparation for an open biopsy is similar to that for any major abdominal surgery. When preparing the patient for an open biopsy you would keep the patient NPO. You may discuss the diagnosis with the family, but that is not a preparation for the procedure. A pre-procedure wash is not normally ordered and antivirals are not administered in anticipation of a biopsy.
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The nurse is caring for a patient with a nursing diagnosis of deficient fluid volume. The nurses assessment reveals a BP of98 / 52 \mathrm{~mm} \mathrm{Hg}$. The nurse should recognize that the patients kidneys will compensate by secreting what substance?
- A. Antidiuretic hormone (ADH)
- B. Aldosterone
- C. Renin
- D. Angiotensin
Correct Answer: C
Rationale: When the vasa recta detect a decrease in BP, specialized juxtaglomerular cells near the afferent arteriole, distal tubule, and efferent arteriole secrete the hormone renin. Renin converts angiotensinogen to angiotensin I, which is then converted to angiotensin II. The vasoconstriction causes the BP to increase. The adrenal cortex secretes aldosterone in response to stimulation by the pituitary gland, which in turn is in response to poor perfusion or increasing serum osmolality. The result is an increase in BP.
Diagnostic testing of an adult patient reveals renal glycosuria. The nurse should recognize the need for the patient to be assessed for what health problem?
- A. Diabetes insipidus
- B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- C. Diabetes mellitus
- D. Renal carcinoma
Correct Answer: C
Rationale: Renal glycosuria can occur on its own as a benign condition. It also occurs in poorly controlled diabetes, the most common condition that causes the blood glucose level to exceed the kidneys reabsorption capacity. Glycosuria is not associated with SIADH, diabetes insipidus, or renal carcinoma.
The nurse is caring for a patient scheduled for renal angiography following a motor vehicle accident. What patient preparation should the nurse most likely provide before this test?
- A. Administration of IV potassium chloride
- B. Administration of a laxative
- C. Administration of Gastrografin
- D. Administration of a 24-hour urine test
Correct Answer: B
Rationale: Before the procedure, a laxative may be prescribed to evacuate the colon so that unobstructedx$-rays can be obtained. A 24-hour urine test is not necessary prior to the procedure. Gastrografin and potassium chloride are not administered prior to renal angiography.
A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?
- A. Ultrasound
- B. X-ray
- C. Computed tomography (CT)
- D. Nuclear scan
Correct Answer: A
Rationale: Ultrasonography is a noninvasive procedure that passes sound waves into the body through a transducer to detect abnormalities of internal tissues and organs. Structures of the urinary system create characteristic ultrasonographic images. Because of its sensitivity, ultrasonography has replaced many other diagnostic tests as the initial diagnostic procedure.
A patient is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? Select all that apply.
- A. Petechiae
- B. Pain
- C. Gastrointestinal symptoms
- D. Changes in voiding
- E. Jaundice
Correct Answer: B,C,D
Rationale: Dysfunction of the kidney can produce a complex array of symptoms throughout the body. Pain, changes in voiding, and gastrointestinal symptoms are particularly suggestive of urinary tract disease. Jaundice and petechiae are not associated with genitourinary health problems.