Nokea
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.
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The nurse is admitting a patient with new onset nephrotic syndrome. Which of the following findings should the nurse expect to assess related to this illness?
- A. Poor skin turgor
- B. High urine ketones
- C. Recent weight gain
- D. Low blood pressure
Correct Answer: C
Rationale: The patient with a nephrotic syndrome will have weight gain associated with edema. Hypertension is a clinical manifestation of nephrotic syndrome. Skin turgor is normal because of the edema. Urine protein is high.
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider?
- A. Foul-smelling urine
- B. Complaint of flank pain
- C. Blood pressure 88/45 mm Hg
- D. Temperature 37.8°C (100°F)
Correct Answer: C
Rationale: Low blood pressure (88/45 mm Hg) indicates potential septic shock, a life-threatening complication of pyelonephritis, requiring urgent intervention. Foul-smelling urine, flank pain, and a mild fever are common findings in pyelonephritis but are less critical unless accompanied by systemic signs like hypotension.
The nurse is caring for a patient whose renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, which of the following foods should the nurse teach the patient to avoid eating?
- A. Milk and dairy products
- B. Legumes and dried fruits
- C. Organ meats and sardines
- D. Spinach, chocolate, and tea
Correct Answer: C
Rationale: Organ meats and fish such as sardines increase purine levels and uric acid. Spinach, chocolate, and tomatoes should be avoided in patients who have oxalate stones. Milk, dairy products, legumes, and dried fruits may increase the incidence of calcium-containing stones.
The nurse is caring for a patient who has had an ureterolithotomy with a left ureteral catheter and a urethral catheter in place. Which of the following actions should the nurse include in the plan of care?
- A. Provide education about home care for both catheters
- B. Apply continuous steady tension to the ureteral catheter.
- C. Clamp the ureteral catheter unless output from
- D. Call the health care provider if the ureteral catheter output drops suddenly.
Correct Answer: D
Rationale: The health care provider should be notified if the ureteral catheter output decreases since obstruction of this catheter may result in an increase in pressure in the renal pelvis. Tension on the ureteral catheter should be avoided in order to prevent catheter displacement. To avoid pressure in the renal pelvis, the catheter is not clamped. Since the patient is not usually discharged with a ureteral catheter in place, patient teaching about both catheters is not needed.
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.