Nokea
The nurse is instructing a 3-year-old's parent regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
- A. Dysuria
- B. Enuresis
- C. Hematuria
- D. Anuria
Correct Answer: B
Rationale: The nurse would be most correct to document that enuresis, the involuntary voiding during sleep or commonly called 'wetting the bed,' is a normal finding in a pediatric client younger than 5 years old. Dysuria (pain on urination), hematuria (red blood cell in urine), and anuria (urine output less than 50 mL/day) are all abnormal findings needing further investigation.
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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.
The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?
- A. Urinary frequency
- B. Urinary urgency
- C. Urinary incontinence
- D. Urinary stasis
Correct Answer: B
Rationale: The nurse would document urinary urgency. Urinary frequency is urinating more frequently than normal often times due to inadequate emptying of the bladder. Urinary incontinence is the involuntary loss of urine. Urinary stasis is a stoppage or diminution of flow.
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 caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period?
- A. Encourage voiding following the procedure.
- B. Assess renal blood work.
- C. Assess cognitive status
- D. Complete a pulse assessment of the legs and feet.
Correct Answer: D
Rationale: A renal angiography provides details about the arterial blood supply to the kidney. A catheter is passed up the femoral artery into the aorta in the area of the renal artery. After the procedure, a pressure dressing remains in place for several hours. It is essential that the nurse palpate pulses in the legs and feet at least every 1 to 2 hours for signs of arterial occlusion. Reviewing lab work is completed in the preoperative period. Voiding assessment and cognitive status provide additional data in the post-procedural period. Assessing cognitive status is completed due to the sedative that is administered in the preprocedural period.
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.