Nokea
The nurse is planning teaching for a patient with benign nephrosclerosis. Which of the following information should the nurse include in the teaching plan?
- A. Monitor and record blood pressure daily.
- B. Obtain and document daily weights.
- C. Measure daily intake and output amounts.
- D. Prevent bleeding caused by anticoagulants.
Correct Answer: A
Rationale: Hypertension is the major symptom of nephrosclerosis. Measurements of intake and output and daily weights are not necessary unless the patient develops renal insufficiency. Anticoagulants are not used to treat nephrosclerosis.
You may also like to solve these questions
The nurse is caring for a female patient who has had a urinary tract infection (UTI). Which of the following interventions should the nurse include in the plan of care?
- A. Encourage the patient to use a diaphragm for contraception.
- B. Sitz baths
- C. Encourage the patient to drink cranberry juice.
- D. Teach the patient how to do isometric perineal exercises.
Correct Answer: B
Rationale: Sitz baths can soothe the perineal area and promote voiding in patients with a UTI. Diaphragm use increases the risk for UTI and should be avoided. While cranberry juice may help prevent UTIs, evidence is inconclusive, and it is not a priority intervention. Isometric perineal exercises (e.g., Kegel exercises) are useful for stress incontinence, not UTI management.
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.
The nurse is caring for a patient who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the patient?
- A. Limit fluid intake for at least 7 days.
- B. Urine should be amber and not contain blood clots.
- C. In about one week urine will have rust-coloured flecks.
- D. Avoid sitz baths for a week after surgery.
Correct Answer: C
Rationale: Approximately 7-10 days following tumour resection or ablation, the patient may observe dark red or rust-coloured flecks in the urine. These are anticipated and represent scabs from the healing tumour resection sites. Other postoperative instructions for a segmental cystectomy include to drink a large volume of fluid each day for the first week following the procedure and to avoid intake of alcoholic beverages. Urine is anticipated to be pink during the first several days after the procedure, but it should not be bright red or contain blood clots. The patient can be encouraged to take a 15-20-minute sitz bath two to three times a day to promote muscle relaxation and to reduce the risk of urinary retention.
After receiving change-of-shift report, which of the following patients should the nurse assess first?
- A. A patient with nephrotic syndrome with a urinary output of 3000 mL yesterday
- B. A patient with urolithiasis who has not voided for 6 hours
- C. A patient with stage 3 chronic kidney disease who needs patient teaching
- D. A patient with stage 4 chronic kidney disease with complaints of dysuria
Correct Answer: B
Rationale: A patient with urolithiasis who has not voided for 6 hours is at risk for urinary obstruction, which can lead to hydronephrosis or renal damage, requiring immediate assessment. The other patients' conditions are less urgent; high urine output, dysuria, and teaching needs do not indicate immediate risk.
Which of the following nursing actions is most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in patients admitted to the hospital?
- A. Avoid unnecessary catheterizations
- B. Encourage adequate oral fluid intake.
- C. Test urine with a dipstick daily for nitrites.
- D. Provide thorough perineal hygiene to patients.
Correct Answer: A
Rationale: Since catheterization bypasses many of the protective mechanisms that prevent urinary tract infection (UTI), avoidance of catheterization is the most effective means of reducing HAI. The other actions will also be helpful, but are not as useful as decreasing urinary catheter use.