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The nurse is teaching a patient about avoiding the recurrence of a urinary tract infection. Which of the following information should be included in the teaching plan?
- A. Teach the patient to wipe from back to front after voiding.
- B. Suggest the use of a diaphragm during intercourse.
- C. Advise the patient to urinate every 2-4 hours during the day.
- D. Advise the patient to report cloudy urine.
- E. Educate about the effects of a bubble bath.
Correct Answer: C,D,E
Rationale: The nurse would teach about voiding every 2-4 hours during the day, avoiding bubble baths, and advising the patient to report cloudy urine, as well as pain, frequency, and urgency. The patient should be taught to wipe from front to back. Diaphragm use should be discouraged temporarily, rather than suggested as an option.
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The nurse is caring for a young adult female patient who is diagnosed with polycystic kidney disease. Which of the following information should the nurse include in teaching at this time?
- A. Importance of genetic counselling
- B. Complications of renal transplantation
- C. Methods for treating persistent and severe pain
- D. Differences between hemodialysis and peritoneal dialysis
Correct Answer: A
Rationale: Because a young female patient may be considering having children, the nurse should include information about genetic counselling when teaching the patient. The well-managed patient will not need to choose between hemodialysis and peritoneal dialysis or know about the effects of transplantation for many years. There is no indication that the patient has persistent pain.
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 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.
The nurse is admitting an older-adult patient with dehydration who is confused and incontinent of urine. Which of the following nursing actions is best to include in the plan of care?
- A. Apply absorbent incontinent pads.
- B. Restrict fluids after the evening meal.
- C. Insert an indwelling catheter until the symptoms have resolved.
- D. Assist the patient to the bathroom every 2 hours during the day.
Correct Answer: D
Rationale: In older or confused patients, incontinence may be avoided by using scheduled toileting times. Indwelling catheters increase the risk for urinary tract infection (UTI). Incontinent pads increase the risk for skin breakdown. Restricting fluids is not appropriate in a patient with dehydration.
Which of the following actions should the nurse teach to a patient to help prevent the recurrence of renal calculi?
- A. Use a filter to strain all urine.
- B. Avoid dietary sources of calcium.
- C. Drink diuretic fluids such as coffee.
- D. Have 2000-3000 ml of fluid a day.
Correct Answer: D
Rationale: A fluid intake of 2000-2200 ml daily is recommended to help flush out minerals before stones can form. Avoidance of calcium is not usually recommended for patients with renal calculi. Coffee tends to increase stone recurrence. There is no need for a patient to strain all urine routinely after a stone has passed, and this will not prevent stones.