Nokea
The nurse is teaching a patient with interstitial cystitis about management of the condition. Which of the following patient statements indicate that further instruction is required?
- A. I will have to stop having coffee and orange juice for breakfast.
- B. I should start taking a high potency multiple vitamin every morning.
- C. I will buy some calcium glycerophosphate (Prelief) at the pharmacy.
- D. I should call the doctor about increased bladder pain or odorous urine.
Correct Answer: B
Rationale: High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.
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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.
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.
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.
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.