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Which of the following explanations should the nurse provide to a patient who asks, 'What is a cystoscopy?'
- A. Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney.
- B. Your health care provider will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys.
- C. Your health care provider will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked.
- D. Your health care provider will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray.
Correct Answer: D
Rationale: With a cystoscopy, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x-rays can be taken. The response beginning, 'Your health care provider will place a catheter' describes a renal arteriogram procedure. The response beginning, 'Your health care provider will inject a radioactive solution' describes a nuclear scan. The response beginning, 'Your health care provider will insert a lighted tube into the bladder, and little catheters will be inserted' describes a retrograde pyelogram.
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The nurse is caring for a patient following an intravenous pyelogram (IVP) and obtains all of the following assessment data. Which of the following findings require immediate action by the nurse?
- A. The heart rate is 58 beats/minute.
- B. The respiratory rate is 38 breaths/minute.
- C. The patient complains of a dry mouth.
- D. The urine output is 400 mL in the first 2 hours.
Correct Answer: B
Rationale: The increased respiratory rate indicates that the patient may be experiencing an allergic reaction (anaphylactic reaction) to the contrast medium used during the procedure. The nurse should immediately assess the patient's oxygen saturation and breath sounds. The other data are not unusual findings following an IVP.
The nurse is preparing a patient for a cystoscopy. Which of the following information should the nurse include in patient teaching about the procedure?
- A. NPO for 8 hours to prevent nausea and vomiting.
- B. Strict bed rest for about 4-6 hours.
- C. Request prescribed opioids as necessary for pain.
- D. May experience blood-tinged urine and urinary frequency.
Correct Answer: D
Rationale: Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.
The nurse is reviewing the result of a patient's creatinine clearance test which is 60 mL/minute. Which of the following values is the patient's glomerular filtration rate (GFR) in mL/minute?
- A. 30
- B. 60
- C. 120
- D. 240
Correct Answer: B
Rationale: The creatinine clearance approximates the GFR. The other responses are not accurate.
During assessment of a patient with decreased renal function, which of the following medications taken by the patient at home is of most concern to the nurse?
- A. Ibuprofen
- B. Warfarin
- C. Folic acid
- D. Penicillin
Correct Answer: A
Rationale: The nonsteroidal anti-inflammatory drugs (NSAIDs) are nephrotoxic and should be avoided in patients with impaired renal function. The nurse also should ask about reasons the patient is taking the other medications, but the medication of most concern is the ibuprofen.
The nurse is reviewing a patient's chart and notes that the patient has dysuria. To assess whether there is any improvement, which of the following questions should the nurse ask?
- A. Do you have any blood in your urine?
- B. Do you have to urinate very frequently?
- C. Do you have any pain when you urinate?
- D. Do you have to get up at night to urinate?
Correct Answer: C
Rationale: Dysuria is painful urination. The alternate responses are used to assess other urinary tract symptoms: hematuria, nocturia, and frequency.