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Adult 1: Unit 3 Renal & Urologic Problems Flashcards | StudBud
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Adult 1: Unit 3 Renal & Urologic Problems
Adult 1: Unit 3 Renal & Urologic Problems
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1
Which type of urinary tract calculi are most common & frequently obstruct the ureter?
Uric acid
Calcium oxalate
Calcium phosphate
Cystine
2
Which characteristics are associated w/urge incontinence? (SATA)
Involuntary uriation preceded by urgency
Caused by overactivy of the detrusor muscle
Found following prostatectomy
Treated with Kegel exercises
Common in postmenopausal women
Bladder contracts by reflex, overriding central inhibition
3
which nursing interventions could be delegated to unlicensed assistive personnel (UAP)? SATA
Provide perineal care with soap & water around a urinary catheter
Teach pt pelvic floor muscle (Kegel) exercises
Assess the need for catheterization
Use bladder scanner to estimate residual urine
Insert indwelling catheter for uncomplicated patient
Assist incontinent patient to commode at regular intervals
4
Caring for 77yo woman w/urinary catheter, nurse monitors for development of UTI. What clinical manifestation most likely
Vague abdominal discomfort and disorientation
Urethral burning and bloody urine
Cloudy urine and fever
Suprapubic pain and slight decline in body temperature
5
Pt w/ suprapubic pain, sx of urinary frequency/urgency; 2 negative cultures. 1 assessment finding: interstitial cystitis
Pain w/bladder filling that is transciently relieved by urination
A large, atonic bladder on urodynamic testing
A voiding pattern that indicates psychogenic urinary retention
Residual urine greater than 200mL
6
Pt w/bladder cancer undergoes cystectomy w/formation of ileal conduit. Pt's 1st post-op day, nurse should plan to do:
Encourage high oral intake to flush mucus from the conduit
Empty drainage bag every 2 to 3 hours & measure the urinary output
Measure & fit stoma for a permanent appliance
Teach pt to self-catheterize the stoma every 4 to 6 hours
7
Prevention of calcium oxalate stones would include dietary restriction of which foods or drinks?
Dried beans and dried fruits
Liver, kidney, and sweetbreads
Milk and milk products
Spinach, cabbage, and tomatoes
8
Jewish male pt, hx of gout, & has been dx with renal calculi. Which treatment will be used w/ this patient? (SATA)
Administer a- penicillamine
Administer thiazide diuretics
Reduce intake of milk products
Reduce animal protein intake
Reduce dietary oxalte
Administer allopurinol
9
Glomerulonephritis is characterized by glomerular damage caused by
Hemolysis or RBC circulating in the glomeruli
Growth of microorganism
Release of bacterial substances toxic to the glomeruli
Accumulation of immune complexes in the glomeruli
10
On assessment of the pt w/ renal calculus passing down the ureter, what should the nurse expect the pt to report?
Severe, colicky back pain radiating to the groin
A feeling of bladder fullness with urgency and frequency
Dull, costovertebral flank pain
History of chronic UTIs
11
Which classification of UTI is described as infection of the renal parenchyma, renal pelvis, & ureters?
Upper UTI
Complicated UTI
Uncomplicated UTI
Lower UTI
12
What is included in nursing care that applies to the management of all urinary catheters in hospitalized pts?
Turning the pt frequently from side to side to promote drainage
Using strict sterile technique irrigation & obtaining culture specimens
Daily cleaning of the catheter site w/ soap & water & application of lotion
Measuring urine output every 1 to 2 hours to ensure patency
13
With which diagnosis will the pt benefit from being taught to do self-catheterization?
Renal artery stenosis
Accelerated nephrosclerosis
Urethral stricture
Renal trauma
14
Which infection is asymptomic in men at 1
st
then progress to cystitis, frequent urination, burning on void, epididymitis
Urethral diverticula
Renal tuberculosis
Urosepsis
Goodpasture syndrome
15
Which characteristic is more likely w/ acute pyelonephritis than w/ a lower UTI?
Dysuria
Fever
Frequency
Urgency
16
In providing care for the pt with adult-onset polycystic kidney disease, what should the nurse do?
Implement measures for pt's deafness & blindness in addt. to renal problems
Help pt to cope w/ the rapid progression of the disease
Suggest genetic counseling resources for the children of the pt
Expect the pt to have polyuira & poor concentration ability of the kidneys
17
Female pt w/UTI, nursing dx: risk for infection r/t lack of knowledge regarding prevention of recurrance. Nurse teaching
Wait to urinate until the urge is very intense
Clean urinary meatus w/ an anti-infective agent after voiding
Empty bladder at least 4 times a day
Drink at least 2 quarts of water every day
18
Woman w/no hx of UTI; has urgency, frequency, dysuria; dipstick & microscopic urinalysis: bacteriuria. Nurse anticipates
Need to have blood specimen drawn for CBC & kidney function tests
Emperical tx w/ TMP-SMX (Bactrim) for 3 days
Obtaining clean-catch midstream urine specimen for culture & sensitivity
No tx w/medication unless she develops fever, chills, & flank pain
19
Female pt w/ UTI also has renal calculi. Nurse knows that these are most likely which type of stone?
Cystine
Uric acid
Struvite
Calcium phosphate
20
Which disease causes connective tissue changes that cause glomerulonephritis?
Diabetes mellitus
Gout
Systemic lupus erythematosus
Amyloidosis
21
Which test is
required
for a
diagnosis
of pyelonephritis?
Urine for culture and sensitivity
Blood culture
Intravenous pyelogram (IVP)
Renal biopsy
22
When caring for the pt w/ interstitial cystitis, what can the nurse teach the pt to do?
Use dietary supplement Calcium glycerophosphate to ↓ bladder irritation
Use high-potency vitamin therapy to decrease autoimmune effects of disorder
Always keep voiding diary to document pain/frequency & patterns of nocturia
Avoid foods that make the urine more alkaline
23
What is the most common cause of acute pyelonephritis resulting from an ascending infection from lower urinary tract?
The pt does not take all of the antibiotics for tx of UTI
The kidney is scarred and fibrotic
There is a preexisting abnormality of the urinary tract
The organism is resistant to antibiotics
24
Besides being mixed with struvite or oxalate stones, what characteristic is associated w/ calcium phosphate calculi?
Genetic autosomal recessive defect
Defective gastrointestinal (GI) and kidney absorption
Three times as common in women as in men
Associated with alkaline urine
25
Obtaining a hx from a pt w/cancer of urinary system, nurse recognizes as risk factor assoc. w/kidney & bladder cancer
Chronic use of phenacetin
Chronic, recurrent nephrolithiasis
Family history of cancer
Smoking
26
A teaching plan developed by the nurse for pt w/new ileal conduit includes instructions to do what?
Use sterile supplies & technique during care of the stoma
Clean the skin around the stoma with alcohol every day
Change the appliance every day & wash it with soap & warm water
Use a wick to keep the skin dry during appliance changes
27
What results in the edema associated with nephrotic syndrome?
Hypercoagulability
Decreased glomerular filtration rate
Hyperalbuminemia
Decreased plasma oncotic pressure
28
Pt has throracic spinal cord lesion & incontinence that occurs day & night. What type of incontinence is pt experiencing
Reflex incontinence
Incontinence after trauma
Functional incontinence
Overflow incontinence
29
To assist patient w/ stress incontinence, what is best thing nurse should teach the pt to do?
Use absorptive perineal pads to contain urine
Void every 2 hours to prevent leakage
↑ intrabdominal pressure during voiding to empty the bladder completely
Perform pelvic floor muscle exercises 40-50x per day
