RN Alterations in Kidney Function and Elimination Assessment

A nurse is caring for a client admitted for acute glomerulonephritis.

Click to highlight the findings that require immediate follow-up.

- client reports nausea and vomits 50 ml of yellow liquid

- reports SOB

- fine crackles auscultated in bilat lungs

- client states "I just feel so tired."

- resp rate 28/min

- BP 184/90 mm Hg

???

A nurse is caring for a group of clients, who all are incontinent of urine, on the med surg unit. Which comorbidities should the nurse expect to find in their medical records?

- COPD

- HF

- DM

- MS

- Lupus

- Chronic obstructive pulmonary disease

- Heart failure

- Multiple sclerosis

A nurse is caring for a client admitted to the urology unit with complaints of SOB and a diagnosis of CKD. Which of the following pathophysiology changes in the renal system led to the admitting diagnosis of CKD?

Chronic nephropathies that lead to fibrosis and destruction of normal kidney structure and function

A nurse is conducting an admission assessment of a client with BPH. The client states they avoid social events due to this condition. Which of the following client findings should the nurse expect to find in the assessment? SATA

- Inability to void

- Dysuria

- Urinary urgency

- Incontinence

- Urinary frequency

- Impotence

- Inability to void

- Dysuria

- Urinary urgency

- Urinary frequency

A nurse is caring for a group of clients on a medical unit. Which of the following clients is the most at risk for an AKI?

- a client who is taking gentamicin for infection

- a client who has HF

- a client who is 1 day post op following colon resection

- client who has a pneumonia

- a client who has an exacerbation of lupus

- a client who is taking gentamicin for infection

(aminoglycosides are nephrotoxic)

- a client who has HF

(leads to pre renal AKI due to an increase in CVP, causing ventricles to dilate decreasing CO)

- a client who has an exacerbation of lupus

(connective tissue disorder w/c may lead to intra renal AKI)

A nurse is caring for a client who has AKI. The nurse should expect which of the following findings in the client's medical record? SATA

- increased BUN

- decreased GFR

- decreased creatinine

- decreased urine output

- JVD

- increased BUN

- decreased GFR

- decreased urine output

- JVD

A nurse is caring for a client diagnosed with bacterial meningitis and is receiving gentamicin. Morning lab results include the following:

BUN 31 mg/dL

creatinine 1.8 mg/dL

GFR 55 mL/min

Which of the following conditions does the client's lab results most likely indicate?

An intra renal acute kidney injury

A nurse is providing discharge teaching to a client with CKD. Which of the following client statements indicate understanding of food restrictions? SATA

- "I can continue to have my frozen meals for dinner."

- "I need to limit my protein intake."

- "Whole milk is a good option for a drink with meals due to the nutrients present."

- "I should broil my meats and vegetables."

- "My lunch can contain deli meat on 2 slices of whole wheat bread."

- Herbs are good substitutes when I cook my meals."

- "I need to limit my protein intake."

- "I should broil my meats and vegetables."

- Herbs are good substitutes when I cook my meals."

A nurse is caring for a group of clients on a urology unit. Which clients are the most at risk for BPH? SATA

- a client who has a BMI of 38

- a client whose father had BPH

- a client who has prostate cancer

- a client who has pyelonephritis

- a client who has metabolic syndrome

- a client who has a BMI of 38

- a client whose father had BPH

- a client who has metabolic syndrome

A nurse is caring for a client in the clinic who reports an inability to drain their bladder and urgency with urination. The client's medical hx indicates they have had BPH for the last 26 yrs. Which of the following other clinical manifestations of BPH will the client most likely report to the nurse? SATA

- pain with urination

- urination at night

- swelling around the eyes

- difficulty getting the urine stream started

- frothy urine

- bloody urine

- pain with urination

- urination at night

- difficulty getting the urine stream started

An occupational nurse at a candy factory is developing a plan of care for clients who are experiencing incontinence that is affecting their job performance. Which of the following client statements would indicate an understanding of a contributing factor to their incontinence at work?

"I probably have problems with incontinence due to our strict break policy that they monitor very closely."

A nurse is planning a discharge teaching plan for a client with acute glomerulonephritis. Which of the following actions should the nurse include in the plan to reduce the development of complications? SATA

- salt restriction

- protein restriction

- smoking cessation

- regulation of HTN

- increased fluid intake

- increased potassium intake

- salt restriction

- protein restriction

- smoking cessation

- regulation of HTN

A nurse id admitting a client to the ED who reports a puffy face and malaise. The client states, "I finished taking amoxicillin for strep throat a few days ago." The nurse suspects the client may have acute glomerulonephritis. If the nurse is correct, which of the following other assessments findings should the nurse expect? SATA

- elevated SBP

- fever

- palpable kidney mass

- diffuse abdominal pain

- dark, frothy urine

- decreased muscle strength

- elevated SBP

- fever

- diffuse abdominal pain

- dark, frothy urine

- decreased muscle strength

A nurse is caring for a client with a history of BPH who has been admitted for a UTI. A student nurse asks what causes BPH in men. The nurse should respond with which of the following statements?

"It is caused by smooth muscle and epithelial cells multiplying at an uncontrolled rate within the transition zone."

A nurse is caring for a client in the ED who reports bloody urine, frequent urination, and lower back pain rated as a 9 on a scale of 0 to 10. The provider performs a physical assessment on the client and tells the client, "I think you have polycystic kidney disease, but we will order a CT scan to confirm." Which of the following physical findings did the provider most likely find during the physical assessment that led to the possible diagnosis of PKD?

Palpable kidney mass

A nurse in a clinic is collecting subjective data from a client who reports of urinary leakage. The client states, "I have sudden urges to urinate and leak a little before getting to the bathroom." Which of the following types of altered urinary elimination is this client most likely experiencing?

Urge incontinence

A nurse is caring for 4 clients on a med surg unit. Which of the following clients is at the highest risk for developing AKI?

A client who was admitted with dehydration from bacterial meningitis receiving vancomycin IV

A nurse is caring for a client admitted with acute glomerulonephritis. The client wants to know how this condition occurs. Which of the following best describes the pathological process of acute glomerulonephritis?

An inflammatory response and a decreased GFR in the kidneys

A nurse is caring for a client with urinary retention. The client asks what causes them to have urinary retention. Which of the following statements would the nurse make regarding possible causes of urinary retention?

- "It may be caused by a stone lodged in your urethra."

- "It may be caused by an underactive bladder from a neurological condition."

- "It may be caused by a defective gene from one of your parents."

- "It may be caused by a narrowing o the urethra."

- "It may be caused by glomeruli inflammation a week after being treated for strep throat."

- "It may be caused by a stone lodged in your urethra."

- "It may be caused by an underactive bladder from a neurological condition."

- "It may be caused by a narrowing o the urethra."

A nurse is caring for a client with a new diagnosis of AKI. The client states, "This is really going to mess my life up." Which of the following is the best response by the nurse to assist the client to begin to understand the impact of this disease?

"Clients with this disease typically have concerns with finances, tx, and adjusting to a new normal."

A nurse is caring for a client newly diagnosed with BPH. Which topics are important to include in the education about this disease? SATA

- increase exercise

- Tamsulosin use and adverse effects

- UTI manifestations

- a diet low in calcium oxalate

- Trimethoprim/sulfamethoxazole use and adverse effects

- urinary retention emergency

- increase exercise

- Tamsulosin use and adverse effects

- UTI manifestations

- urinary retention emergency

A nurse is developing a plan of care for a client in a long-term skilled facility who has urinary incontinence. The interventions include bladder training and timed voiding. Which of the following statements by the client best indicates how the interventions have impacted they quality of life?

"I don't worry so much about peeing myself and feel more confident going out of my room."

A nurse is caring for a group of clients on a med surg unit. Which of the following clients is the most at risk for developing acute glomerulonephritis?

A client who was admitted for a staphylococcal skin infection

A nurse on the dialysis unit is caring for a client who has ESRD and is getting ready for their first hemodialysis session. Which of the following topics should the nurse include when discussing the impact of hemodialysis treatment on the client's life?

- diet restrictions

- home recording of the volume removed at each exchange

- risk for depression

- fluid restrictions

- tome requirements

- diet restrictions

- risk for depression

- fluid restrictions

- tome requirements

A nurse is performing an assessment on a client coming into the clinic with complaints of painful urination. The client reports that they leak urine when they sneeze, cough, or lift heavy objects. Which of the following best describes the cause of this type of urinary elimination alteration?

Weakness of the urethral sphincter or the pelvic floor muscles

A nurse is caring for a client who has chronic glomerulonephritis. The AP brings a snack into the client's room. Which of the following foods should the nurse stop the AP from giving this client?

Banana

- High in K. A client w/ glomerulonephritis has renal insufficiency and must be on a low K diet.

A nurse is completing discharge teaching for a client on home intermittent peritoneal dialysis. Which of the following statements by the client indicate an understanding of fluid balance self-management?

- "I will weigh myself every other day."

- "I will only take my diuretic pill if my feet are puffy."

- "I will drink only the amount of fluid in a day that my doctor told me to."

- "I will call my doctor if I feel short of breath all of a sudden."

- "I will do extra peritoneal dialysis sessions if I gain too much weight on a day."

- "I will drink only the amount of fluid in a day that my doctor told me to."

- "I will call my doctor if I feel short of breath all of a sudden."

A nurse manager on the urology unit is providing continuing education to nurses on the management of care of a client with BPH. To promote an interprofessional treatment approach related to the psychosocial impact the disease has on the client, the nurse should request a referral for which of the following health care professional?

Psychiatrist

A nurse is caring for an 88 year old client in a senior living center. After reviewing the client's EMR, determine which of the following info would demonstrate that the client's condition has improved. SATA

- AO x4

- no incontinence

- temp 36.9 deg C (98.4 deg F)

- no muscle weakness

- urine yellow and clear

- denies abdominal pain

- absence of bacteria in urine culture

- AO x4

- temp 36.9 deg C (98.4 deg F)

- urine yellow and clear

- denies abdominal pain

- absence of bacteria in urine culture

A nurse is assessing a client with AKI and developing fluid overload caused by long-term use of aminoglycosides. For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

ANTICIPATED:

- Fluid restriction of 1 L/day

- Furosemide 40 mg IV

- Normal saline at 75 ml/hr IV

- O2 per NC at 2 L/min to keep O2 sat 95% and above

NONESSENTIAL:

- Bladder scan for residual urine after every void

- Neuro consult

CONTRAINDICATED:

- CT scan w/ contrast of kidneys