Question 1

The home health nurse is caring for a patient with chronic renal failure.Which assessment finding(s)indicate(s)that the patient is experiencing uremic syndrome?

Accepted Answer

Uremia or uremic syndrome signs generally appear when blood urea nitrogen (BUN)concentration passes 100 mg/dL.Complaints about restless legs syndrome are frequent,and the leg discomfort may interfere with sleep.The skin becomes dry,scaly,and a pallid yellowish gray.Uremic frost (a late sign)appears as evaporated sweat leaves urea crystals on the eyebrows.Calcium is not absorbed from the intestinal tract,and this leads to the loss of calcium from the body and a corresponding drop in serum calcium.If the hypocalcemia is not corrected,the patient will eventually suffer from muscle cramps,twitching,and possibly seizures.The patient is usually hypertensive rather than hypotensive.

Question 2

In which situation(s)should the nurse question an order for carbenicillin for a patient with a urinary infection?

Accepted Answer

Carbenicillin is an extended-spectrum penicillin medication.It interferes with the effectiveness of oral birth control medication and warfarin and should not be given to people allergic to penicillin.Age and a history of hypertension are not contraindications to carbenicillin.

Question 3

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

-Cardiogenic shock

Accepted Answer

Cardiogenic shock can cause prerenal acute renal failure due to decreased blood flow to the kidneys as a result of decreased cardiac output.

Answer: B
 Cardiogenic shock can also lead to intrarenal acute renal failure due to direct damage to the kidneys from decreased perfusion and oxygenation.

Answer: C
 Cardiogenic shock is not a typical cause of postrenal acute renal failure, which is caused by obstruction of urine flow.

Question 4

The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation.Which finding(s)increase(s)the patient's risk for the development of renal calculi?

Accepted Answer

Risk factors for development of renal calculi include uric acid crystals in urine,frequent bacterial urinary infections,prolonged immobility or bed rest,and a parathyroid gland tumor.Another risk factor includes inadequate fluid intake.

Question 5

The nurse is aware that 80% of UTIs in females are the result of contamination from __________.

Accepted Answer

The answer of The nurse is aware that 80% of...

Question 6

The nurse caring for a patient who has just had an arteriovenous (AV)access created in his right forearm.Which finding(s)is/are important for the nurse to assess?

Accepted Answer

The nurse should auscultate for a bruit,assess capillary refill times in both hands,and ensure that the right arm is elevated properly.The nurse should not take the patient's blood pressure in the affected (right)arm,and this procedure does not result in an abdominal incision.

Question 7

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

-Vascular changes related to diabetes mellitus

Accepted Answer

Intrarenal ARF, which is caused by damage to the structures within the kidney, can be associated with vascular changes related to diabetes mellitus. Prerenal ARF is caused by decreased blood flow to the kidney, and postrenal ARF is caused by obstruction of urine flow. Neither of these are directly related to vascular changes related to diabetes mellitus.

Question 8

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

-Hypovolemic shock

Accepted Answer

Hypovolemic shock leads to decreased blood flow to the kidneys, which is a characteristic cause of prerenal acute renal failure (ARF).

Question 9

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

-Prostate hypertrophy

Accepted Answer

Postrenal ARF is likely caused by an obstruction in the urinary tract, such as prostate hypertrophy.

Question 10

The nurse is caring for a patient who is undergoing plasmapheresis.The nurse should carefully monitor the patient for which potential complication(s)?

Accepted Answer

Plasmapheresis is a therapy used in autoimmune disorders,such as acute glomerulonephritis or myasthenia gravis.It removes the autoantibodies causing the disease.This procedure can be done at the bedside by a trained technician with specialized equipment.The patient's blood is accessed through a shunt or a central IV catheter and the blood components are separated from the plasma by filtration or centrifuge.Then,the cellular components are returned to the patient and the plasma is replaced with a fluid such as normal saline or albumin.Assessment for bleeding at puncture site,bruits,hypotension,and electrolyte imbalances is essential.Allergic reactions are not anticipated.

Question 11

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.)

-Ureteral obstruction

Accepted Answer

Ureteral obstruction is a cause of postrenal ARF. The obstruction prevents urine from flowing out of the kidneys, leading to decreased kidney function.

Question 12

The nurse is caring for patient with a urinary tract infection (UTI)who is to receive cefazolin (Ancef).The nurse should carefully monitor the patient for which side effect(s)?

Accepted Answer

Cefazolin (Ancef)may cause vaginitis,arrhythmias,a sunburn-like rash,and confusion.Cefazolin may increase clotting time.

Question 13

A patient has been admitted to the acute care facility to rule out glomerulonephritis.Which assessment finding(s)is/are supportive of the potential diagnosis?

Accepted Answer

The patient with acute glomerulonephritis usually becomes suddenly ill with fever,chills,flank pain,widespread edema,puffiness about the eyes,visual disturbances,and marked hypertension.The urine may be smoky and will contain red blood cells and protein,and urine will have an increased specific gravity.Serum creatinine and BUN levels rise above normal rather than decrease.Diagnosis is based on physical findings.

Quiz 34: Care of Patients with Disorders of the Urinary System

The home health nurse is caring for a patient with chronic renal failure.Which assessment finding(s) indicate(s) that the patient is experiencing uremic syndrome?

In which situation(s) should the nurse question an order for carbenicillin for a patient with a urinary infection?

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.) -Cardiogenic shock

The nurse is collecting the health history of a patient who has had multiple episodes of renal calculi formation.Which finding(s) increase(s) the patient's risk for the development of renal calculi?

The nurse is aware that 80% of UTIs in females are the result of contamination from __________.

The nurse caring for a patient who has just had an arteriovenous (AV) access created in his right forearm.Which finding(s) is/are important for the nurse to assess?

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.) -Vascular changes related to diabetes mellitus

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.) -Hypovolemic shock

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.) -Prostate hypertrophy

The nurse is caring for a patient who is undergoing plasmapheresis.The nurse should carefully monitor the patient for which potential complication(s) ?

The nurse associates the types of acute renal failure with their probable cause to enhance the patient's understanding.Match the type of acute renal failure (ARF) with its probable cause: (The options can be used once, more than once, or not at all.) -Ureteral obstruction

The nurse is caring for patient with a urinary tract infection (UTI) who is to receive cefazolin (Ancef) .The nurse should carefully monitor the patient for which side effect(s) ?

A patient has been admitted to the acute care facility to rule out glomerulonephritis.Which assessment finding(s) is/are supportive of the potential diagnosis?