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Urinary - nursing

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Nursing Concepts

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Nursing Concepts

Urinary - nursingThe nurse assesses a patient admitted to the medical-surgical unit who has a diagnosis of type I diabetes mellitus. The nurse notes that the patient's urine is cloudy and foul-smelling. Which of the following diagnostic tests does the nurse anticipate will be ordered based on th...

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Number of pages 146
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Institution Nursing Concepts
Course Nursing Concepts

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Urinary - nursing

Nursing Concepts (Arizona State University)

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The nurse assesses a patient admitted to the medical-surgical unit who has a
diagnosis of type I diabetes mellitus. The nurse notes that the patient's urine
is cloudy and foul-smelling. Which of the following diagnostic tests does the
nurse anticipate will be ordered based on this finding?

1. urine culture and sensitivity (C&S)
2. blood urea nitrogen (BUN)
3. creatinine clearance
4. residual urine
Correct Answer: 1

Rationale: Urine culture and sensitivity (C&S) is correct because cloudy and
foul-smelling urine indicates a urinary tract infection. The diagnostic test to
identify the organism responsible is a urine C&S. Blood urea nitrogen (BUN)
measures the amount of urea (end product of protein metabolism) in the
blood plasma. It does not identify infection. Creatinine clearance is a 24-hour
urine test used to identify renal function; it will not identify an infection.
Residual urine measures the amount of urine left in the bladder after voiding,
and does not identify an infection.
When preparing a patient for an intravenous pyelogram (IVP), the nurse
reviews diagnostic data, noting all of the following. Which of these findings
requires notification of the physician before proceeding with the test?

1. blood urea nitrogen (BUN) 55 mg/dLdl
2. serum creatinine 1.3 mg/dL
3. urine culture <10,000 organisms/mL
4. residual urine of 80 mL
Correct Answer: 1

Rationale: Blood urea nitrogen (BUN) 55 mg/dL is correct because this level is
elevated, indicating that there might be a problem of renal function. The
physician will need to be notified because an IVP involves the injection of dye
that must eventually cleared by the kidney, and if there is already
compromised renal function, the test may not be administered. Serum
creatinine 1.3 mg/dL, urine culture <10,000 organisms/mL, and residual
urine of 80 mL are all incorrect because these values are all within the
normal range, and therefore will not require physician notification
A nurse working in a postoperative unit is caring for a patient who states, "I
voided a small amount of urine, but I feel as if I need to void more and am
unable to do so." The patient receives a prescription for a post-voiding
residual urine test. The nurse correctly prepares to perform the procedure by
gathering supplies that include which of the following?

1. a urine collecting device and a straight urinary catheter
2. a urine collecting device and a voiding diary

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3. an indwelling urinary catheter and an insertion kit
4. a peripheral IV insertion kit and a urine collecting device
Correct Answer: 1

Rationale: To evaluate the amount of urine in bladder post-voiding is correct.
This diagnostic test is ordered to determine urinary retention or incomplete
bladder emptying, which could be a consequence of the operative
experience. To correctly perform the procedure, the nurse gathers a urinary
collecting device and asks the patient to void. A straight urinary catheter is
inserted and removed and the amount of urine obtained from the bladder is
measured. Voiding diaries, indwelling urinary catheters, and peripheral IVs
are not required for this procedure.
Because of normal changes due to aging, the nurse anticipates that a 75-
year-old patient's serum creatinine level might be which of the following?

1. 0.3 mg/dL
2. 2.4 mg/dL
3. 4.8 mg/dL
4. 6.4 mg/dL
Correct Answer: 1

Rationale: Lower than normal is correct because serum creatinine level
reflects the by-product of muscle breakdown, and an older adult with less
muscle mass can be expected to have a lower-than-normal level. 0.5-1.5
mg/dL is the normal creatinine range for adults. Higher than normal, variable
with fluid status, and within normal range are all incorrect because the
question is asking for the expected change due to the aging process, and
that is less muscle mass, and therefore less serum creatinine.
When assessing a patient who is scheduled to have a CT scan of the kidneys,
which of these findings would prompt the nurse to notify the primary
healthcare provider?

1. allergy to iodine and seafood
2. . urinary output of 1,200 mL in 24 hours
3. last bowel movement one day ago
4. height 5'8" and weight 160 pounds
Correct Answer: 1

Rationale: Allergy to iodine and seafood is correct because a CT scan of the
kidneys requires the injection of a radiopaque dye that contains iodine. A
patient who is allergic to iodine or seafood will be unable to have this test.
Urinary output of 1,200 mL in 24 hours, last bowel movement one day ago,
and height 5'8" and weight 160 pounds are all incorrect because these are all
normal findings, and therefore do not require that the physician be notified.

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A nurse is assessing a 68-year-old female patient who states, "I am having
episodes of urinary incontinence." The nurse should recognize this statement
as indicating which of the following?

1. an abnormal finding requiring further testing
2. an indication of the presence of a urinary infection
3. a normal outcome of the aging process
4. the result of having several children
Correct Answer: 1

Rationale: An abnormal finding requiring further testing is correct because
incontinence is not a normal part of the aging process, and therefore will
require further investigation to identify the cause. An indication of the
presence of a urinary infection is incorrect because although frequency and
urgency can be symptoms of a urinary tract infection, a culture and
sensitivity test is necessary in order to determine infection. A normal
outcome of the aging process and a result of having several children are
incorrect because incontinence is not normal, and is it not necessarily the
result of having had several children.
A nurse is caring for a patient who has a diagnosis of peritonitis related to a
ruptured appendix. The patient states, "I hope I don't get a kidney infection
from this with my kidneys being so close to my appendix. I had a kidney
infection before and I felt terrible." Which explanation would be most
appropriate for the nurse to give the patient?

1. "Your kidneys are located outside the peritoneum, the sack that encloses
the appendix."
2. "Good thinking. Infections in the abdomen can spread to other organs."
3. "You need to speak with your primary healthcare provider about your
concern."
4. "We can check your urine daily to assure the infection is not spreading."
Correct Answer: 1
The nurse is caring for patient who has been diagnosed with an altered
mycogenic mechanism of the renal blood vessels. The patient asks, "Why is
it so important that I treat my hypertension and keep my blood pressure
within normal limits?" The nurse's best response is which of the following?

1. "Your kidneys may have difficulty protecting themselves from high blood
pressure."
2. "Your blood pressure medication is toxic to your kidneys in high doses."
3. "If not controlled, the condition will require an indwelling urinary catheter."
4. "High blood pressure increases your risk for kidney stones."
Correct Answer: 1

Rationale: The myogenic mechanism, which responds to pressure changes in

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