RANd0M
Serum Creat #?
GFR #?
BUN #?
Serum Osmolarity #?
PER TAMIKAS HANDOUT
Serum Creat: 0.5-1.2
GFR: 120-130 (adult)
BUN: 10-20
Serum Osmolarity: 285- 295
A client who has been taking adjunct medications for their UTI is nervous because they have been urinating red-orange urine. The nurse suspects the client is taking what medication?
a) anaspaz
b) keflex
c) phenazopyridine
d) ciprofloxacin
c) phenazopyridine
BONUS:
what is another name for this?
pyridium
Which is a teaching point to reduce stress incontinence?
a) pelvic floor exercises
b) wearing depends
c) self catheterization
d)bladder training
a) pelvic floor exercises
A client presents to the ED with a distended abdomen, chills, & pallor. The client rates their pain 10/10 and feels no relief after administration of ibuprofen. Upon doing a short PMH the nurse discovers the client recently lost a significant amount of weight. What do you suspect is happening?
a) CVA
b) calculi
c) renal colic
d) renal stenosis
c) renal colic
The clinic nurse provides instructions to a female client with recurrent cystitis and includes which information for health promotion activities? SATA
a. wipe back to front
b. soak in perfumed tubs q.24 for odor control
c. wear cotton undies
d. douche regularly
c. wear cotton undies
gottttttt emmm!
The nursing instructor should intervene during which part of the following scenario?
The student nurse is doing a routine physical examination. The student instructs the client to empty the bladder prior to the exam. The student began the assessment with percussion in the lower abdomen and continued toward the umbilicus.
The student instructs the client to empty the bladder prior to the exam...
an empty bladder does not produce sound on percussion.
A male client age 67 presents to the ED with a low grade fever and will be admitted for observation. The clients daughter feels agitated stating that her father is just aging and that the hospital just wants money.
Which s/s could the nurse explain may be attributed to a UTI?
a. generalized fatigue
b. new incontinence
c. hypoventilation
d. weight gain
e. anorexia
a. generalized fatigue
b. new incontinence
e. anorexia
... hyperventilation would be correct not hypo & a change in cognitive functioning
The student nurse is performing a bladder scan after the client voided. The student nurse documents normal findings when what # is documented?
a) 125 mL
b) 30-50 mL
c) 0
d) this number should be specific to the client
b) 30-50 mL
A patient is scheduled for an intravenous pyelogram (IVP) to assess for kidneys stones. Which finding below requires the nurse to contact the physician?
A. Patient reports flank pain that radiates downward
B. Patient has hematuria
C. Patient has cloudy urine
D. Patient is allergic to shellfish
D. Patient is allergic to shellfish
The nurse provides care for a client with cystitis who does not drink FL while at work. How should the nurse address FL intake as part of health promotion activities?
a. drink at least 3,000 mL of fL daily and perhaps take a reusable water bottle with you.
b. drink a lot more fL you are not getting enough.
c. don't worry about drinking at work since morning and evening should be enough
d. can you at least triple your fL intake?
a. drink at least 3,000 mL of fL daily and perhaps take a reusable water bottle with you.
TRUE OR FALSE
Urodynamic testing is a study that assesses how the well the kidney produces filtrate.
False
Urodynamic testing is a study that assesses how the bladder and urethra are performing their job at storing and releasing urine.
Consists of several tests
A client presents to the clinic complaining of pyuria and flank pain. The client self diagnosed herself with a UTI and took some left over fluconazole her mom had. After a positive CVA test and positive bacterial urine culture what would you say to explain why the clients UTI has no resolved?
The client took medication that would treat a fungal infection while her infection is bacterial.
BONUS:
What are some meds that might be RX to this client?
ciprofloxacin (cipro)
cephalexin (keflex)
ceftriaxone
The nursing instructor understands the students need further education when...
a) the students state that stress incontinence is caused by weakness in the external sphincter and pelvic floor, often seen after vaginal deliveries
b) retropubic suspension is a surgical procedure that tightens the vaginal walls
c) oxybutynin is a drug used in the tx of an overactive bladder
d) functional incontinence mostly impacts those those who have a loss of cognitive function
b) retropubic suspension is a surgical procedure that tightens the anterior vaginal wall
....anterior vaginal repair
FILL IN THE BLANK (from your brain)
1) The nurse knows that a Lithotripsy ______ stones, so that the stones can pass.
TRUE or FALSE
2) The client will receive general anesthesia.
WHAT ARE SOME NURSING CONSIDERATIONS? SATA
(a)ekg (b) no hematuria (c) bilateral abdominal bruising (d) strain urine (e) pain meds
1) breaks up stones
2) FALSE... conscious sedation
3) a, d, e
(hematuria is normal for a few days, bruising on AFFECTED side)
The nurse is caring for a client with a suspected UTI. Which diagnostic test will provide the most information about this potential problem?
a. Post void urine retention
b. 24 hr urine collection
c. urine culture and sensitivity
d. antistreptolysin- O titer
c. urine culture and sensitivity
URINALYSIS:
1) Normal SP GR #? (also which # indicates dilution/concentration?
2) Normal pH for urine?
3) TRUE or FALSE: Urine should never contain the following.... glucose, protein, ketones, RBC, WBC, sediment casts, crystals, nitrates, parasites, bacteria.
1) Normal SP GR: 1.10 (dilute)- 1.030 (concentrated)
2) Normal pH for urine is 6
3) FALSE... everything is correct but bacteria... <1,000 colonies per mL is considered normal
TRUE or FALSE
1) The most common cause of UTI is e.coli
2) After a renography the client must avoid other due to the injection of a radioactive isotope.
3) When reading the results of a urine culture the presence of Leukocyte esterase and nitrate indicates infection.
1) TRUE
2) FALSE
3) FALSE.... urinalysis!
TRUE or FALSE
1) Overflow incontinence often leads to chronic urinary retention?
2) Certain medications may cause urinary retention?
3) Urinary retention may result from.... SATA
DM, INCONTINENCE, HTN, TRAUMA, PREGNANCY, NEUROLOGIC DISORDERS
1) FALSE.... chronic urinary retention often leads to overflow
2) TRUE
3) DM, TRAUMA, PREGNANCY, NEUROLOGIC DISORDERS
The nurse knows the client with calcium oxalate stones does not need further education when what statement is made?
a. I understand that I should avoid organ meat to prevent this from happening again
b. I understand that I should avoid spinach, black tea, rhubarb
c. I understand that I should avoid dairy & whole grains.
d. My diet does not have an affect on calculi
b. I understand that I should avoid spinach, black tea, rhubarb
1. You're assessing your patients during morning rounding. Which patient below is at MOST risk for developing a urinary tract infection?
A. A 25 year old patient who finished a regime of antibiotics for strep throat 10 weeks ago.
B. A 55 year old female who is post-opt day 7 from hip surgery.
C. A 68 year old male who is experiencing nausea and vomiting.
D. A 87 year old female with Alzheimer’s disease who is experiencing bowel incontinence.
D. A 87 year old female with Alzheimer’s disease who is experiencing bowel incontinence.
e.coli is leading bacterial cause of UTI
Cystoscopy:
1) A scope is inserted into _____ through _____. After procedure _____________ urine is normal where ______ are not.
2) Post procedure what is a priority intervention when the client has a catheter?
Physical assessment
3)TRUE or FALSE
Bruits on either side of the abdomen along the midclavicular line & CVA's indicates patency and is a positive finding.
1) A scope is inserted into bladder through urethra. After procedure pink-tinged urine is normal where clots are not.
2) If a patient has a catheter post procedure, irrigate it with sterile saline as ordered to prevent clots
3) FALSE
Bruits could indicate renal artery stenosis
1) Teaching considerations for client's when taking Anaspaz? SATA.
constipation, Diarrhea, urinary incontinence, urinary retention, dry mouth, drowsy
2) Nursing consideration when caring for a client with a UTI? SATA
vigorous perineal care, urine inspection, maintaining sterility with urinary cath, douching
1) constipation, urinary retention, dry mouth, drowsy
2) urine inspection, maintaining sterility with urinary cath
1) Crede maneuver & valsalva maneuver are interventions for ______ incontinence along with ____ ____-_____.
2) Describe Crede Maneuver
3) TRUE or FALSE...valsalva maneuver works to push out urine by increasing intra-abdominal pressure.
1) Crede maneuver & valsalva maneuver are interventions for overflow incontinence along with intermittent self- catheterization.
2) Application of non-forceful, smooth, even pressure from umbilicus towards the lowest part of abdomen. The pressure is applied only downward toward the bladder.
3) TRUE
TRUE or FALSE
1) A high calcium diet is the primary cause of calculi.
2) Calculi is typically asymptomatic until it reaches the lower urinary tract.
3) Morphine is the first line treatment for calculi.
4) Ambulation helps promote stone passage.
1) FALSE
( cause: unknown, metabolic defects, urinary stasis, urinary retention, immobility, dehydration )
2) TRUE
3) FALSE
(mild pain: ibuprofen- advil, motrin IB; Acetaminophen- tylenol; naproxen- aleve--- Severe pain: morphine
4) TRUE
A 76 year old female is admitted due to a recent fall. The patient is confused and agitated. The family members report that this is not normal behavior for the patient. They explain that the patient is very active in the community and cares for herself. Based on the information you have gathered about the patient, which physician's order takes priority?
A. "Collect a T3 and T4 level"
B. "Insert a Foley Catheter"
C. "Keep patient NPO"
D. "Collect a urinalysis"
D. "Collect a urinalysis"