Urinary System

Question 1

Dysuria

Answer 1

Pain when urinating

Question 2

What should the nurse do if urine dipstick test shows protein in urine?

Answer 2

Ask what meds patient takes, medication can affect testing.

Question 3

Nephron

Answer 3

Functional unit of the kidney

Question 4

GFR

Answer 4

Amount of blood filtered per minute by the kidneys ( normal is 125 mL/ min)

Question 5

Costovertebral angle (cva)

Answer 5

Landmark useful in locating kidneys- formed by rib cage and vertebral column.

Question 6

Anuria

Answer 6

Urine output < 100 mL per 24 hrs.

Basically no urine

Question 7

Enuresis

Answer 7

Involuntary nocturnal urination

Question 8

Oliguria

Answer 8

Scant urine

100-400mL per day

Question 9

Polyuria

Answer 9

Large amount of urine in a given time

Question 10

Why is acetazolazide given?

Answer 10

To alkalize urine

Question 11

Why is mannitol given?

Answer 11

To decrease intracranial pressure

( for cerebral edema)

Question 12

2 side effects of furosemide Lasix- loop diuretic

Remember works on loop of Henley ( loops lose calcium!)

Answer 12

Ototoxicity ( ringing ears)
Hypokalemia

Will remove calcium, chloride ect.

Question 13

Hydrochlorothiazide

Answer 13

Works on distal convoluted tubule.

Calcium SPARING

Question 14

Triamterene

Answer 14

Potassium SPARING. Gets rid of sodium

Question 15

Spironolactone

Answer 15

Potassium sparing. Could cause hyperkalemia.
S/E gynocomastia
Arythmia.

Question 16

Causes of kidney damage?

Answer 16

Acute:
dehydration
Hypovolemia

Chronic:
Diabetes
Renal artery stenosis

Question 17

Acute renal failure- cause of prerenal?

Answer 17

Poor renal perfusion

Hypovolemia
Injury
Dehydration
Heart failure

Question 18

A renal stone in the pelvis of the kidney will alter the function of the kidneys by interfering with

Answer 18

The collection and drainage of urine from the kidney

Question 19

Intrarenal

Direct damage

Answer 19

Pyelonephritis
Infections
Nephrotoxic medications
Direct injury

Question 20

Post renal

Urinary obstruction

Answer 20

BPH
Renal stone
Stricture
( anything that causes stasis)

Question 21

Renal failure

Answer 21

Retain waste products
Sodium
Potassium

Question 22

What happens in chronic kidney disease

Answer 22

Malaise
Hypertension
Proteinuria
Hyperkalemia -arrhythmia 
Mineral and bone disorders 
Neuropathy 
Metabolic acidosis
Severe uremia- pruritis , CNS depression
Edema
Oliguria

Question 23

A patient with kidney disease has oliguria and a creatinine clearance 40 ML per minute. These findings most directly reflect abnormal function of

Answer 23

Glomerular filtration

Question 24

The nurse identifies a risk for urinary calculi in a patient who relates a past history that includes

Answer 24

Hyperparathyroidism

Question 25

Diminished ability to concentrate urine, associated with aging of the urinary system, is attributed to

Answer 25

Decreased function of the loop of Henley and tubules

Question 26

During the physical assessment of the urinary system the nurse

Answer 26

Auscultated over each CVA to detect impaired renal bloodflow

Question 27

Severe uremia

Answer 27

Pruritis | CNS depression

Question 28

Normal findings expected by the nurse on physical assessment of the urinary system include

Answer 28

A nonpalpable left kidney and no CVA tenderness elicited by kidney punch

Question 29

A diagnostic study that indicates renal bloodflow, glomerular filtration, tubular function, and excretion is

Answer 29

A renal scan

Question 30

Dialysis

Answer 30

Major fluid shifts! Monitor BP No BP IN ARM with shunt Thrill and bruit Can feel a thrill! Auscultation for bruit!

Question 31

Pyelonephritis

Answer 31

``` Assessment: Dysuria Fever Fatigue Flank pain N & V ```

Question 32

I'm reading the urinalysis results of a dehydrated patient, the nurse would expect to find

Answer 32

Specific gravity of 1.035

Question 33

Glomerulonephritis

Answer 33

Inflammation of the glomeruli which affects both kidneys equally and is 3rd leading cause of ESKD in the US.

Question 34

Foods high in purine

Answer 34

Sardines, mussels, liver, kidney, meat soups sweetbreads. Medium levels- chicken , salmon, crab

Question 35

Foods high in calcium

Answer 35

Milk, fish with bones, dried fruits, nuts, ovaltine, chocolate.

Question 36

High oxalate foods

Answer 36

Dark roughage, spinach, rhubarb, cabbage, celery, parsley, chocolate, instant coffee, tea

Question 37

When teaching a patient with pyelonephritis about the disorder the nurse informed the patient that the organisms that cause Pyelonephritis most commonly reach the kidneys through

Answer 37

And ascending infection

Question 38

The immunologic mechanisms involved in a post streptococcal glomerulonephritis include

Answer 38

Thickening of the GBM from auto immune microangiographic changes

Question 39

The edema that occurs in nephrotic syndrome is due to

Answer 39

Decrease colloidal osmotic pressure caused by loss of serum albumin

Question 40

A patient has admitted to the hospital with severe renal colic. The nurse is first priority and management of the patient is to

Answer 40

Administer opioids as prescribed

Question 41

A patient with a Ureterolithotomy returns from surgery with the nephrostomy tube in place. Post operative nursing care of the patient includes

Answer 41

Encouraging fluids of at least 2 to 3 L per day after nausea has subsided

Question 42

A patient has had a cystectomy and ilio conduit diversion performed. Four days postoperatively, mucus threads are seen in the drainage bag. The nurse should

Answer 42

Chart that has a normal observation

Question 43

What descriptions characterize acute kidney injury

Answer 43

The primary cause of death is infection and the disease course is usually reversible

Question 44

RIFLE defines three stages of a KIA based on changes in the

Answer 44

Serum creatinine or urine output from baseline

Question 45

During the oliguric phase of AKI, the nurse managers the patient for

Answer 45

ECG changes and pulmonary edema

Question 46

If a patient is in the diuretic phase of AKI, the nurse must monitor for which serum electrolytes and balances?

Answer 46

Hypokalemia and hypo natremia

Question 47

A patient is admitted to the hospital with chronic kidney disease. The nurse understands that this condition is characterized by

Answer 47

Progressive irreversible destruction of the kidneys

Question 48

Nurses need to teach patients at risk for developing chronic kidney disease. Individuals considered to be at risk include

Answer 48

Older African-Americans, patients over 60 years old, those with a history of hypertension, and those with a history of type two diabetes

Question 49

Patients with chronic kidney disease experience an increased incidence of cardiovascular disease related to

Answer 49

Hypertension, vascular calcification's, and hyper insulinemia causing dyslipidemia

Question 50

Nutritional support and management or essential across the entire continuum of chronic kidney disease. Which statements would be considered true related to nutritional therapy?

Answer 50

Fluid is usually restricted for patients receiving peritineal dialysis, sodium and potassium maybe restricted in someone with advanced chronic kidney disease, decreased fluid intake and low potassium diet or hallmarks of the diet for a patient receiving hemodialysis

Question 51

And ESKD patient receiving hemodialysis is considering asking a relative to donate a kidney for transportation. In assisting the patient to make a decision about treatment, the nurse informed the patient that

Answer 51

A successful transplantation usually provides better quality of life than that offered by dialysis

Question 52

To assess the patency of a newly placed arteriovenous graft for dialysis, the nurse should

Answer 52

Palpate the area of the graph to fill a normal thrill, listen with the stethoscope over the graph to detect a bruit, frequently monitor the pulses and neurovascular status distal to the graft

Question 53

A major advantage of peritoneal dialysis is

Answer 53

The diet is less restricted and dialysis can be performed at home

Question 54

A kidney transplant pt complains of having fever, chills, and dysuria over the past two days. What is the first action that the nurse should take

Answer 54

Assess the temperature and initiate work up to rule out infection

Question 55

Acute kidney injury

Answer 55

Sudden loss of renal function due to poor circulation or renal cell damage - usually reversible

Question 56

Which of the following patients highest risk for a urinary tract infection?1 Grade: 1 A 78-year- old female with dementia and incontinence A 23-year- old female with anemia and history of inguinal hernia repair A 78-year- old male with urinary urgency A 56-year- old female with uterine prolapse

Answer 56

A 78-year- old female with dementia and incontinence

Question 57

Glomerulonephritis is _____________.1

Answer 57

An inflammatory disorder of the glomerulus caused by immunological reaction

Question 58

Your patient is receiving peritoneal dialysis. Which of the following should you report to the physician immediately?

Answer 58

Cloudy outflow

Question 59

Which statement from a patient would cause you to suspect renal calculi?

Answer 59

“I have sudden sharp pain that goes from my back to my testicles.”

Question 60

Which of the following is an important dietary recommendation for patients with chronic kidney disease?

Answer 60

low potassium

Question 61

The signs and symptoms of your patient with acute kidney injury result from the kidneys inability to regulate fluid and electrolytes. True or false?

Answer 61

TRUE

Question 62

The most common cause of acute kidney injury is from the prerenal phase. What is this?

Answer 62

decrease in blood flow to the kidney

Question 63

Your dialysis patient has a fistula. You assess for a bruit and a thrill but do not hear/feel it. What is your first step before calling the physician?

Answer 63

There is not a nursing intervention; you must call the MD for further orders

Question 64

_______________ is the most common cause of urosepsis.

Answer 64

use of urinary catheter

Question 65

Nephrotic syndrome is __________________.

Answer 65

a kidney disease where protein is lost by plasma into the urine

Question 66

For stable patient with chronic kidney disease that is continuing to decompensate, what will most likely be initiated?

Answer 66

dialysis