Saunders: Renal Latest Update
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A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals
hematuria. The client does not have a fever. The nurse should next ask the client about a history of
which condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Renal cancer in the client's family
4. Blow or trauma to the bladder or abdomen
- Answer -Answer: 4. Blow or trauma to the bladder or abdomen
Rationale: Bladder trauma or injury should be considered or suspected in the client with low abdominal
pain and hematuria. Glomerulonephritis and pyelonephritis would be accompanied by fever because
they are infections. Renal cancer would cause pain in the flank area, not the low abdomen.
A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory
peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the
prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce
instructing the client to take which action?
1. Ambulate in the home.
2. Immediately notify the health care provider.
3. Perform straight catheterization of the bladder.
4. Flush the peritoneal catheter with a thrombolytic medication.
- Answer -Answer: 1. Ambulate in the home
Rationale: The most common causes of decreased outflow of dialysate in peritoneal dialysis are
displacement and obstruction of the catheter. Obstruction may be a result of malposition, adherence of
the catheter tip to internal organs, constipation, or infection. The client with decreased catheter outflow
should first attempt to displace the catheter tip from internal organs by changing positions or walking.
This may be a simple solution to the problem. If the client has been constipated, treatment of the
constipation would be necessary. The health care provider need not be notified immediately, unless the
,client is exhibiting signs of infection or if attempts to noninvasively clear the obstruction are not
effective. Straight catheterization of the bladder will not alleviate this problem, and the client should
never instill any type of medication into the catheter besides the medications contained in the dialysate
solution.
A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client
instructions to prevent a recurrence. The nurse determines that the client needs further teaching if the
client states the intention to do which?
1. Drink increased amounts of fluids.
2. Limit the force of the stream during voiding.
3. Continue to take antibiotics until all symptoms are gone.
4. Use condoms to eliminate risk from chlamydia and gonorrhea. - Answer -Answer: 3. Continue to
take antibiotics until all symptoms are gone.
Rationale: The client who experiences epididymitis from UTI should increase intake of fluids to flush the
urinary system. Because organisms can be forced into the vas deferens and epididymis from strain or
pressure during voiding, the client should limit the force of the stream. Condom use can help prevent
urethritis and epididymitis from sexually transmitted infections. Antibiotics are always taken until the full
course of therapy is completed.
A client has received instructions on self-management of peritoneal dialysis. The nurse determines that
the client needs further teaching if the client makes which statement?
1. "I will monitor my weight daily."
2. "I will take my vital signs daily."
3. "I will use meticulous aseptic technique for dialysate bag changes."
4. "I will use a strong adhesive tape to anchor the catheter dressing." - Answer -Answer: 4. "I will
use a strong adhesive tape to anchor the catheter dressing."
Rationale: The client is at risk for impairment of skin integrity resulting from the presence of the
catheter, exposure to moisture, and irritation from tape and cleansing solutions. The client should be
instructed to use paper or nonallergenic tape to prevent skin irritation and breakdown. It is proper
procedure for the client to use aseptic technique and to self-monitor vital signs and weight on a daily
basis.
A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse
take?
, 1. Restrict fluids.
2. Administer a sedative.
3. Determine a history of allergies.
4. Administer an oral preparation of radiopaque dye. - Answer -Answer: 3. Determine a history of
allergies
Rationale: An iodine-based dye may be used during the IVP and can cause allergic reactions such as
itching, hives, rash, tight feeling in the throat, shortness of breath, and bronchospasm. Checking for
allergies is the priority. Options 1, 2, and 4 are unnecessary.
A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the
dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?
1. Stop the dialysis.
2. Slow the infusion.
3. Decrease the amount to be infused.
4. Explain that the pain will subside after the first few exchanges - Answer -Answer: 4. Explain that
the pain will subside after the first few exchanges
Rationale: Pain during the inflow of dialysate is common during the first few exchanges because of
peritoneal irritation; however, it disappears after a week or two. The infusion amount should not be
decreased, and the infusion should not be slowed or stopped.
A client tells the nurse she completed an educational program to manage her stress incontinence but is
now discouraged. Which information from the client indicates the need for further teaching? Select all
that apply.
1. She performs the Kegel exercises every other day.
2. She quit drinking coffee with cream but drinks diet cola.
3. She has decreased her caloric and fat intake to lose weight.
4. She maintains her fluid intake to 3000mL of fluid daily.
5. She has begun an exercise program that includes lifting weights. - Answer -Answer: 1. She
performs the Kegel exercises every other day.
Questions with Verified Answers
Guaranteed Perfect Score
A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals
hematuria. The client does not have a fever. The nurse should next ask the client about a history of
which condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Renal cancer in the client's family
4. Blow or trauma to the bladder or abdomen
- Answer -Answer: 4. Blow or trauma to the bladder or abdomen
Rationale: Bladder trauma or injury should be considered or suspected in the client with low abdominal
pain and hematuria. Glomerulonephritis and pyelonephritis would be accompanied by fever because
they are infections. Renal cancer would cause pain in the flank area, not the low abdomen.
A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory
peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the
prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce
instructing the client to take which action?
1. Ambulate in the home.
2. Immediately notify the health care provider.
3. Perform straight catheterization of the bladder.
4. Flush the peritoneal catheter with a thrombolytic medication.
- Answer -Answer: 1. Ambulate in the home
Rationale: The most common causes of decreased outflow of dialysate in peritoneal dialysis are
displacement and obstruction of the catheter. Obstruction may be a result of malposition, adherence of
the catheter tip to internal organs, constipation, or infection. The client with decreased catheter outflow
should first attempt to displace the catheter tip from internal organs by changing positions or walking.
This may be a simple solution to the problem. If the client has been constipated, treatment of the
constipation would be necessary. The health care provider need not be notified immediately, unless the
,client is exhibiting signs of infection or if attempts to noninvasively clear the obstruction are not
effective. Straight catheterization of the bladder will not alleviate this problem, and the client should
never instill any type of medication into the catheter besides the medications contained in the dialysate
solution.
A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client
instructions to prevent a recurrence. The nurse determines that the client needs further teaching if the
client states the intention to do which?
1. Drink increased amounts of fluids.
2. Limit the force of the stream during voiding.
3. Continue to take antibiotics until all symptoms are gone.
4. Use condoms to eliminate risk from chlamydia and gonorrhea. - Answer -Answer: 3. Continue to
take antibiotics until all symptoms are gone.
Rationale: The client who experiences epididymitis from UTI should increase intake of fluids to flush the
urinary system. Because organisms can be forced into the vas deferens and epididymis from strain or
pressure during voiding, the client should limit the force of the stream. Condom use can help prevent
urethritis and epididymitis from sexually transmitted infections. Antibiotics are always taken until the full
course of therapy is completed.
A client has received instructions on self-management of peritoneal dialysis. The nurse determines that
the client needs further teaching if the client makes which statement?
1. "I will monitor my weight daily."
2. "I will take my vital signs daily."
3. "I will use meticulous aseptic technique for dialysate bag changes."
4. "I will use a strong adhesive tape to anchor the catheter dressing." - Answer -Answer: 4. "I will
use a strong adhesive tape to anchor the catheter dressing."
Rationale: The client is at risk for impairment of skin integrity resulting from the presence of the
catheter, exposure to moisture, and irritation from tape and cleansing solutions. The client should be
instructed to use paper or nonallergenic tape to prevent skin irritation and breakdown. It is proper
procedure for the client to use aseptic technique and to self-monitor vital signs and weight on a daily
basis.
A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse
take?
, 1. Restrict fluids.
2. Administer a sedative.
3. Determine a history of allergies.
4. Administer an oral preparation of radiopaque dye. - Answer -Answer: 3. Determine a history of
allergies
Rationale: An iodine-based dye may be used during the IVP and can cause allergic reactions such as
itching, hives, rash, tight feeling in the throat, shortness of breath, and bronchospasm. Checking for
allergies is the priority. Options 1, 2, and 4 are unnecessary.
A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the
dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?
1. Stop the dialysis.
2. Slow the infusion.
3. Decrease the amount to be infused.
4. Explain that the pain will subside after the first few exchanges - Answer -Answer: 4. Explain that
the pain will subside after the first few exchanges
Rationale: Pain during the inflow of dialysate is common during the first few exchanges because of
peritoneal irritation; however, it disappears after a week or two. The infusion amount should not be
decreased, and the infusion should not be slowed or stopped.
A client tells the nurse she completed an educational program to manage her stress incontinence but is
now discouraged. Which information from the client indicates the need for further teaching? Select all
that apply.
1. She performs the Kegel exercises every other day.
2. She quit drinking coffee with cream but drinks diet cola.
3. She has decreased her caloric and fat intake to lose weight.
4. She maintains her fluid intake to 3000mL of fluid daily.
5. She has begun an exercise program that includes lifting weights. - Answer -Answer: 1. She
performs the Kegel exercises every other day.
