Adult Health: Urinary/Renal Question
and answers 100% correct
The nurse is caring for a client with an ileal conduit. While assisting the client
in removing external pouch, the nurse observes that the stoma appears bluish
grey. What is the nurse's best action?
1.) Administer an antibacterial agent and assess for further signs of infection
2.) Document the findings and continue to monitor for changes
3.) Measure the stoma and apply a large pouching device
4.) Report the findings to the HCP immediately - correct answers Answer: 4.)
Report the findings to the HCP immediately
Ileal Conduit - correct answers Surgical technique that uses an excised piece
of the client's ileum to create an incontinent urinary diversion
What does a healthy stoma look like? - correct answers Pink to Brick-Red and
Moist
What does a pink to brick-red and moist stoma indicate? - correct answers
Vascularity and Viability
What should a nurse do if a stoma is dusky or any shade of blue? - correct
answers Contact HCP Immediately (suspect impaired infusion)
What does a stoma that is dusky or any shade of blue indicate? - correct
answers Medical Emergency: Contact HCP Immediately
Signs and Symptoms of Infection - correct answers -Fever
,-Elevated WBC
-Odor
-Delayed Healing
What can prevent decreased perfusion and skin irritation of a stoma? - correct
answers Applying an appropriate-size pouching system (approximately 0.1in
larger than the stoma)
What can prevent urine backflow through a stoma and reduce the risk for
infection? - correct answers Using a larger drainage bag, especially at night
The evening shift nurse reviews the preoperative checklist and latest serum
laboratory values for an elderly client with a ruptured diverticulum who is
scheduled for surgery in the early morning. Which laboratory value is most
important for the nurse to report the HCP?
1.) Creatinine level 2.5 mg/dL
2.) Potassium level 3.5 mEq/L
3.) Sodium level 134 mEq/L
4.) White blood cell count 16,000/mm3 - correct answers Answer: 1.)
Creatinine level 2.5 mg/dL
What does an elevated creatinine level increase the risk of in intra- and
postoperative procedures? - correct answers Complications
What increases the risk for postoperative exacerbation of kidney injury? -
correct answers -Nothing-by-mouth (NPO) status preoperatively
-Dehydration: Fluid shift from peritonitis
-Intraoperative fluid losses
-Antibiotic Therapy
,-Advanced age affect renal function
Normal Potassium Level - correct answers 3.5-5
Normal Sodium Level - correct answers 135-145
Normal WBC Level - correct answers 4,000-11,000
What is the expected WBC level for a client with ruptured diverticulum and
peritonitis? - correct answers Elevated White Blood Count
Peritonitis - correct answers Inflammation of the Peritoneum
Diverticulum - correct answers A small pouch, or sac, found in the lining or
wall of a tubular organ such as the colon
Diverticulitis - correct answers Inflammation of a Diverticulum
The nurse provides post-procedure teaching for a female client who had a
cystoscopy as an outpatient. Which client statement indicates the need for
additional instruction?
1.) I can expect pink-tinged urine for at least 24hrs
2.) I can take a warm bath and acetaminophen if I have discomfort or bladder
spasms
3.) I should expect frequency and burning when I urinate
4.) I should expect to see blood clots in my urine for up to 24hrs - correct
answers Answer: 4.) I should expect to see blood clots in my urine for up to
24hrs
, Cystoscopy - correct answers Procedure that uses a flexible fiber-optic
inserted through the urethra into the urinary bladder with the client in the
lithotomy position
What position should a client be for a Cystoscopy? - correct answers
Lithotomy Position
Lithotomy Position - correct answers Lying on back with legs raised and feet
in stirrups
What are the Complications of Cystoscopy? - correct answers -Urinary
Retention
-Hemorrhage
-Infection
Complications of Cystoscopy - correct answers -Urinary Retention
-Hemorrhage
-Infection
After a Cystoscopy the client should notify the HCP if what occurs? - correct
answers -Bright red blood when urinating
-Blood clots
-Inability to urinate
-Fever >100.4 F and Chills
-Abdominal Pain unrelieved by analgesia
and answers 100% correct
The nurse is caring for a client with an ileal conduit. While assisting the client
in removing external pouch, the nurse observes that the stoma appears bluish
grey. What is the nurse's best action?
1.) Administer an antibacterial agent and assess for further signs of infection
2.) Document the findings and continue to monitor for changes
3.) Measure the stoma and apply a large pouching device
4.) Report the findings to the HCP immediately - correct answers Answer: 4.)
Report the findings to the HCP immediately
Ileal Conduit - correct answers Surgical technique that uses an excised piece
of the client's ileum to create an incontinent urinary diversion
What does a healthy stoma look like? - correct answers Pink to Brick-Red and
Moist
What does a pink to brick-red and moist stoma indicate? - correct answers
Vascularity and Viability
What should a nurse do if a stoma is dusky or any shade of blue? - correct
answers Contact HCP Immediately (suspect impaired infusion)
What does a stoma that is dusky or any shade of blue indicate? - correct
answers Medical Emergency: Contact HCP Immediately
Signs and Symptoms of Infection - correct answers -Fever
,-Elevated WBC
-Odor
-Delayed Healing
What can prevent decreased perfusion and skin irritation of a stoma? - correct
answers Applying an appropriate-size pouching system (approximately 0.1in
larger than the stoma)
What can prevent urine backflow through a stoma and reduce the risk for
infection? - correct answers Using a larger drainage bag, especially at night
The evening shift nurse reviews the preoperative checklist and latest serum
laboratory values for an elderly client with a ruptured diverticulum who is
scheduled for surgery in the early morning. Which laboratory value is most
important for the nurse to report the HCP?
1.) Creatinine level 2.5 mg/dL
2.) Potassium level 3.5 mEq/L
3.) Sodium level 134 mEq/L
4.) White blood cell count 16,000/mm3 - correct answers Answer: 1.)
Creatinine level 2.5 mg/dL
What does an elevated creatinine level increase the risk of in intra- and
postoperative procedures? - correct answers Complications
What increases the risk for postoperative exacerbation of kidney injury? -
correct answers -Nothing-by-mouth (NPO) status preoperatively
-Dehydration: Fluid shift from peritonitis
-Intraoperative fluid losses
-Antibiotic Therapy
,-Advanced age affect renal function
Normal Potassium Level - correct answers 3.5-5
Normal Sodium Level - correct answers 135-145
Normal WBC Level - correct answers 4,000-11,000
What is the expected WBC level for a client with ruptured diverticulum and
peritonitis? - correct answers Elevated White Blood Count
Peritonitis - correct answers Inflammation of the Peritoneum
Diverticulum - correct answers A small pouch, or sac, found in the lining or
wall of a tubular organ such as the colon
Diverticulitis - correct answers Inflammation of a Diverticulum
The nurse provides post-procedure teaching for a female client who had a
cystoscopy as an outpatient. Which client statement indicates the need for
additional instruction?
1.) I can expect pink-tinged urine for at least 24hrs
2.) I can take a warm bath and acetaminophen if I have discomfort or bladder
spasms
3.) I should expect frequency and burning when I urinate
4.) I should expect to see blood clots in my urine for up to 24hrs - correct
answers Answer: 4.) I should expect to see blood clots in my urine for up to
24hrs
, Cystoscopy - correct answers Procedure that uses a flexible fiber-optic
inserted through the urethra into the urinary bladder with the client in the
lithotomy position
What position should a client be for a Cystoscopy? - correct answers
Lithotomy Position
Lithotomy Position - correct answers Lying on back with legs raised and feet
in stirrups
What are the Complications of Cystoscopy? - correct answers -Urinary
Retention
-Hemorrhage
-Infection
Complications of Cystoscopy - correct answers -Urinary Retention
-Hemorrhage
-Infection
After a Cystoscopy the client should notify the HCP if what occurs? - correct
answers -Bright red blood when urinating
-Blood clots
-Inability to urinate
-Fever >100.4 F and Chills
-Abdominal Pain unrelieved by analgesia
