Lewis Chapter 45: Renal and Urological
Problems
A patient returns to the clinic with recurrent dysuria after being treated with
trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the
nurse plan to take?
a. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the
symptoms.
ANS: B
Since uncomplicated urinary tract infections (UTIs) are usually successfully
treated with 3 days of antibiotic therapy, this patient will need a urine culture
and sensitivity to determine appropriate antibiotic therapy. Tylenol would not
be as effective as other over-the-counter (OTC) medications such as
phenazopyridine (Pyridium) in treating dysuria. The fluid intake should be
increased to at least 1800 mL/day. Since the UTI has persisted after treatment
with Bactrim, the patient is likely to need a different antibiotic.
DIF: Cognitive Level: Application REF: 1123-1125
The nurse determines that instruction regarding prevention of future urinary
tract infections (UTIs) for a patient with cystitis has been effective when the
patient states,
a. "I can use vaginal sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day."
ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal
sprays is dis-
couraged. The bladder should be emptied before and after intercourse, but
cleaning with soap and water is not necessary. A quart of fluids is insufficient
to provide adequate urine output to decrease risk for UTI.
,Which information will the nurse include when teaching the patient with a
urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)?
a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
c. The urine may turn a reddish-orange color.
d. Use the Pyridium before sexual intercourse.
ANS: C
Patients should be taught that Pyridium will color the urine deep orange.
Urinary analgesics should only be needed for a few days until the prescribed
antibiotics decrease the bacterial count. Taking Pyridium before intercourse
will not be helpful in reducing the risk for UTI. Pyridium does not cause
photosensitivity.
We have an expert-written solution to this problem!
A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital
with chills, fever, and vomiting. Which finding by the nurse will be most helpful
in determining whether the patient has an upper urinary tract infection (UTI)?
a. Suprapubic pain
b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness
ANS: D
Costovertebral tenderness is characteristic of pyelonephritis. The other
symptoms are characteristic of lower UTI and are likely to be present if the
patient also has an upper UTI.
DIF: Cognitive Level: Application REF: 1128
After teaching a patient with interstitial cystitis about management of the
condition, the nurse determines that further instruction is needed when the
patient says,
a. "I will have to stop having coffee and orange juice for breakfast."
b. "I should start taking a high potency multiple vitamin every morning."
c. "I will buy some calcium glycerophosphate (Prelief) at the pharmacy."
d. "I should call the doctor about increased bladder pain or odorous urine."
ANS: B
, High-potency multiple vitamins may irritate the bladder and increase
symptoms. The other patient statements indicate good understanding of the
teaching.
When admitting a patient with acute glomerulonephritis, it is most important
that the nurse ask the patient about
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones.
ANS: A
Acute glomerulonephritis frequently occurs after a streptococcal infection such
as strep throat. It is not caused by hypertension, urinary tract infection (UTI),
or kidney stones.
DIF: Cognitive Level: Application REF: 1131-1132
We have an expert-written solution to this problem!
Which finding by the nurse for a patient admitted with glomerulonephritis
indicates that treatment has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. Peripheral and periorbital edema is resolved.
d. The antistreptolysin-O (ASO) titer is decreased.
ANS: C
Since edema is a common clinical manifestation of glomerulonephritis,
resolution of the edema indicates that the prescribed therapies have been
effective. Antibodies to streptococcus will persist after a streptococcal
infection. Nitrites will be negative and the patient will not experience dysuria
since the patient does not have a urinary tract infection.
DIF: Cognitive Level: Application REF: 1131-1133
We have an expert-written solution to this problem!
A patient with nephrotic syndrome develops flank pain. The nurse will
anticipate teaching the patient about treatment with
a. antibiotics.
Problems
A patient returns to the clinic with recurrent dysuria after being treated with
trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the
nurse plan to take?
a. Remind the patient about the need to drink 1000 mL of fluids daily.
b. Obtain a midstream urine specimen for culture and sensitivity testing.
c. Teach the patient to take the prescribed Bactrim for at least 3 more days.
d. Suggest that the patient use acetaminophen (Tylenol) to treat the
symptoms.
ANS: B
Since uncomplicated urinary tract infections (UTIs) are usually successfully
treated with 3 days of antibiotic therapy, this patient will need a urine culture
and sensitivity to determine appropriate antibiotic therapy. Tylenol would not
be as effective as other over-the-counter (OTC) medications such as
phenazopyridine (Pyridium) in treating dysuria. The fluid intake should be
increased to at least 1800 mL/day. Since the UTI has persisted after treatment
with Bactrim, the patient is likely to need a different antibiotic.
DIF: Cognitive Level: Application REF: 1123-1125
The nurse determines that instruction regarding prevention of future urinary
tract infections (UTIs) for a patient with cystitis has been effective when the
patient states,
a. "I can use vaginal sprays to reduce bacteria."
b. "I will drink a quart of water or other fluids every day."
c. "I will wash with soap and water before sexual intercourse."
d. "I will empty my bladder every 3 to 4 hours during the day."
ANS: D
Voiding every 3 to 4 hours is recommended to prevent UTIs. Use of vaginal
sprays is dis-
couraged. The bladder should be emptied before and after intercourse, but
cleaning with soap and water is not necessary. A quart of fluids is insufficient
to provide adequate urine output to decrease risk for UTI.
,Which information will the nurse include when teaching the patient with a
urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)?
a. Take the medication for at least 7 days.
b. Use sunscreen while taking the Pyridium.
c. The urine may turn a reddish-orange color.
d. Use the Pyridium before sexual intercourse.
ANS: C
Patients should be taught that Pyridium will color the urine deep orange.
Urinary analgesics should only be needed for a few days until the prescribed
antibiotics decrease the bacterial count. Taking Pyridium before intercourse
will not be helpful in reducing the risk for UTI. Pyridium does not cause
photosensitivity.
We have an expert-written solution to this problem!
A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital
with chills, fever, and vomiting. Which finding by the nurse will be most helpful
in determining whether the patient has an upper urinary tract infection (UTI)?
a. Suprapubic pain
b. Bladder distention
c. Foul-smelling urine
d. Costovertebral tenderness
ANS: D
Costovertebral tenderness is characteristic of pyelonephritis. The other
symptoms are characteristic of lower UTI and are likely to be present if the
patient also has an upper UTI.
DIF: Cognitive Level: Application REF: 1128
After teaching a patient with interstitial cystitis about management of the
condition, the nurse determines that further instruction is needed when the
patient says,
a. "I will have to stop having coffee and orange juice for breakfast."
b. "I should start taking a high potency multiple vitamin every morning."
c. "I will buy some calcium glycerophosphate (Prelief) at the pharmacy."
d. "I should call the doctor about increased bladder pain or odorous urine."
ANS: B
, High-potency multiple vitamins may irritate the bladder and increase
symptoms. The other patient statements indicate good understanding of the
teaching.
When admitting a patient with acute glomerulonephritis, it is most important
that the nurse ask the patient about
a. recent sore throat and fever.
b. history of high blood pressure.
c. frequency of bladder infections.
d. family history of kidney stones.
ANS: A
Acute glomerulonephritis frequently occurs after a streptococcal infection such
as strep throat. It is not caused by hypertension, urinary tract infection (UTI),
or kidney stones.
DIF: Cognitive Level: Application REF: 1131-1132
We have an expert-written solution to this problem!
Which finding by the nurse for a patient admitted with glomerulonephritis
indicates that treatment has been effective?
a. The patient denies pain with voiding.
b. The urine dipstick is negative for nitrites.
c. Peripheral and periorbital edema is resolved.
d. The antistreptolysin-O (ASO) titer is decreased.
ANS: C
Since edema is a common clinical manifestation of glomerulonephritis,
resolution of the edema indicates that the prescribed therapies have been
effective. Antibodies to streptococcus will persist after a streptococcal
infection. Nitrites will be negative and the patient will not experience dysuria
since the patient does not have a urinary tract infection.
DIF: Cognitive Level: Application REF: 1131-1133
We have an expert-written solution to this problem!
A patient with nephrotic syndrome develops flank pain. The nurse will
anticipate teaching the patient about treatment with
a. antibiotics.
