Chapter 045

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Potter & Perry: Fundamentals of Nursing, 7thEdition

Test Bank

Chapter 4: !rinary Elimination

"!#T$P#E C%$CE

1. The nurse determines that the nursing diagnosisstress urinary incontinence related todecreased pelvic muscle toneis the most appropriate for an oriented adult female client.

A therapeutic nursing intervention based on this diagnosis is to:

1. Apply adult diapers2. Catheterize the client

3. Administer Urecholine

. Teach !egel e"ercises

A#$:

%elvic floor e"ercises& also 'no(n as !egel e"ercises& improve the strength of pelvic

floor muscles and consist of repetitive contractions of muscle groups. These e"erciseshave demonstrated effectiveness in treating stress incontinence& overactive bladders& and

mi"ed causes of urinary continence. The client is oriented and therefore could be taught

!egel e"ercises to improve pelvic floor muscle tone. Applying adult diapers does notimprove the client)s problem of incontinence and places the client at ris' for s'in

brea'do(n. *ecause bladder catheterization carries the ris' for urinary tract infection

+UT,-& it is preferable to rely on other measures for management of incontinence. The

nurse can support the use of !egel e"ercises as an ine"pensive nonpharmacologicalintervention to reduce the client)s stress incontinence. *ethanechol +Urecholine-

stimulates the parasympathetic nervous system to promote complete bladder emptying

and is primarily used to treat urinary retention and possible overflo( incontinence.#onpharmacological approaches should be attempted before pharmacological approaches

are ta'en.

,/: A 0/: 11 *4: Comprehension

T%: #ursing %rocess: %lanning

5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care andComfort9limination

2. hich of the follo(ing statements should the nurse use to instruct the nursing assistantcaring for a client (ith an ind(elling urinary catheter;

1. mpty the drainage bag at least every hours.2. Clean up the length of the catheter to the perineum.3. Use clean techni>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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The urinary drainage bag should be emptied at least every hours. ,f large outputs are

noted& more fre>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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A sterile specimen can be obtained through the special port found on the side of the

ind(elling catheter. The nurse clamps the tubing belo( the port& allo(ing fresh&

uncontaminated urine to collect in the tube. After the nurse (ipes the port (ith anantimicrobial s(ab& a sterile syringe needle is inserted& and at least 3 to @ m6 of urine is

(ithdra(n. Using sterile techni *4: Comprehension

T%: #ursing %rocess: ,mplementation


@. ,mmediately after an intravenous pyelogram +,E%- the nurse should observe the client for(hich of the follo(ing;

1. ,nfection in the urinary bladder

2. An allergic reaction to the contrast material

3. Urinary suppression caused by inFury to 'idney tissues. ,ncontinence as a result of paralysis of the urinary sphincter

A#$: 2After an ,E% the nurse should encourage fluid inta'e to dilute and flush dye from the

client and observe the client for late symptoms of allergy +e.g.& rash-. There is no

increased ris' for infection of the urinary bladder from an ,E%. This (ould be more li'ely

(ith an invasive procedure& such as an endoscopy +cystoscopy-. An ,E% should not inFuretissues of the 'idney or cause paralysis of the urinary sphincter.

,/: A 0/: 11@ *4: Comprehension

T%: #ursing %rocess: Assessment

5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

. A client (ith an e"cessive alcohol inta'e has a reduced amount of antidiuretic hormone

+A-. The nurse anticipates the client (ill e"hibit:1. ematuria

2. An increased blood pressure3. ry mucous membranes. A lo( serum sodium level

A#$: 3

5osby items and derived items = 2>>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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Alcohol inhibits the release of A& resulting in increased (ater loss in urine. The client

may sho( signs of decreased fluid volume +dehydration-& including dry mucous

membranes. The effects of e"cessive alcohol inta'e and reduced antidiuretic hormone(ill not cause hematuria. aving decreased levels of antidiuretic hormone (ill lead to

increased urine production. The client may e"hibit a decreased blood pressure resulting

from decreased fluid volume and an increased serum sodium level (ith dehydration.

,/: A 0/: 1133 *4: ComprehensionT%: #ursing %rocess: Assessment


Comfort9limination

G. A client is going to have a cystoscopy. hich of the follo(ing reflects the correct

information that should be taught before the procedure;

1. HAre you allergic to iodine;I2. HThere (ill be no need to have a special consent form.I

3. HJou (ill need to have fluids restricted the evening before the cystoscopy.I. HJou (ill probably be given sedatives before the procedure.I

A#$:

Although this procedure may be accomplished using local anesthesia& it is more

commonly performed using general anesthesia or conscious sedation to avoidunnecessary an"iety and trauma for the client. A cystoscopy involves direct visualization.

#o contrast dye is usedK therefore the nurse does not need to as' if the client is allergic to

iodine. A signed consent form is obtained. /luids are not restricted before or after theprocedure. The flushing action helps remove bacteria from the urethra.


T%: #ursing %rocess: ,mplementation5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

. A postpartum client has been unable to void since her delivery of her baby this morning.

hich of the follo(ing nursing measures (ould be beneficial for the client initially;

1. ,ncrease fluid inta'e to 3@>> m6.2. ,nsert ind(elling /oley catheter.

3. 0inse the perineum (ith (arm (ater.

. Apply firm pressure over the bladder.

A#$: 3


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The nurse can pour (arm (ater over the client)s perineum and create the sensation to

urinate. A client (ith normal renal function (ho does not have heart or 'idney disease

should drin' 2>>> to 2@>> m6 of fluid daily. ,ncreasing the client)s fluid inta'e to 3@>>m6 is e"cessive. *ecause bladder catheterization carries the ris' for UT,& it should be

avoided if possible. The nurse should try other noninvasive measures to promote

urination before calling the health care provider for an order to insert a /oley catheter.The nurse should not apply firm pressure over the bladder of a postpartum (oman (ith

an intact nervous system. The nurse could create more damage by e"erting force on the

client)s uterus at this time.

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T%: #ursing %rocess: %lanning5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

?. The nurse is visiting the client (ho has a nursing diagnosis of urinary retention. Upon

assessment the nurse anticipates that this client (ill e"hibit:1. $evere flan' pain and hematuria2. %ain and burning on urination

3. A loss of the urge to void

. A feeling of pressure and voiding of small amounts

A#$:

ith urinary retention& urine continues to collect in the bladder& stretching its (alls and

causing feelings of pressure& discomfort& tenderness over the symphysis pubis&restlessness& and diaphoresis. The sphincter temporarily opens to allo( a small volume of

urine +2@ to > m6- to escape& (ith no real relief of discomfort. $evere flan' pain and

hematuria are supporting data for an upper urinary tract infection +pyelonephritis-. %ain

and burning on urination are symptoms of a lo(er urinary tract infection +such as abladder infection-. $upportive data for refle" incontinence (ould include a loss of the

urge to void.




1>. The unit manager is evaluating the care of a ne( nursing staff member. hich of thefollo(ing is an appropriate techni>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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To collect a cleanDvoided specimen& the nurse should collect the specimen +3> to > m6-

after the initial stream of urine has passed. #onsterile gloves are ade>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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$pecial s'in care is a priority in caring for a client (ith a urinary diversion. 6ocal

irritation and s'in brea'do(n occur (hen urine comes in contact (ith the s'in for long

period. $pecial clothing is not necessary for the client (ith a urinary diversion& but theclient must (ear a stomal pouch continuously because there is no sphincter control for

regulation of urine flo(. There is no need to plan for a reduction in activity.


T%: #ursing %rocess: ,mplementation5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

1. hich of the follo(ing (ould indicate that the clinician performing the catheterization ofa female client (as competent;

1. !eeping both hands sterile throughout the procedure

2. 0einserting the catheter if it (as misplaced initially in the vagina3. ,nflating the balloon to test it before catheter insertion

. Advancing the catheter G to inchesA#$: 3

*efore inserting the ind(elling catheter& the balloon should be tested by inFecting the

fluid from the prefilled syringe into the balloon port. The dominant hand is 'ept sterile

throughout the procedure. The nondominant hand is not 'ept sterile because it touches theclient. ,f the catheter is misplaced& it should be left in the vagina as a landmar' indicating

(here not to insert& and another sterile catheter should be inserted into the urethra. The

catheter should be advanced 2 to 3 inches in the female client.

,/: A 0/: 11@? *4: Comprehension

T%: #ursing %rocess: valuation


1G. The nurse caring for a client (ho is receiving closed catheter irrigation instills ?@> m6 of

normal saline irrigant during the shift. There is a total of 1G2@ m6 in the drainage bag.

The nurse calculates the client)s urinary output for the shift to be:

1. GG@ m62. ?@> m6

3. 1G2@ m6

. 2G@ m6

A#$: 1The amount of fluid used to irrigate the bladder and catheter should be subtracted fromthe total output to determine an accurate urinary output. 1G2@ m6 ?@> m6 L GG@ m6.

,/: A 0/: 11 *4: ComprehensionT%: #ursing %rocess: ,mplementation


Comfort9limination


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1. The nurse caring for a client in an e"tended care facility should provide (hich

intervention in a bladder retraining program;1. %roviding negative reinforcement (hen the client is incontinent

2. aving the client (ear adult diapers as a preventative measure

3. %utting the client on a

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2. $pecific gravity 1.>1

3. %rotein amounts to 12 mg91>> m6

. hite blood cells +*Cs- @ to per lo(Dpo(er field casts

A#$: 2

The normal specific gravity of urine is 1.>1> to 1.>2@. The normal urine p is . to .>&

(ith an average of .>. %rotein is not normally found in the urine. The normal value forurine protein is >& or up to mg91>> m6. The number of *Cs is > to per lo(Dpo(er

field& and casts should be > in a normal urinalysis.

,/: A 0/: 11> *4: Comprehension

T%: #ursing %rocess: Assessment5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

21. The client is e"periencing urinary retention& and the health care provider is contacted. The

nurse anticipates a medication that (ill be ordered to promote emptying of the bladder is:

1. "ybutynin chloride +itropan-2. *ethanechol +Urecholine-

3. %ropantheline +%roD*anthine-

. #ystatin +5ycostatin-

A#$: 2

Cholinergic drugs& such as bethanechol +Urecholine-& increase contraction of the bladder

and improve emptying. *ethanechol stimulates parasympathetic nerves to increasebladder (all contraction and rela" the sphincter. "ybutynin chloride +itropan- is an

anticholinergic drug that depresses the neurotransmitter acetylcholine +(hich normally

stimulates the bladder-& and thus reduces incontinence. %ropantheline +%roD*anthine- is

an anticholinergic drug that depresses the neurotransmitter acetylcholine +(hich normallystimulates the bladder-& and thus reduces incontinence. #ystatin +5ycostatin- is an

antifungal agent.




22. hich of the follo(ing actions by the nurse (ould indicate the need for remedialeducation in the removal of an ind(elling catheter;

1. raping the female client bet(een the thighs2. btaining a specimen before removal3. Cutting the catheter to deflate the balloon

. Chec'ing the client)s output for 2 hours after removal

A#$: 3


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The nurse should not cut the catheter to deflate the balloon. The nurse inserts an empty&

sterile syringe into the inFection port. The nurse slo(ly (ithdra(s all of the solution to

deflate the balloon totally. The nurse then pulls the catheter out smoothly and slo(ly. Thenurse positions the client in the same position as during catheterization. The nurse places

a to(el bet(een a female client)s thighs or over a male client)s thighs. $ome institutions

recommend collecting a sterile urine specimen before removal of the catheter or sendingthe catheter tip for culture and sensitivity tests. The nurse should assess the client)s

urinary function by noting the first voiding after catheter removal and documenting the

time.

,/: A 0/: 11@ *4: Comprehension

T%: #ursing %rocess: valuation5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

23. A condom catheter is to be used for an adult male client in the e"tended care facility. ,n

the application of the condom catheter& the nurse employs appropriate techni

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An initial urinary symptom of diabetes mellitus is polyuria. Urgency is not a symptom of

diabetes mellitus. Urgency may be caused by a full bladder& bladder irritation from

infection& incompetent urethral sphincter& or psychological stress. ysuria is not asymptom of diabetes mellitus. ysuria may be caused by bladder inflammation& trauma&

or inflammation of the urethral sphincter. ematuria is not a symptom of diabetes

mellitus. ematuria may be a symptom of neoplasms of the bladder or 'idney&glomerular disease& infection of the 'idney or bladder& trauma to urinary structures&

calculi& or bleeding disorders.




2@. The nurse is assessing a client admitted (ith complaints related to chronic 'idneydysfunction. The nurse recognizes that this client is most li'ely to present (ith (hich of

the resulting symptoms;1. Anemia2. ypotension

3. iabetes mellitus

. Clinical depression

A#$: 1

Clients (ith chronic alterations in 'idney function cannot produce sufficient ?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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2G. hich of the follo(ing clients is at greatest ris' for developing a renal infection;1. A 2GDyearDold male

2. A 1DyearDold male

3. A ?DyearDold female. A @DyearDold female

A#$: 3

The short length of the urethra predisposes (omen and girls to infection. ,t is easy forbacteria to enter the urethra from the perineal area. The ?DyearDold female has the shortest

urethra and so has the greatest ris'.

,/: A 0/: 1131 *4: Analysis


Comfort9limination

2. hich of the follo(ing clients (ill most benefit from client9parent education regardingthe prevention of renal infections via proper hygiene habits;

1. 5ales ages 3@ to @

2. 5ales ages 3 to 13. /emales ages 3 to 12

. /emales ages 2> to @>

A#$: 3The 3D to 12DyearDold female has the shortest urethra and so has the greatest need. The

short length of the urethra predisposes (omen and girls to infection. ,t is easy for bacteriato enter the urethra from the perineal area.

,/: C 0/: 1131 *4: Analysis

T%: #ursing %rocess: %lanning5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

2?. The nurse is intervie(ing a client (ith a history of benign prostatic hypertrophy +*%-.

,n light of this diagnosis& the nurse should include information regarding (hich of thefollo(ing in order to assess the chronic effects of this renal disorder;1. #umber of times he usually urinates in a 2Dhour period

2. hat medications he is currently ta'ing for the condition

3. The results of his latest prostateDspecific antigen +%$A- testing

. hether he usually e"periences a complete emptying of his bladder

A#$:


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,f a chronic obstruction such as prostate enlargement hinders bladder emptying& over time

the micturition refle" changes& causing bladder overactivity& and can cause the bladder to

not completely empty. The remaining options focus on the impact the condition has ondaily living and the monitoring necessary to determine the presence of prostate cancer.

,/: C 0/: 113 *4: AnalysisT%: #ursing %rocess: Assessment


3>. hich of the follo(ing statements made by a client (ith benign prostatic hypertrophy

+*%- during an admissions intervie( reflects the best understanding of the longDtermeffects of this condition;

1. H, usually get up 3 to times a night to urinate.I

2. H5y health care provider prescribed some medication that has helped.I3. HAt least , can usually empty my bladderK , really hate that feeling of being full.I

. HThe prostate specific antigen +%$A- results have stayed stable for the last 3 tests.IA#$: 3

,f a chronic obstruction such as prostate enlargement hinders bladder emptying& over time

the micturition refle" changes& causing bladder overactivity& and can cause the bladder to

not completely empty. The remaining options focus on the impact the condition has ondaily living and the monitoring of the client for prostate cancer.



Comfort9limination

31. The nurse realizes that a postsurgical client (ho under(ent a left 'nee replacement is

most li'ely to e"perience (hich of the follo(ing urinary complications;1. ysuria

2. *ladder spasms

3. A bladder infection

. *urning on urination

A#$: 1

5edications including anesthesia interfere (ith both the production and thecharacteristics of urine and affect the act of urination. ifficulty (ith urination is a

common complication of general anesthesia. The remaining options are not directlyconnected to postsurgical complications.

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Comfort9limination


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32. The nurse recognizes that a client recovering from anesthesia re

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ith retention the client may void small amounts of urine 2 or 3 times an hour (ith no

real relief of discomfort or may continually dribble urine. *e a(are of the volume and

fre>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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Clients (ith lo(er UT,s have pain or burning during urination +dysuria- as urine flo(s

over inflamed tissues. /ever& chills& nausea& vomiting& and malaise develop as the

infection (orsens. An irritated bladder +cystitis- causes a fre>?& 2>>@ by 5osby& ,nc.& an affiliate of lsevier ,nc.

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$ome men (ho cannot stand to urinate become overly distressed. Although the other

options may have some effect& the primary cause is most li'ely the emotional stress of not

being able to assume the usual position for male urination.

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Comfort9limination

3?. hich of the follo(ing statements made by an older adult (ith a history of urinary tract

infections sho(s the best understanding of interventions that minimize the ris' for

developing such infections;1. H, drin' ounces of cranberry Fuice a day to discourage bacterial gro(th in my

bladder.I

2. Hhenever , feel an infection coming on& , immediately call my health careprovider.I

3. H, told the nurses , didn)t (ant a urinary catheter unless , absolutely had to haveone.I. Hhenever , can& , avoid drin'ing after %5 because , usually go to bed about 11

%5.I

A#$: 15a'e fluids such as cranberry Fuice available as part of the client)s fluid inta'e.

Cranberry Fuice discourages bacterial adherence to the bladder (all. The remaining

options either have less impact on a daily basis or are more related to early detectionrather than prevention.

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T%: #ursing %rocess: valuation5$C: #C678 test plan designation: %hysiological ,ntegrity9*asic Care and

Comfort9limination

>. The nurse is caring for a 23DyearDold male client (ho is in the ,CU (ith second and third

degree burns over > percent of his body. ne of the first symptoms that the client is

having organ failure is that the urine output is less than:1. 3> m69hour

2. > m69hour

3. @> m69hour. > m69hour

A#$: 1An output of less than 3> m69hr indicates possible renal alterations.

,/: * 0/: 113 *4: ApplicationT%: #ursing %rocess: Assessment

5$C: #C678 test plan designation %hysiological ,ntegrity9*asic Care and

Comfort9limination


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A#$: 2

%eritoneal dialysis is an indirect method of cleansing the blood of (aste products using

osmosis and diffusion (ith the peritoneum functioning as a semipermeable membrane.This method removes e"cess fluid and (aste products from the bloodstream (hen a

sterile electrolyte solution +dialysate- is instilled into the peritoneal cavity by gravity via a

surgically placed catheter. The dialysate remains in the cavity for a prescribed timeinterval and then is drained out by gravity& ta'ing accumulated (astes and e"cess fluid

and electrolytes (ith it. This places the client at ris' for electrolyte imbalances.



5$C: #C678 test plan designation %hysiological ,ntegrity9*asic Care andComfort9limination

. A DyearDold client has had 'idney disease for the past 1> years. is 'idneys are nolonger functioning. The nurse 'no(s that (hich of the follo(ing offers the client the

potential for restoration of normal 'idney function;1. 6asi" therapy2. emodialysis

3. %eritoneal dialysis

. !idney transplant

A#$:

Unli'e the other treatments& successful organ transplantation offers the client the potential

for restoration of normal 'idney function.

,/: C 0/: 113> *4: Analysis


5$C: #C678 test plan designation %hysiological ,ntegrity9*asic Care andComfort9limination

@. A @DyearDold female client has been hospitalized for severe abdominal pain. The health

care provider has ordered a %CA pump for the client to help control the pain. ,t has been

determined that the pain is due to cholelithiasis and the client is scheduled for a

cholecystectomy later that day. The client returns to the unit postoperatively (ith a /oleycatheter anchored. The nurse notes that the client)s urine output has decreased. The nurse

'no(s that this is most li'ely due to:

1. $tress response2. %reoperative #% status

3. !idney failure. %ostDoperative urinary retention

A#$: 1


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The stress response releases an increased amount of A& (hich increases (ater

reabsorption. $tress also elevates the level of aldosterone& causing retention of sodium

and (ater. *oth of these substances reduce urine output in an effort to maintaincirculatory fluid volume. Although the client (as #% postoperatively& she had a pain

pump& (hich indicates that she had a running ,E (ith fluids. ,t is not indicated that the

client had 'idney failure& and since the client had an anchored urinary catheter& she (ouldnot have urinary retention.




Comfort9limination

. A G3DyearDold female client (ith %ar'inson)s syndrome (as prescribed levodopa (hen

other therapies had failed. The client is alarmed that her urine has become dar' bro(nand is concern. The nurse e"plains to the client that one of the side effects of this

medication is that it may cause:1. er urine to become dar' bro(n or blac'2. eart failure

3. !idney failure

. air loss

A#$: 1

$ome medications change the color of urine. %henazopyridine +%yridium- colors the urine

a bright orange to rustK amitriptyline causes a green or blue discoloration& (hereaslevodopa discolors the urine to bro(n or blac'.

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T%: #ursing %rocess: %lanning5$C: #C678 test plan designation %hysiological ,ntegrity9*asic Care and

Comfort9limination

G. A 3DyearDold diabetic female client had a spontaneous vaginal birth of a 3GD(ee' .2 'g

infant. The nurse caring for the client postDpartum understands that due to the traumatic

birth the client is at increased ris' for:1. Acute urinary retention

2. ematuria

3. !idney failure. nuresis

A#$: 1


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,n acute retention 'ey signs are bladder distention and absence of urine output over

several hours. The client under the influence of anesthetics or analgesics often feels only

pressure& but the alert client has severe pain as the bladder distends beyond its normalcapacity. ,n severe urinary retention the bladder holds as much as 2>>> to 3>>> m6 of

urine. 0etention occurs as a result of urethral obstruction& surgical or childbirth trauma&

alterations in motor and sensory innervation of the bladder& medication side effects& oran"iety.

,/: C 0/: 1132 *4: Analysis



Comfort9limination

. A DyearDold male client (ith chronic renal problems is in the hospital for a

nephrostomy. The nurse understands that this is the surgical insertion of a tube that (illdrain urine from the client)s:

1. *ladder 2. Urethra3. Ureters

. 0enal pelvis

A#$: $ome clients have a need for urinary drainage directly from one or both 'idneys. ,n this

case a tube placed directly into the renal pelvis. This procedure is called a nephrostomy.

,/: A 0/: 1132 *4: !no(ledge



Comfort9limination

"!#T$P#E 'E(PN(E

1. hich of the follo(ing clients presents (ith an increased ris' for urinary incontinence;

+$elect all that apply.-1. The GDyearDold diagnosed (ith par'insonism @ years ago

2. The 2@DyearDold (ith Crohn)s disease diagnosed years ago

3. The 2DyearDold Alzheimer)s disease client diagnosed years ago

. The 3DyearDold mother of t(o diagnosed (ith multiple sclerosis years ago

@. The G3DyearDold diagnosed (ith benign prostatic hyperplasia +*%- years ago. The ?DyearDold client diagnosed (ith type 2 diabetes ? years ago

A#$: 1& 3& & @&


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5any diseases and conditions affect the ability to micturate. iabetes mellitus and

multiple sclerosis cause changes in nerve functions that can lead to possible loss of

bladder tone& reduced sensation of bladder fullness& or inability to inhibit bladdercontractions. lder men often suffer from *%& (hich ma'es them prone to urinary

retention and incontinence. $ome clients (ith cognitive impairments& such as

Alzheimer)s disease& lose the ability to sense a full bladder or are unable to recall theprocedure for voiding. iseases that slo( or hinder physical activity interfere (ith the

ability to void. egenerative Foint disease and par'insonism are e"amples of conditions

that ma'e it difficult to reach and use toilet facilities. Crohn)s disease is gastrointestinal innature and does not directly affect micturition.



Comfort9limination

2. The nurse is caring for a client (ith type 1 diabetes (ho has been diagnosed (ith endDstage renal disease +$0-. The nurse regularly assesses the client for (hich of thefollo(ing; +$elect all that apply.-

1. #ausea

2. %olyuria

3. 6ethargy. Eomiting

@. Confusion

. eadache

A#$: 1& 3& & @&

iseases that cause irreversible damage to 'idney tissue result in endDstage renal disease

+$0-. ventually the client has symptoms resulting from uremic syndrome. Anincrease in nitrogenous (astes in the blood& mar'ed fluid and electrolyte abnormalities&

oliguria& nausea& vomiting& headache& dro(siness& coma& and convulsions characterizethis syndrome.


T%: #ursing %rocess: Assessment5$C: #C678 test plan designation %hysiological ,ntegrity9*asic Care and

Comfort9limination

3. hich of the follo(ing symptomatology is reflective of a lo(er urinary tract infection;

+$elect all that apply.-1. Chills and fever2. #ausea and vomiting

3. /re

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Test *an'

A#$: 1& 2& 3& &

Clients (ith lo(er UT,s have pain or burning during urination +dysuria- as urine flo(s

over inflamed tissues. /ever& chills& nausea& vomiting& and malaise develop as theinfection (orsens. An irritated bladder +cystitis- causes a fre

Chapter 045

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