Renal and Urological Disorders Flashcards

A patient with a urinary catheter develops a fever, flank pain, and costovertebral angle (CVA) tenderness. The nurse suspects:

Answer: Pyelonephritis (upper UTI)

Fever, flank pain, and CVA tenderness indicate pyelonephritis (kidney infection), which can progress to sepsis if not treated promptly.

A patient passes a kidney stone. The nurse correctly instructs the patient to:

Answer: Strain all urine and save the stone for laboratory analysis

Stone analysis determines composition (calcium, uric acid, struvite, cystine), which guides dietary modifications and medication therapy to prevent recurrence.

A patient with benign prostatic hyperplasia (BPH) is unable to void and has a distended bladder. After catheterization, 900 mL of urine is drained. The nurse should:

Answer: Clamp the catheter after 400–600 mL and monitor for hematuria or hypotension

Rapid decompression of a severely distended bladder can cause decompression hematuria and vasovagal hypotension; clamping after 400–600 mL allows gradual decompression.

A patient with CKD receives erythropoietin (EPO) therapy. The nurse should monitor for which serious adverse effect?

Answer: Hypertension and thromboembolic events

EPO stimulates RBC production and can elevate hematocrit rapidly, increasing blood viscosity and the risk of hypertension, thrombosis, and stroke.

A patient with CKD has a serum bicarbonate of 16 mEq/L. The nurse recognizes this as:

Answer: Metabolic acidosis from impaired acid excretion

The failing kidney cannot adequately excrete hydrogen ions or reabsorb bicarbonate, causing metabolic acidosis (low bicarbonate) in CKD.

A patient recovering from acute tubular necrosis (ATN) is now in the diuretic phase. The nurse's priority is monitoring for:

Answer: Dehydration, hypokalemia, and hyponatremia from excessive urine output

During the diuretic phase of ATN, massive fluid and electrolyte losses (hypokalemia, hyponatremia) can lead to dehydration and hemodynamic instability.