Nursing Quiz: Kidney Disease and Incontinence

Blood Pressure Measurement

• Avoid taking blood pressure measurements on the left arm to prevent decreasing blood flow and clotting.
• The left arm is often the preferred site for arteriovenous (AV) fistulas or grafts.

Chronic Kidney Failure

• Pathophysiological processes of chronic kidney failure are not specified.

Glomerulonephritis

• Diet restrictions are necessary for a patient with glomerulonephritis.
• Associated findings include:
  • Hematuria
  • Proteinuria
  • Edema
  • Hypertension

Urinary Incontinence

Stress Incontinence

• Pathophysiological process involves weakened muscles in the pelvic floor.

Overflow Incontinence

• Pathophysiological process involves bladder outlet obstruction or detrusor underactivity.

Urge Incontinence

• Pathophysiological process involves overactive detrusor muscle contractions.

Urinary Incontinence

• Pathophysiological processes involve weakened muscles, nerve damage, or bladder dysfunction.

Benign Prostatic Hyperplasia (BPH)

• A patient with BPH should see a psychiatrist to address related depression and anxiety.
• Clients most at risk for BPH are:
  • Older males
  • Family history
  • African American males
• Findings associated with BPH include:
  • Urinary frequency
  • Nocturia
  • Hesitancy
  • Straining
  • Decreased urine flow

Acute Kidney Injury (AKI)

• Clients at highest risk for AKI are:
  • Older adults
  • Those with pre-existing kidney disease
  • Those taking nephrotoxic medications
• Findings associated with AKI include:
  • Oliguria
  • Azotemia
  • Electrolyte imbalance

Post-Operative Care

• Following a transurethral resection of the prostate (TURP), the nurse should report to the provider:
  • Hematuria
  • Clot retention
  • Urinary retention
• The nurse should instruct the client to increase fluid intake in their diet with chronic kidney disease.

Dialysis

• A sign of acute kidney rejection is graft dysfunction.
• Adverse side effects from dialysis include:
  • Hypotension
  • Muscle cramps
  • Nausea and vomiting
• Early manifestations of peritonitis include:
  • Abdominal pain
  • Nausea and vomiting
  • Fever
• Manifestations of a UTI include:
  • Dysuria
  • Frequency
  • Urgency
  • Hematuria

Urine Specimen Collection

• When collecting a 24-hour urine specimen for creatinine clearance, the nurse should:
  • Instruct the client to discard the first morning void
  • Emphasize the importance of completing the entire 24-hour collection
  • Ensure the client refrigerates the specimen during collection

Prostate-Specific Antigen (PSA) Test

• Reinforce teaching about the PSA test with a client, emphasizing its role in detecting prostate cancer.

Bladder Trauma

• Manifestations of bladder trauma include:
  • Hematuria
  • Abdominal pain
  • Difficulty urinating
  • Pelvic pain