A nurse is caring for four clients on the urology unit. Which of the following clients should the nurse plan to teach about kidney stone prevention?
The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting.
The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass.
The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria.
The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure.
The Correct Answer is A
A. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting: These are hallmark signs of a current or recent episode of kidney stones. Once the acute symptoms are managed, this client would benefit the most from kidney stone prevention education, including dietary modifications and increased fluid intake, to reduce recurrence risk.
B. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass: These signs suggest a chronic kidney condition such as polycystic kidney disease or another form of kidney pathology rather than nephrolithiasis. Kidney stone prevention is not the primary teaching focus for this client.
C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria: These symptoms are more consistent with a lower urinary tract condition such as benign prostatic hyperplasia (BPH) or a urinary tract infection, rather than kidney stones. Prevention teaching should be focused on the underlying cause.
D. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure: These symptoms point to nephrotic syndrome or glomerulonephritis, which involve protein loss and renal inflammation. The pathophysiology here differs from that of kidney stone formation, and stone prevention would not be the priority.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Discussing organ donation with the family": While organ donation is important, it is not the priority in the setting of an actively dying client. The primary concern at this stage should be addressing the immediate needs of the client and their family, focusing on emotional support and comfort.
B. "Communicating sensitively with the client and family.": When caring for a client who is actively dying, providing emotional support and clear communication with the family is critical. Sensitively addressing the family’s concerns and the client’s comfort is essential in this stage of care.
C. "Creating a plan for pain relief, nutrition, and hydration.": While ensuring pain relief is important, in the context of an actively dying patient, the focus should primarily be on comfort rather than ongoing interventions like nutrition and hydration, which may no longer be beneficial.
D. "Contacting the family's spiritual advisor.": While spiritual support is valuable, it should not be the first priority. Ensuring the client’s comfort and providing emotional support to the family should be prioritized initially, and the spiritual advisor can be contacted afterward if desired.
Correct Answer is ["A","C"]
Explanation
A. Hypertension: Hypertension is a common manifestation in clients with pyelonephritis, especially in severe or untreated cases. The infection can cause kidney inflammation and disrupt normal kidney function, leading to elevated blood pressure as the kidneys struggle to regulate fluid balance and sodium.
B. Lower abdominal pain: Lower abdominal pain is typically associated with bladder infections (cystitis), not pyelonephritis. Pyelonephritis usually causes flank or costovertebral angle pain due to the involvement of the kidneys, rather than localized lower abdominal discomfort.
C. Mental confusion: Mental confusion can be a sign of systemic infection, particularly in elderly clients or those with severe pyelonephritis. It may indicate that the infection has led to sepsis or that the kidneys are no longer able to filter toxins effectively, affecting mental status.
D. Frothy urine: Frothy urine may be seen in cases of proteinuria, but it is not a classic or primary sign of pyelonephritis. While kidney function impairment can occur in severe infections, frothy urine is more often associated with nephrotic syndrome or glomerular disease.
E. Weak urine stream: A weak urine stream is not a typical manifestation of pyelonephritis. This symptom is more commonly associated with lower urinary tract issues such as benign prostatic hyperplasia or urinary retention.
F. Fish-type urine odor: Fish-type urine odor is not characteristic of pyelonephritis. It is more often associated with infections caused by specific bacteria such as Proteus species, which can lead to a distinct odor, but it is not a typical presentation for pyelonephritis.
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