The nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which individuals are at risk of developing urinary obstructions? (Select all that apply).
A 69 year old female with anemia secondary to insufficient erythropoietin production
A 70 year old male with benign prostatic hyperplasia (BPH)
A 58 year old male with renal calculi
A 29 year old female, pregnant for the first time
Correct Answer : B,C,D,E
A. A 69-year-old female with anemia secondary to insufficient erythropoietin production: While anemia can occur due to chronic kidney disease, it does not directly cause urinary tract obstruction. The lack of erythropoietin affects red blood cell production, not urine flow.
B. A 70-year-old male with benign prostatic hyperplasia (BPH): BPH is a common cause of urinary obstruction in older men. The enlarged prostate compresses the urethra, leading to impaired urine outflow and increased risk of urinary retention.
C. A 58-year-old male with renal calculi: Kidney stones are a frequent cause of urinary tract obstruction. They can block the flow of urine in the ureters, renal pelvis, or bladder, leading to pain, hydronephrosis, and infection risk.
D. A 29-year-old female, pregnant for the first time: Pregnancy can cause urinary obstruction due to the enlarged uterus compressing the ureters, especially in the second and third trimesters, resulting in reduced urine flow and potential hydronephrosis.
E. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury: Neurogenic bladder disrupts normal bladder function and control, which can lead to urinary retention and obstruction due to poor coordination of bladder muscle and sphincter activity.
F. A 43-year-old male with an acid-base imbalance secondary to malnutrition: While malnutrition can affect many organ systems, acid-base imbalance by itself is not a direct cause of urinary tract obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Potential Condition: Hepatic Encephalopathy
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The client has very high ammonia levels (236 mcg/dL), elevated liver enzymes, and low albumin, all pointing toward hepatic encephalopathy. Additional signs include a history of alcohol abuse, cirrhosis, and altered liver function, which commonly contribute to ammonia accumulation and neurotoxicity.
Actions to Take:
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Administer lactulose: Helps lower serum ammonia by promoting its excretion via the GI tract.
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Assess for asterixis: A classic sign of hepatic encephalopathy characterized by a flapping tremor of the hands.
Parameters to Monitor:
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Neurologic status: To detect changes in mental status or worsening encephalopathy.
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Safety measures: Clients with hepatic encephalopathy are at high risk for confusion, falls, and injury, necessitating close supervision and safety interventions.
Correct Answer is A
Explanation
A. Urine output <30mL/hour: Oliguria is defined as a markedly reduced urine output, typically less than 400 mL per day or less than 30 mL per hour. It indicates decreased kidney function or perfusion and is common in progressive renal conditions.
B. Absence of urine output: This describes anuria, not oliguria. Anuria is defined as urine output less than 100 mL per day and signifies severe kidney failure or complete urinary tract obstruction.
C. Increased urine output: This describes polyuria, often associated with conditions like uncontrolled diabetes mellitus or diabetes insipidus, not oliguria.
D. Urine output >100mL/hour: This is well above the threshold for oliguria and may suggest diuresis or overhydration. It does not meet the criteria for decreased kidney output.
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