Author Question: The nurse is caring for a 68-year-old hospitalized patient with a decreased glomerular filtration ... (Read 65 times)

evelyn o bentley · **on:** Jun 25, 2018

The nurse is caring for a 68-year-old hospitalized patient with a decreased glomerular filtration rate who is scheduled for an intravenous pyelogram (IVP). Which action will be included in the plan of care?

a. Monitor the urine output after the procedure.
b. Assist with monitored anesthesia care (MAC).
c. Give oral contrast solution before the procedure.
d. Insert a large size urinary catheter before the IVP.

Question 2

A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will

a. have the patient empty the bladder completely, then obtain the next urine specimen that the patient is able to void.
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
c. insert a short sterile mini catheter attached to a collecting container into the urethra and bladder to obtain the specimen.
d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.

Anna · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
Patients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the patient's urine output. MAC sedation and retention catheterization are not required for the procedure. The contrast medium is given IV, not orally.

Answer to Question 2

ANS: B
This answer describes the technique for obtaining a clean-catch specimen. The answer beginning, insert a short, small, mini' catheter attached to a collecting container describes a technique that would result in a sterile specimen, but a health care provider's order for a catheterized specimen would be required. Using Betadine before obtaining the specimen is not necessary, and might result in suppressing the growth of some bacteria. The technique described in the answer beginning have the patient empty the bladder completely would not result in a sterile specimen.