The nurse is caring for a client with a urinary tract alteration. ...

[Bernana]

The nurse is caring for a client with a urinary tract alteration. The nurse reviews the laboratory results and notes that the client has increased blood and protein in the urine and a high blood level of nitrogenous wastes.
 
  The client asks if this means nephrotic syndrome. What should the nurse respond?
 
  1. You are correct, have you had this before?
  2. Because you have azotemia as well, you have a different form of nephrotic syndrome.
  3. Nephrotic syndrome does not include azotemia, but an increase in blood lipids.
  4. You have a simple case of urinary tract infection (UTI).

Question 2

The nurse is working in a long-term care facility. As clients are assessed, the nurse notes that one client is confused and incontinent, which is new behavior for the client. The nurse should further assess the client, suspecting:
 
  1. the client has had a stroke.
  2. the client's oxygen level is decreased.
  3. the client has cystitis.
  4. the client has kidney stones.

[matt95]

Answer to Question 1

Answer: 3

1. The client has symptoms of glomerulonephritis.
2. Azotemia is a consequence of glomerulonephritis.
3. Nephrotic syndrome is not a disease, but a group of symptoms usually seen together that does not include azotemia.
4. The client with a UTI will have white blood cells in the urine, fever, and bacteria in the urine that does not progress unless untreated.

Answer to Question 2

Answer: 3

1. Stroke symptoms would be very different, including the inability to speak and paralysis.
2. If a client were experiencing chronic obstructive pulmonary disease (COPD), the nurse might check the oxygen level, but the client with decreased oxygen should not be incontinent.
3. Older clients will not respond to infection as younger clients do. Often, confusion is the first sign, and the client's temperature might be normal or low. Confusion, coupled with incontinence as a new behavior, should alert the nurse to assess for cystitis.
4. The client with kidney stones will show a decreased urine output and pain.