A patient is admitted with high BUN and creatinine levels, low ...

[scienceeasy]

A patient is admitted with high BUN and creatinine levels, low blood pH, and elevated serum potassium level. Based on these laboratory findings the nurse suspects which diagnosis?
 
  a. Cystitis
  b. Renal Calculi
  c. Enuresis
  d. Renal Failure

Question 2

The surgeon orders hourly urine output measurement for a patient after abdominal surgery. The patient's urine output has been greater than 60 mL/hour for the past 2 hours. Suddenly, the patient's urine output drops to almost nothing.
 
  What should the nurse do first?
  a. Irrigate the catheter with 30 mL of sterile solution.
  b. Replace the patient's indwelling urinary catheter.
  c. Infuse 500 mL of normal saline solution IV over 1 hour.
  d. Notify the surgeon immediately.

[covalentbond]

Answer to Question 1

D
Elevated BUN, creatinine, and serum potassium levels and low blood pH are signs of renal failure. Cystitis is an infection of the bladder and would not result in abnormal renal function. Renal calculi typically produce blood in the urine but do not lead to marked renal dysfunction and failure. Enuresis is involuntary urination, particularly common in children, and does not produce renal dysfunction. The cause of enuresis is often emotional, developmental, or trauma related.

Answer to Question 2

A
If the patient's urinary output suddenly ceases, the nurse should irrigate the urinary catheter to assess whether the catheter is blocked. If no blockage is detected, the nurse should notify the surgeon. The surgeon may request that the catheter be changed if irrigation does not help or if the tubing is not kinked. However, the nurse should not change a catheter in the immediate postoperative period without consulting with the surgeon. The surgeon may prescribe an IV fluid bolus if the patient is suspected to have a deficient fluid volume.