The nurse is caring for a patient who reports an urgent need to ...

[JMatthes]

The nurse is caring for a patient who reports an urgent need to urinate but is unable to pass more than a few drops of urine on the toilet. Which is the priority assessment to be performed by the nurse?
 
  a. Bladder scan to determine the amount of urine in the bladder
  b. Auscultation to assess circulation through the right and left renal arteries
  c. Bimanual palpation to assess for possible enlargement of the kidneys
  d. Calculate the patient's intake and output to check for fluid volume deficit

Question 2

The nurse is caring for a patient who has developed kidney failure. Which test finding leads the nurse to contact the nephrologist and arrange for emergency hemodialysis?
 
  a. Serum potassium level 7.4 mEq/L
  b. Serum creatinine level of 2.8 mg/dL
  c. Large amounts of protein in the urine
  d. 1500 mL of retained urine in the bladder

[djpooyouma]

Answer to Question 1

ANS: A
The patient with suspected urinary retention should have a bladder scan performed to determine the amount of urine in the bladder. If a significant amount of urine is found in the bladder, the physician may be notified to obtain an order for straight catheterization.

Answer to Question 2

ANS: A
Patients in renal failure often require dialysis once the serum potassium level exceeds 6.5 mEq/L. Critically high serum potassium levels can lead to lethal arrhythmias and must be corrected promptly. Patients with advanced renal failure may require emergency hemodialysis if the potassium level does not lower with other methods (insulin and 50 dextrose, kayexalate).