Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis?
Costovertebral angle tenderness, flank pain, and chills are symptoms of acute pyelonephritis.
What is the appropriate infusion time for the dialysate in your 38 y.o. patient with chronic renal failure?
Dialysate should be infused quickly. The dialysate should be infused over 15 minutes or less when performing peritoneal dialysis. The fluid exchange takes place over a period ranging from 30 minutes to several hours.
Your patient is complaining of muscle cramps while undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?
Treatment includes administering normal saline or hypertonic normal saline solution because muscle cramps can occur when the sodium and water are removed to quickly during dialysis. Reducing the rate of dialysis, not increasing it, may alleviate muscle cramps.
Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient’s teaching plan?
Calcium-phosphate deposits in the skin may cause pruritus. Scratching leads to excoriation and breaks in the skin that increase the patient’s risk of infection. Keeping fingernails short and clean helps reduce the risk of infection.
Which patient is at greatest risk for developing a urinary tract infection (UTI)?
Women are more prone to UTI’s after menopause due to reduced estrogen levels. Reduced estrogen levels lead to reduced levels of vaginal Lactobacilli bacteria, which protect against infection.
You have a patient that might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely?
A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void.
Which instructions do you include in the teaching care plan for a patient with cystitis receiving phenazopyridine (Pyridium).
Pyridium is taken to relieve dysuria because is provides an analgesic and anesthetic effect on the urinary tract mucosa. The patient can stop taking it after the dysuria is relieved.
A 30 y.o. female patient is undergoing hemodialysis with an internal arteriovenous fistula in place. What do you do to prevent complications associated with this device?
Don’t take blood pressure readings in the arm with the fistula because the compression could damage the fistula.
Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect?
Disequilibrium syndrome is caused by a rapid reduction in urea, sodium, and other solutes from the blood. This can lead to cerebral edema and increased intracranial pressure (ICP). Signs and symptoms include headache, nausea, restlessness, vomiting, confusion, twitching, and seizures.
You have a patient that is receiving peritoneal dialysis. What should you do when you notice the return fluid is slowly draining?
Tubing problems are a common cause of outflow difficulties, check the tubing for kinks and ensure that all clamps are open. Other measures include having the patient change positions (moving side to side or sitting up), applying gentle pressure over the abdomen, or having a bowel movement.
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