Genitourinary Disorder (Q)

genitourinary disorder

SITUATION I

Mr. A, age 45, American, has a 10-year-history of type 2 diabetes. He was treated with Angiotensin-converting enzyme inhibitor for his hypertension. He has stable background retinopathy and is a non-smoker. He has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments.see answer

Question 1:

When planning care for this patient, what are the measures you should include in your nursing directives to promote patient's safety?

Question 2:

You have completed your teachings to Mr. A about self-monitoring between hemodialysis treatments. You determine that the patient best understands the information if the patient started to record daily his what?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

Question 3:

He is scheduled for hemodialysis this morning and is due to receive a daily dose of enalapril (Vasotec). When you should plan to administer this medication and why?

1. _____________________________________________________________________________________________________________________________.

Question 4:

Mr. A who is on hemodialysis suddenly experiencing shortness of breath and complains of chest pain. The client is tachycardic, pale and anxious. What do you suspect is happening to him?

1. _____________________________________________________________________________________________________________________________.

Question 5:

What are your priority actions?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

SITUATION II

The client had been diagnosed to have chronic renal failure. He will undergo hemodialysis for the first time today.see answer

Question 1:

What signs and symptoms when experienced by the patient suggest that he is experiencing disequilibrium syndrome?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

SITUATION III

A 70-year-old woman who is mentally capable and is able to perform her ADL's reports two or more episodes of significant urgency per day and a constant desire to void that interrupts her activities. In addition, she reports nausea and vomiting, no appetite, chills and having a fever two days ago. Urine culture and sensitivity was done and it came out that the patient is positive for urinary tract infection.see answer

MEDICAL ORDERS

Ciprofloxacin (Cipro) 250 mg q 12 h for 10 days.

Pyridium (Phenazopyridine) 100 mg 3x a day after meal.

You are teaching the patient and her daughter about the importance of taking all her antibiotics and increasing fluids in the diet.

Question 1:

What reason that puts this patient at risk for not obtaining sufficient fluids?

1. _____________________________________________________________________________________________________________________________.

Question 2:

Provide three additional teachings you will give them regarding on how to prevent urinary tract infections?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

SITUATION IV

A lively 77-year-old female patient has been diagnosed with simple glaucoma. She lives alone, takes medications for asthma, is on a fixed income, and walks to Catholic Mass every Sunday mornings.see answer

Question 1:

You must be certain that the ophthalmologist is aware of which of the aforementioned facts about the patient and why? 3 points

1. _____________________________________________________________________________________________________________________________.

SITUATION V

A 43-year-old gentleman came with a problem of blurred vision in the left eye. He was a senior executive in a software company and his work involved a lot of reading and computer work. He had been having this problem for the last 3- 4 months. The lens in the left eye showed a small central cataract while the right eye is normal. He was advised to consider cataract surgery in the left eye.see answer

Question 1:

The patient has undergone cataract extraction today and is preparing to go home, what instructions you should reinforce to the patient?

1. _____________________________________________________________________________________________________________________________.

2. _____________________________________________________________________________________________________________________________.

3. _____________________________________________________________________________________________________________________________.

SITUATION VI

An adult patient is admitted for diagnosis and treatment of a left lung lesion. The patient has just returned to the nursing unit following the bronchoscopy.see answer

Question 1:

A nurse would implement what nursing intervention for this patient before offering foods or fluids?

1. _____________________________________________________________________________________________________________________________.

SITUATION VII

A patient who has chronic glomerulonephritis has deteriorated to the early stages of renal failure. The nursing team meets to address the patient’s early renal failure in relation to the care plan.see answer

Question 1:

What diagnostic test, considered a sensitive indicator of advanced kidney disease, will need to be closely monitored by the nursing team?

1. _____________________________________________________________________________________________________________________________.

SITUATION VIII

Mr. B is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi.see answer

Question 1:

What measures would be most important for you to include in the pretest preparation?

1. _____________________________________________________________________________________________________________________________.

Mr. B is definitely diagnosed with renal calculi and is admitted to your unit. Today, the patient is experiencing severe flank pain and nausea; the temperature is 100.6 ° F (38.1 ° C) and his other vital signs are normal.

Question 2:

What is your priority nursing goal for this patient?

1. _____________________________________________________________________________________________________________________________.

Question 3:

The patient reports that the pain is intermittent and less colicky. What nursing directives will you add to the TNP?

SITUATION IX

A patient with chronic renal failure (CRF) is receiving a hemodialysis treatment. The patient latest vital signs are as follows: BP-90/60 mmHg, P-99 bpm, R-21 bpm, T-40˚C oral. He is warm to touch and is having chills. He also complains of nausea.

see answer

Question 1:

What do you suspect is happening to the patient?

1. _____________________________________________________________________________________________________________________________.

SITUATION X

A male patient has been prescribed allopurinol (Zyloprim) for his renal calculi.see answer

Question 1:

You are reviewing the laboratory reports for this patient. What laboratory findings indicate that the drug has had a therapeutic effect?

1. _____________________________________________________________________________________________________________________________.

SITUATION XI

The client, who is a newlywed, is afraid to discuss her diagnosis of cystitis with her husband.see answer

Question 1:

What is your best approach or response to the patient?

1. _____________________________________________________________________________________________________________________________.

SITUATION XII

A male patient with a newly inserted indwelling urinary catheter insists on walking to the hospital lobby with his family.

see answer

Question 1:

What instruction is most important that you will teach the patient regarding his catheter?

1. _____________________________________________________________________________________________________________________________.

SITUATION XIII

Mr. X, age 68 with benign prostatic hyperplasia (BPH) doesn't respond to medical treatment and was admitted to the facility for surgical intervention (TURP-Transurethral resection of the prostate) today. Two years ago, the patient has had right knee arthroplasty, following that surgery he was delirious for almost 48 hours.see answer

Question 1:

Identify another one priority problem (#2) and two nursing directives to each problem (#1&#2).

On the 2nd day after his TURP operation, he complains of intense pain to his right knee during physiotherapy.

Question 2:

Identify another priority problem #3 and 1 nursing directive for that problem on the TNP above

See Answers