a client with liver and renal failure has severe ascites. on initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. the nurse empties more than 2,000 ml from the collection bag. one hour later, she finds the collection bag full again. the nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. the physician orders a urinalysis to be obtained immediately. the presence of which substance is considered abnormal?

An aberrant finding in a typical urine sample is albumin. If the bladder broke, albumin-containing ascites that are prevalent in liver failure would leak from the indwelling urine catheter since the catheter is no longer confined in the bladder.
Urine typically contains creatinine, urobilinogen, and chloride.

The blood potassium level of a patient with chronic renal failure is 6.8 mEq/L. What should the nurse evaluate initially?

Pulse
The nurse can promptly identify a life-threatening cardiac arrhythmia by palpating the pulse if there is a high blood potassium level. Only the arrhythmia can cause a change in the client's blood pressure. The nurse should thus check the patient's blood pressure afterwards. Because the serum potassium level has little impact on respirations or temperature, the nurse can also postpone taking these measurement.

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