1. Scenario 1 PREOPERATIVE DIAGNOSIS
Chronic pyelonephritis.

POSTOPERATIVE DIAGNOSIS
Vesicoureteral reflux.

PRIMARY PROCEDURE
URETHROCYSTOGRAPHY.

BRIEF HISTORY
This 25-year-old male has had a history of long-standing urinary tract infections with multiple recurrences. Urine cultures were positive for Escherichia coli.

PROCEDURE
Consent forms were signed, and the patient was taken to the radiology procedure suite. He was placed on the combination table and adjusted to allow for the films to be centered at the level of the upper border of the pubic symphysis. He was given mild sedation, prepped, and draped. A catheter was inserted into the urinary meatus through the urethra into the bladder. The bladder was then distended with the contrast material until the patient felt the urge to micturate. Voiding was then recorded on videotape. Vesicoureteral reflux was noted. The patient tolerated the procedure well and was taken to a recovery room. After he was fully awake, he was advised to have the abnormality surgically corrected.

Hint: Code for radiological supervision and interpretation.

Apatient who is 38 years of age is diagnosed with autosomal dominant polycystic kidney disease, a hereditary disease that results in fluid-filled cysts occupying space in the kidneys. the cysts can interfere with the function of the kidney and may burst and cause bleeding inside the kidney. the patient with polycystic kidney disease may or may not have a berry aneurysm of a blood vesseel in the brain that could lead to bleeding and death, cysts on the ovaries, and a mitral valve prolapse (in females) that can lead to dysrhythmias (irregular heart rhythms), or diverticula (outpouching of the bowel) that are susceptible to infection and inflammation and may lead to gastrointestinal bleeding. the patient is susceptible to retaining fluid in the abdomen so the abdomen is large to constipation, and to hypertension. there is no cure for the disease. the patient receives supportive care for the various symptoms or complications the patient may have. a. when explaining to the patient and the family about polycystic kidney disease, the nurse should explain what characteristics about an autosomal dominant genetic disease? b. how does variable expression of genetic characteristics play a role in the course of polycystic kidney disease and how can the nurse further predict the level of the disease? c. identify the roles of the nurse in integrating genetics in the nursing care provided for the patient.