Chapter 55: Management of Patients With Urinary Disorders Prep-U

The nurse is caring for several older clients. For which client would the nurse be especially alert for signs and symptoms of pyelonephritis? A client with a urinary tumor A client with acute renal failure A client with urinary obstruction A female client with preexisting chronic glomerulonephritis

A client with urinary obstruction Explanation: The client with urinary obstruction is at the highest risk of developing pyelonephritis because a urinary obstruction is the most common cause of pyelonephritis in older adults. Acute glomerulonephritis usually occurs in older adults with preexisting chronic glomerulonephritis. Older clients with acute renal failure or urinary tumor are not at high risk for developing pyelonephritis.

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? Urgency Incomplete bladder emptying Incontinence Urinary retention

Incontinence Explanation: Incontinence is noted in clients diagnosed with Parkinson disease. Urinary retention is associated with spinal cord injury. Urgency is associated with an overactive bladder. Incomplete bladder emptying is associated with diabetes mellitus.

A nurse caring for a patient with a neurogenic bladder knows to assess for the major complication of: Consistent pain Permanent distention Daily and painful spasms Infection

Infection Explanation: Infection is caused by an increased urinary bacterial count that results from incomplete and delayed emptying of the bladder.

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor? Client with a history of cigarette smoking Client with a history of bladder inflammation Client with a history of a sexually transmitted disease Client with a history of untreated gonorrhea

Client with a history of cigarette smoking Explanation: Environmental and occupational health hazards are associated with bladder tumors. Therefore, the client who smokes is at the greatest risk for a malignant tumor. The client with a history of untreated gonorrhea is most vulnerable to urethral strictures, while the client with a history of bladder inflammation may be vulnerable to interstitial cystitis. Finally, the client with sexually transmitted disease may be vulnerable to acquiring urethritis.

Which information is important when teaching a client how to perform self-catheterization? Catheterization should occur every 4 to 6 hours and before bedtime. The nurse uses nonsterile technique in the hospital setting. Peroxide is recommended for cleaning the urinary catheter. The catheter is rinsed with sterile normal saline after being soaked in a cleaning solution.

Catheterization should occur every 4 to 6 hours and before bedtime. Explanation: The average daytime clean intermittent catheterization schedule is every 4 to 6 hours and just before bedtime. The catheter is rinsed with tap water after being soaked in a cleaning solution. Either antibacterial soap or povidone-iodine solution is recommended for cleaning urinary catheters at home. The nurse uses sterile technique in the hospital setting.