Chp 38: Urinary Elimination

The nurse is providing instructions to a client with kidney stones on measures to help prevent urinary tract infections (UTIs). Which statement made by the client would indicate to the nurse that further teaching is necessary? Select all that apply. "I will start wearing underwear with a cotton crotch." "I will notify my health care provider if my urine starts smelling again." "I will drink 10 ounces of cranberry juice every day." "I will drink about ten 8-oz glasses of water a day." "I will bathe in the bathtub rather than take a shower."

"I will drink 10 ounces of cranberry juice every day." "I will bathe in the bathtub rather than take a shower."

The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response? "Let's review the types of fluids that your child drinks in the morning." "I would only worry about this if you were raising a daughter." "This is extremely abnormal. You will need to see your son's pediatrician." "It would be appropriate to place your son in incontinence undergarments."

"Let's review the types of fluids that your child drinks in the morning."

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? clean-catch specimen intermittent specimen random specimen 24-hour specimen

24-hour specimen

The nurse is changing a stoma appliance on an ileal conduit. Which nursing action(s) is recommended procedure? Select all that apply. Apply faceplate by using firm, even pressure for approximately 60 seconds. Apply a silicone-based adhesive remover by spraying or wiping as needed. Remove appliance faceplate by pulling appliance from skin rather than pushing. Gently remove the appliance, starting at the top and keeping the abdominal skin taut. Clean skin around stoma with alcohol on a gauze pad. Make sure skin around stoma is thoroughly dry by patting it dry.

Apply a silicone-based adhesive remover by spraying or wiping as needed. Gently remove the appliance, starting at the top and keeping the abdominal skin taut. Make sure skin around stoma is thoroughly dry by patting it dry.

The health care provider has prescribed an indwelling catheter for a client. When the nurse explains the procedure, the client refuses to allow placement of the catheter. Which action should the nurse take next? Ask the client why they do not want a catheter. Document the fact that the client is not adhering to the treatment regimen. Describes the immediate and long-term benefits of catheterization. Inform the client that the health care provider will be contacted.

Ask the client why they do not want a catheter.

A nurse has been asked to speak about health promotion topics for a group of women older than 40 years of age. The nurse states that exercises may help with urinary urgency. Which exercise instruction will the nurse provide to the group? Lie on the floor, raise, then lower your legs 20 times per day. Contract the pubic muscles for 3 seconds, then relax. Contract abdominal muscles 10 times per day. Squat down and then jump up to a standing position.

Contract the pubic muscles for 3 seconds, then relax.

What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? It can be left in place for a long period of time. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. The client can apply it himself with minimal supervision. A sterile urine specimen can be obtained from the drainage bag tubing.

It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.

The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate? Ask the client to bear down until the catheter is expelled. Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. Remove the catheter from the vagina and attempt to insert it into the bladder. Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics.

Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.

A client with an emergently placed central venous catheter (CVC) is to have emergent hemodialysis. Upon assessment of the CVC the nurse visualizes redness, drainage, and odor to the area around the CVC. Palpation of the surrounding skin causes the client pain. Which intervention is the priority? Checking for blood return in the CVC Notifying the health care provider of the assessment findings Obtaining laboratory studies Placing the client as N.P.O. status

Notifying the health care provider of the assessment findings

The nurse assesses redness, drainage, and odor to the area around a client's peritoneal dialysis catheter. Palpation of the abdomen causes the client pain. Which intervention is the priority? Obtaining laboratory studies. Notifying the health care provider of the assessment findings. Flushing the catheter with 15 - 20 mL of normal saline Sitting the client up in a greater than a 40-degree angle.

Notifying the health care provider of the assessment findings.

A nurse will use a bladder scanner to assess a client with urinary frequency. How should the nurse best prepare the client for this procedure? Administer a diuretic, as ordered. Position the client in a supine position. Assess the client's need for analgesia. Have the client rest for 15 minutes before the assessment.

Position the client in a supine position.

An older adult female client tells the nurse, "Whenever I sneeze or cough, I urinate a little bit. It's very embarrassing." The nurse interprets the client's statement as indicating which type of incontinence? Urge Stress Overflow Functional

Stress

The clinic nurse is collecting data from a female client with frequent, recurrent urinary tract infections who was discharged from the hospital. Which data collection would indicate to the nurse that the client is adhering to discharge instructions? The client drinks two glasses of water before and after sexual intercourse. The client soaks in the bathtub daily for perineal care. The client drinks eight 8-oz glasses of cranberry juice daily. Since the client is symptom-free, she no longer takes the prescribed antibiotics.

The client drinks two glasses of water before and after sexual intercourse.

The nurse is inserting a urinary catheter into a 63-year-old male client and encounters resistance. What is the most likely cause of the resistance? The client has an enlarged prostate. The diameter of the catheter is too large. The client has an occult abscess in the urethra. The nurse failed to deflate the retention balloon after pretesting it for integrity.

The client has an enlarged prostate.

A nurse who is right-handed is inserting a woman's indwelling urinary catheter. The nurse will use cotton balls and antiseptic solution to cleanse the woman's meatus and perineum. Which of the nurse's actions is most appropriate? Grasp a cotton ball with forceps in her left hand and spread the woman's labia with her right hand. Perform hand hygiene between cleansing the woman's labia and inserting the catheter. Insert the catheter with her left hand while supporting the woman with her right hand. Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.

Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.

For which client will the nurse plan interventions addressing a neurogenic bladder? client recovering from a stroke client being treated for pyelonephritis 4-year old child who has not successfully been toilet trained client with weak pelvic floor muscles

client recovering from a stroke

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? aromatic, green reddish-brown, clear dark brown, cloudy clear, light yellow

dark brown, cloudy

The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate? dehydration kidney injury hypovolemia balanced fluids

dehydration

A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample? afternoon first thing in the morning before bedtime evening

first thing in the morning

A client at the health care facility has been diagnosed with total urinary incontinence. How will the nurse describe the condition of the client? loss of large amount of urine when intra-abdominal pressure rises loss of bladder control as a result of adverse medication effects or psychological stress loss of urine without any identifiable pattern or warning need to void is perceived frequently, with short-lived ability to sustain control of flow

loss of urine without any identifiable pattern or warning