Chronic PrepU- Ch. 55 Urinary Disorders

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

Ciprofloxacin (Cipro)

urethrovesical reflux

An obstruction to free-flowing urine leading to the reflux of urine from the urethra into the bladder

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?

Bladder retraining

trimethoprim-sulfamethoxazole combination medication

Co-trimoxazole (Bactrim, Septra)

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?

Coffee in the morning

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence?

Decreased pelvic muscle tone due to multiple pregnancies

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

Encouraging intake of at least 2 L of fluid daily

Which of the following is a cause of a calcium renal stone?

Excessive intake of vitamin - hypercalcemia - hyperparathyroidism - excessive intake of milk and alkali, and renal tubular acidosis.

A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?

Low-purine diet (to reduce the excretion of uric acid in the urine)

A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?

Monitor urine output hourly and report output less than 30 mL/hr.

anti-infective urinary tract medication.

Nitrofurantoin (Macrodantin, Furadantin)

Sympathomimetics have which of the following effects on the body?

Relaxation of bladder wall

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?

The nursing assistant places the drainage bag on the client's abdomen for transport. (right way: maintain the drainage bag lower than the genital region to avoid a backflow of urine into the bladder SOOO place the drainage bag on the lower area of the wheelchair, and hold the drainage bag while the client is in the process of moving.)

interstitial cystitis

inflammation of the bladder wall the eventually causes disintegration of the lining and loss of bladder elasticity

prostatitis

inflammation of the prostate gland

pyelonephritis

inflammation of the renal pelvis

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?

"This medication will relieve your pain."

A client has a suspected diagnosis of bladder stones. Stones may form in the bladder or originate in the upper urinary tract and travel to and remain in the bladder. What are some signs and symptoms that this client may be experiencing? Select all that apply.

- Hematuria - Suprapubic pain - Difficulty starting urinary stream

cystectomy

surgical removal of the urinary bladder

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:

notify the physician about cloudy or foul-smelling urine.

The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which factor as contributing to UTIs in older adults?

Immunocompromise -cognitive impariment -high incidence of chronic illness - immobility - incomplete emptying of the bladder - obstructed flow of urine - frequent use of antimicrobial agents.

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem?

UTI

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?

Urinary retention

ureterovesical or vesicoureteral reflux

backward flow of urine from the bladder into one or both ureters

neurogenic bladder

bladder dysfunction that results from a disorder or dysfunction of the nervous system and leads to urinary incontinence

urethritis

inflammation of the urethra

cystitis

inflammation of the urinary bladder

overflow incontinence

involuntary loss of urine associated with overdistention + overflow of the bladder

urinary incontinence

involuntary or uncontrolled loss of urine from the bladder

Phenazopyridine (Pyridium)

is a urinary analgesic agent used for the treatment of burning and pain associated with UTIs.

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

kidney

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

low purine

What are Struvite stones associated with?

neurogenic bladder and foreign bodies.

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

risk for infection

urosepsis

spread of infection from the urinary tract to the bloodstream that results in a systemic infection

ureterosigmoidostomy

transplantation of the ureters into the sigmoid colon, allowing urine to flow through the colon and out the rectum

ileal conduit

transplantation of the ureters to an isolated section of the terminal ileum, with one end of the ureters brought to the abdominal wall

residual urine

urine that remains in the bladder after voiding

micturition

voiding or urination

pyuria

white blood cells in the urine

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.

• Deficient knowledge: management of urinary diversion • Disturbed body image • Risk for impaired skin integrity

What is gout associated with?

Uric acid