med surg prep u ch 55

Bladder retraining following removal of an indwelling catheter begins with

instructing the client to follow a 2- to 3-hour timed voiding schedule.

A client is learning how to perform Kegel exercises. Which statement by the client indicates a need for additional teaching?

"I need to hold the position for at least 15 seconds."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?

"My urine will be eliminated through a stoma."

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report?

"When did you last urinate?"

Which medication may be ordered to relieve discomfort associated with a UTI?

Phenazopyridine

Which type of medication may be used to inhibit bladder contraction in a client with incontinence?

Anticholinergic agent

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

Which objective symptom of a UTI is most common in older adults, especially those with dementia?

Change in cognitive functioning

Patients with urolithiasis need to be encouraged to:

Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.

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

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

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

Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications?

Iatrogenic

The nurse advises the patient with chronic pyelonephritis that he should:

Increase fluids to 3 to 4 L/24 hours to dilute the urine.

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?

Pyridium

Which nursing intervention should the nurse caring for the client with pyelonephritis implement?

Teach client to increase fluid intake up to 3 liters per day.

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:

WBC 50

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

acute pain

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

assessing present voiding patterns

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

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?

diabetes mellitus

Which instruction would be included in a teaching plan for a client diagnosed with a UTI?

drink liberal amounts of fluids

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

excessive intake of vitamin D

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to:

help the client cope with the anxiety associated with changes in body image.

Which metabolic defects are associated with stone formation?

hyperparathyroidism

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

Which factor contributes to UTI in older adults?

immunocompromise

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 reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

low purine

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program?

medication usage

A client has a suspected bladder tumor. What is the most common first symptom of a malignant tumor of the bladder?

painless hematuria

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

painless hematuria

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.

perform hand hygiene prior to patient care; assist the patients with frequent toileting; provide careful perineal care

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

perform meticulous perineal care daily with soap and water

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

peritonitis

Which characteristic is seen with a healthy stoma?

pink color

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?

relieve the pain

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

risk for infection

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?

stress

Which type of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?

stress

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections?

the urethra

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization?

type and size of the catheter to be used

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?

urge

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?

uric acid

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?

urinary calculi

Which of the following is the most common site of a nosocomial infection?

urinary tract