NADN 2110 Student Review- Urinary Elimination

WITHIN 6-8 HOURS AFTER CATH REMOVAL

After removing a cath during what time frame should a patient have his/her first void?

ANSWER: A,C Rationale: A pH of 8 would mean the urine isn't as acidic as it should be, this making it easier for bacteria to grow. A light yellow to amber urine color is normal. Cloudiness means there is sediment in the urine, which could be because of an infection, such as a UTI. Concentrated urine is related to how hydrated the patient is.

During Mrs. Smiths' urine analysis, the nurse identified her urine to be light yellow, cloudy, concentrated, and a pH of 8. Which of these findings are abnormal? Select all that apply. A. pH of 8 B. Light yellow color C. Cloudiness D. Concentrated

250-400mL

For an adult, what is the average amount of urine per void?

diabetes

If glucose and ketones are present in a patient's urine what may the patient have?

ANSWER: C Rationale: Trouble urinating on their own could result in a catheter, not a 24 hour specimen. When looking for a specific bacteria, the physician would use a clean catch urine specimen. For kidney excretion, a 24 hour urine specimen is used to see how accurate the kidneys are working. Specific gravity is checked using another test using the urine.

The physician has made an order for Mr. Jones to receive a 24 hour urine specimen. For which reason would the physician order this? A. Mr. Jones is having trouble urinating on his own B. The physician is checking Mr. Jones' bladder for a specific bacteria C. To measure his kidney excretion D. To check Mr. Jones' specific gravity

DEHYDRATION

Urine specimen is Amber color with a specific gravity of 1.030 what do you suspect may be occurring with your patient?

Color, clarity, odor, volume

What are you assessing a patient's urine for?

20-30 minutes

When collecting a urine specimen from a catheter, how long should you clamp it for?

Correct ANSWER:D Rationale: The guidelines for initiating bladder retraining include assessing the client's present intake patterns, voiding patterns, and reasons for each accidental voiding. Lowering the client's fluid intake won't reduce or prevent incontinence. The client should be encouraged to drink 1.5 to 2 L of water per day. A voiding schedule should be established after assessment.

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a. Restricting fluid intake to reduce the need to void b. Establishing a predetermined fluid intake pattern for the client c. Encouraging the client to increase the time between voidings d. Assessing present voiding patterns

Correct answer A The client's statement about voiding after sexual intercourse to prevent urinary tract infection is accurate. Taking frequent bubble baths, wiping the perineum from back to front, and wearing snug fitting pants increases the risk of urinary tract infection. The client should avoid taking frequent bubble baths, using harsh soaps, and wearing tight-fitting pants because they can irritate the urethra. The client also should always wipe from front to back after urinary or fecal elimination.

A client with a urinary tract infection is to be discharged from the healthcare facility. After teaching the client about measures to prevent urinary tract infections, the nurse determines that the teaching was successful when the client states which of the following? A. "I need to void after sexual intercourse." B. "I need to wear snug-fitting pants." C. "I should always wipe back to front after using the bathroom." D. "I should take frequent bubble baths."

Correct ANSWER: A Rationale: Suggestions to manage urinary incontinence include avoiding constipation such as eating adequate fiber and drinking adequate amounts of fluid. Scented powders, lotions, or sprays should be avoided because they can intensify the urine odor, irritate the skin, or cause a skin infection. Stimulants such as caffeine, alcohol, and aspartame should be avoided. The client should void regularly, approximately every 2 to 3 hours to ensure bladder emptying.

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate? a. "Make sure to eat enough fiber to prevent constipation." b. "Try drinking coffee throughout the day." c. "Use scented powders to disguise any odor." d. "Limit the number of times you urinate during the day."

Correct Answer A, D, E Factors affecting urinary elimination include fluid intake, loss of body fluid, nutrition, body position, cognition, obstruction of urine flow, infections of the urinary tract, hypotension, neurologic injury, decreased muscle tone, pregnancy, surgery, and medications. Time of arising usually is not a factor because most people void soon after getting out of bed. Hypotension, not hypertension, can affect urinary elimination.

A group of nursing students are reviewing normal patterns of urinary elimination and factors that affect it. The students demonstrate an understanding of the information when they identify which of the following as a factor? Select all that apply A. Fluid intake B. Time of arising C. Hypertension D. Cognition E. Body position

Correct Answer A. The nurse should inform the client that amitriptyline turns the urine blue-green. The risk of urinary retention is increased with medications that have anticholinergic effects. Tricyclic antidepressants and antihistamines are examples of such drugs. Narcotics can decrease the sensation of bladder fullness and the glomerular filtration rate.

A home care nurse visits a client diagnosed with depression who informs the nurse that he has been prescribed amitriptyline. Which of the following would the nurse include when teaching the client about the effects of this medication? A. Causes the urine to turn blue-green B. Decreases sensation of bladder fullness C. Causes urinary retention D. Decreases glomerular filtrate rate

3, 5

A patient may be diagnosed with a UTI if their RBC is higher than ____ and WBC is higher than ____.

Correct ANSWER: C) Orange red Pyridium Is noted for turning the year and orange red, and the patient needs to be aware of this

A patient taking Phenazopyridine (pyridium, a urinary track analgesic) Should be cautioned that her year and may change to what color? A) Pale yellow B) Green C) Orange red D) Brown

Correct ANSWER: A)The male urethra is more vulnerable to injury during insertion Because of its length the male urethra is more prone to injury and requires that the catheter be inserted 6" to 8". This procedure requires surgical asepsis to prevent introducing bacterica into the urinary tract. The placement of an indwelling catheter has a risk of UTI

The Doctor has order an indwelling catheter inserted in a hospitalized male "PT". The nurse is aware of which of the following considerations? A)The male urethra is more vulnerable to injury during insertion B)In the hospital, a clean technique is used for catheter insertion C)The catheter is inserted 2" to 3" into the meatus D)Since it uses a closed system, the risk for urinary infection is absent

Correct ANSWERS:A, B, E Rationale: Functions of the kidney include secretion of prostaglandins, regulation of blood pressure, and synthesis of aldosterone and vitamin D. The pancreas secretes insulin. The body does not produce Vitamin B.

The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? Select all that apply. a. Vitamin D synthesis b. Secretion of prostaglandins c. Vitamin B production d. Secretion of insulin e. Regulation of blood pressure

ANSWER: B Rationale: For cleaning an indwelling catheter, it is opposite for male and females. For male cleaning, the catheter is cleaned first, then the penis and other parts are cleaned. Working from cleanest to dirtiest. For a female, the catheter tubing is cleaned following the cleaning of the labia.

When caring for an indwelling catheter on a male patient, which is the correct order? A. Thigh, catheter, end of penis, shaft, scrotum B. Catheter, end of penis, shaft, scrotum, thigh, rectum C. End of penis, shaft, scrotum, thigh, catheter, rectum D. Catheter, shaft, thigh, rectum

ANSWER: A,B,C,D Rationale: All of these answers are things a nurse should be assessing for.

When monitoring intake and output on a patient with an indwelling catheter, there are specific things the nurse needs to do. Select all that apply. A. Assess patency of tube B. Assess urine color, clarity, amount, and odor C. Encourage patient to increase fluids D. Assess for at least 30ml of urine per hour

CLAMP TUBING FOR 20-30 MINS(NO LONGER), CLEAN PORT WITH ALCOHOL/BEDADINE, AND THEN USE 23-25 GUAGE NEEDLE WITH A SYRINGE OBTAINING ATLEAST 10ML

When obtaining an urine specimen from a cath that is strict aspesis what must you do?

Correct ANSWER: B) Retention Urgency is a strong desire to void. Oliguria is scanty or greatly diminished amount of urine voided in a given time. Dysuria is difficulty urinating

Which of the following terms did note a patient's inability to void even though the kidneys are producing urine that enters the bladder? A) Urgency B) Retention C)Oliguria D)Dysuria

ANSWER: A Rationale: Elavil causes the urine to have a blueish green tint. Difficulty urinating is not a symptom with this medication. Pyridium causes the urine to turn an orange red color. High concentrated urine has to do with how hydrated a person is.

While Mr. Thomas was prescribed Elavil, what is one thing the nurse should have informed him about with taking this new medication? A. Greenish blue urine color change B. Difficulty with urination C. Orange urine color change D. High concentrated urine

HAVE TO DISCARD THE PREVIOUS URINE AND START OVER

You are collecting a 24 hour urine on a patient and you have almost made it through 24 hours of collection however your patient has accidently voided into the toliet instead of the hat/bedpan. What must you do now?

UTI

You have a patient with a urine that is light yellow, slightly cloudy, foul odor and a pH 8 What symptoms could this indicate?

Correct Answer D. An ammonia odor, cloudy appearance, and blood in the urine all suggest an abnormality. Urine usually has a light yellow to a sort of amber color, clear, and be aromatic.

The nurse collects a urine sample from a client for urinalysis. Which of the following would the nurse document as a normal characteristic? A. An ammonia odor B. Cloudiness C. Blood in the urine D. Light yellow color

Correct Answer C. The patient needs to drain at least 30 mL of urine an hour to stay in normal range. The patient's urine amount is in the normal limits.

The nurse is checking her patient's intake and output and discovers her patient with the foley has only drained 40mL in the past hour. What should she do next? A. Notify the physician immediately B. Check placement of the catheter C. Nothing D. Bladder scan her right away