NUR 222 - Ch 28 - PrepU

Which drugs, originally developed for hypertension, relax smooth muscle tissue found in the prostate?

Alpha blockers (Page 785)

The nurse is employed in a urologist's office. Which classification of *medication* is anticipated for clients having difficulty with *urinary incontinence*?

Anticholinergic

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

Anticholinergic agent (Page 779)

An ileal conduit is created for a client after a *radical cystectomy*. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

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 (Page 782)

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?

"Increase your fluid intake to 2 to 3 L per day." (Page 793)

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

"Make sure to eat enough fiber to prevent constipation." (Page 781)

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." (Page 797)

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." (Page 776)

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?" (Page 783)

Following a post void bladder scan, straight catheterization is performed if the bladder has how many milliliters left in it?

100 (Page 787-788)

A client who is diagnosed with *calcium oxalate stones* is instructed to limit calcium intake. The client is instructed to *consume ______ mg of calcium per day, or less*, as part of dietary treatment.

1000

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 (Page 790)

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

A low-purine diet

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?

Change in cognitive functioning (Page 780)

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

An older adult client is being evaluated for suspected pyelonephritis and is ordered *kidney, ureter, and bladder (KUB) x-ray*. The nurse understands the significance of this order is related to which rationale?

Detects calculi, cysts, or tumors

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

Encouraging intake of at least 2 Liters of fluid daily (Page 781)

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

Excessive intake of vitamin D (Page 792)

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

Hematuria

The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do?

Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation. (Page 794)

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

Increase fluids to 3 to 4 Liters per 24 hours to dilute the urine. (Page 778)

The treatment of choice for a spinal cord-injured patient with impaired bladder emptying would include which of the following?

Intermittent self-catheterization (Page 788)

An 82-year-old client experiences urinary incontinence. Which factor should the nurse assess before beginning a bladder training program for this client?

Physical and environmental conditions (Page 784)

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

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 (Page 792)

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 (Page 792)

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?

Maintain skin and stoma integrity (Page 797)

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.

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

Need to urinate after engaging in sexual intercourse

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

Need to urinate after engaging in sexual intercourse (Page 775)

Which of the following is the most common symptom of bladder cancer?

Painless gross hematuria (Page 796)

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 (Page 796)

Which finding is an early indicator of bladder cancer?

Painless hematuria (Page 796)

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?

Painless, gross hematuria (Page 796)

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. (Page 777)

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

Perform meticulous perineal care daily with soap and water (Page 788)

Which medication may be ordered to relieve discomfort associated with a urinary tract infection?

Phenazopyridine (Page 776)

Which term refers to inflammation of the renal pelvis?

Pyelonephritis (Page 772)

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

Pyridium (Page 776)

Which laboratory value supports a diagnosis of pyelonephritis?

Pyuria (Page 777)

*Sympathomimetics* have which of the following effects on the body?

Relaxation of bladder wall (Page 783)

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

Stress (Page 779)

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?

Take the antibiotic for 3 days as prescribed. (Page 776)

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 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.

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

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 (Page 780)

A client complains of a sudden onset of sharp, severe flank pain. the client indicates that the pain, which comes in waves, travels to the supra-pubic 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

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

WBC 50 (Page 775)

A patient taking an *alpha-adrenergic medication for* the treatment of *hypertension* is having a problem with *incontinence*. What does the nurse tell the patient?

When the medication is discontinued or changed, the incontinence will resolve. (Page 780)

The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily:

at the same time, on the same scale, with similar clothing. (Page 742)

Bladder retraining following removal of an indwelling catheter begins with

instructing the client to follow a 2- to 3-hour timed voiding schedule. (Page 787)

A client has just been diagnosed with acute pyelonephritis. What education would the nurse offer this client regarding fluids?

Significantly increase fluid intake.

A female patient visits her primary health care provider with a complaint of *frequency of urination and incontinence when she sneezes*. The health care provider suspects the patient is experiencing *cystitis*. The nurse knows that this is most likely due to which of the following?

Reflux of urine from the urethra into the bladder (Page 773)

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. (Page 790)

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

Assessing present voiding patterns (Page 779)

A 32-year-old client has been admitted to the renal unit with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. As her nurse, what would be a significant aspect of your discharge education?

Recurring infection prevention

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

Risk for infection (Page 791)

Which of the following nursing actions is most important in caring for the client following lithotripsy?

Strain the urine carefully for stone fragments.