Pathophysiology - Ch 35

The nurse is providing emotional support to a client who has just been diagnosed with low-grade urothelial bladder cancer. When the client inquires about prognosis rates for this type of cancer, the nurse responds that: it is usually noninvasive and has an excellent prognosis. it is typically invasive but has a good prognosis. although it is a rare form of bladder cancer it has an excellent prognosis. it is highly metastatic and has a poor prognosis.

it is usually noninvasive and has an excellent prognosis. Explanation: The most common bladder cancer is derived from urothelium cells that line the bladder so it also known as urothelial cancer. These types of tumors include low-grade noninvasive tumors that have an excellent prognosis.

The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement? "Alterations in bladder function can include urinary obstruction with retention or stasis of urine." "Alterations in bladder function can only occur when there is incontinence." "Alterations in bladder function occurs frequently in the elderly." "Alterations in bladder function can include urinary incontinence with involuntary loss of urine."

"Alterations in bladder function can only occur when there is incontinence." Explanation: Alterations in bladder function include urinary obstruction with retention or stasis of urine and urinary incontinence with involuntary loss of urine. Alterations in bladder function does occur more frequently with aging.

The client has just been diagnosed with bladder cancer and asks the nurse what causes it. What would be the nurse's best response to the client? "You should not worry about its cause." "The cause is unknown." "It is usually inherited." "It is due to something outside the body."

"The cause is unknown." Explanation: The nurse should tell the client that the cause of bladder cancer is unknown; however, evidence suggests that its origin is due to local influences such as carcinogens that are excreted in the urine and stored in the bladder. It is not inherited and it would not be therapeutic to tell the client not to be concerned about its cause.

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is: Bladder Uterine Kidney Testicular

Bladder Explanation: Bladder cancer is the most frequent form of urinary cancer in the United States. Uterine cancer and testicular cancer are not considered to be cancers of the urinary tract.

An older adult with urge incontinence and overactive bladder begins medication treatment with oxybutynin. Which side effects would the nurse include in the education? Increased tearing and drowsiness may occur. Dry mouth and constipation are common. You may experience feelings of euphoria. Stop the medication if you develop spasms.

Dry mouth and constipation are common. Explanation: Anticholinergic effects of the muscarinic blocking agent oxybutynin include dry mouth and constipation. People taking anticholinergic drugs may also experience gastroesophageal reflux, blurred vision, urinary retention, and cognitive effects. Spasms are not common.

A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (14 kg) overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer? Bladder cancer is the number one type of cancer in overweight smokers. It is caused by carcinogens that are excreted in the urine and stored in the bladder. Obesity is a known cause of bladder cancer. There is insufficient evidence to make a conclusion.

It is caused by carcinogens that are excreted in the urine and stored in the bladder. Explanation: Evidence suggests that bladder cancer is related to local influences such as carcinogens that are excreted in the urine and stored in the bladder. These include the breakdown products of aromatic amines used in the dye industry, and products used in the manufacture of rubber, textiles, paint, chemicals, and petroleum. About 30% to 50% of all bladder cancers are associated with cigarette smoking. Obesity is not related to bladder cancer.

What is the most common sign of bladder cancer? Severe oliguria Hyperproteinuria Painless hematuria Hyperphosphaturia

Painless hematuria Explanation: The most common sign of bladder cancer is intermittent painless hematuria. Oliguria and proteinuria and hyperphosphaturia are associated with renal failure.

The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply. Chemotherapy Herbal therapy Hypnosis Surgical removal Radiation therapy

Surgical removal radiation therapy chemotherapy Explanation: The methods used in treatment depend upon the grade of the tumor and degree of invasiveness. They include surgical removal, radiation therapy, and chemotherapy. Hypnosis and herbal therapy are not recommended treatments for this disease.

The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence? Chronic Transient Neurogenic Stress

Transient Explanation: The causes of incontinence can be divided into two categories: transient and chronic. Of particular importance is the role of pharmaceuticals as a cause of transient urinary incontinence. Numerous medications, such as long-acting sedatives and hypnotics, psychotropics, and diuretics, can induce incontinence. Chronic urinary incontinence occurs as a failure of the bladder to store urine (stress incontinence) or a failure to empty urine (neurogenic incontinence).

A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs? Administration of diuretics as ordered to promote frequent bladder emptying Administration of alpha-adrenergic agonist drugs as ordered Bladder ultrasonography two to three times daily Intermittent catheterization

Administration of alpha-adrenergic agonist drugs as ordered Explanation: The client likely has stress incontinence, for which alpha-adrenergic agonist drugs may be ordered. Diuretics are not used to treat incontinence. Bladder ultrasound neither assesses nor treats stress incontinence. Catheterization does not address the underlying problem.

A 65-year-old female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include: long-term intermittent catheterization. bladder retraining. lithotripsy. cystoscopy.

cystoscopy. Explanation: The most common sign of bladder cancer is painless hematuria. Frequency, urgency, and dysuria occasionally accompany the hematuria. Cystoscopy is among the most common diagnostic tests related to bladder cancer. Lithotripsy addresses renal calculi. Bladder retraining and catheterization are not directly related to the diagnosis and treatment of bladder cancer.

A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as: Stress incontinence Urge incontinence Transient incontinence Overflow incontinence

Urge incontinence Explanation: Urge incontinence is the involuntary loss of urine associated with a strong desire to void (urgency). Stress incontinence represents the involuntary loss of urine that occurs when, in the absence of detrusor muscle action, the intravesical pressure exceeds the maximum urethral closure pressure. Overflow incontinence is an involuntary loss of urine that occurs when intravesical pressure exceeds the maximal urethral pressure because of bladder distention in the absence of detrusor activity. Incontinence may occur as a transient and correctable phenomenon, or it may not be totally correctable and may occur with various degrees of frequency.

A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as: Stress Urge Functional Overflow

Stress Explanation: Stress incontinence is the involuntary loss of urine associated with activities such as coughing and sneezing. Urge incontinence is the urgency and frequency associated with hyperactivity of the detrusor muscle. Overflow incontinence is the involuntary loss of urine when intravesicular pressure exceeds maximal urethral pressure. Functional incontinence is the lack of cognitive function to go to the bathroom.