Topic 10: Elimination and Reproduction

The nurse instructs an older adult client on performance of Kegel exercises. Which direction should the nurse provide to help the client identify the appropriate muscles to exercise?

void and stop the stream

A nurse administers medications to an older adult client. Which statement, if made by the client, indicates proper use of tamsulosin?

"My urine flow starts much faster now."

An older adult client admits to experiencing urinary incontinence. Which question will the nurse ask first?

"When did it start?"

Which older female reproductive system problem is associated with the nursing diagnosis anxiety?

sexual dysfunction

The nurse assesses an older woman regarding urinary health. Which interview question(s) is appropriate? Select all that apply.

"Do you ever leak urine?" "Do you have any discomfort or burning when you pass urine?" "Do you ever wear pads or protective garments to protect your clothing from wetness?" "When you urinate do you have any difficulty starting the stream or keeping the stream going?"

A home care registered nurse evaluated the plan of care for an older adult client with urge incontinence. Which statement by the client indicates the need for further teaching?

"I am concerned. I still have to get up once or twice per night to urinate."

The nurse is collecting health history information from an older adult client. Which statement(s) by the client indicates the presence of a risk factor for impaired urinary function? Select all that apply.

"I am not a big water drinker." "When you get to be my age, it is hard to make it to the bathroom." "I have been on a calcium channel blocker for years."

The nurse is assisting an older adult client with changing the client's sanitary briefs, which revealed that the client was incontinent of urine. Which statement by the client requires further follow up by the nurse?

"I have found this is something that happens from time to time at my age."

The nurse reviews an older adult client's urinary symptoms. Which statement by the client requires follow up by the nurse?

"I have trouble making it to the restroom on time."

The nurse is reviewing lifestyle changes with an older adult client to support urinary continence. Which statement by the client requires further follow up by the nurse?

"I will stay at home to ensure that I can remain close to the toilet."

An older adult client is embarrassed because of an episode of urinary incontinence associated with a fecal impaction. What should the nurse explain to the client about this type of incontinence?

"It was probably because of your bowel problem."

The nurse is providing education about urinary incontinence to an older adult client. Which statement by the client requires further follow up by the nurse?

"Urinary incontinence is a condition for which there is no treatment."

The nurse is caring for an older adult client who is recovering from hip surgery. The client has an indwelling urinary catheter in place. The client states, "I must have this catheter because they think old people will wet the bed." How will the nurse respond?

"Urinary incontinence is not something that is expected because of old age alone."

While the nurse is performing an assessment on an older adult client, the client discloses a recent problem with urinary incontinence. The client reports discussing this problem with friends, but not with a health care provider. How will the nurse respond?

"What are some ways that you have taken care of this issue?"

An older male client asks if something is wrong because it is taking longer to achieve an erection. How should the nurse respond to this client's concern?

"You are experiencing a normal age-related change."

The nurse educates an older adult client with stress incontinence. Which statement will the nurse include in the education?

"Your condition is a result of increased intra-abdominal pressure."

When changing bed linens, the nurse notes three areas of urinary incontinence: 4 in (10 cm), 5 in (12.5 cm), and 6 in (15 cm). For how many milliliters of urine should the nurse estimate that this client experienced incontinence? Record your answer using a whole number.

150

The nurse develops a plan of care for a family with a experiencing caregiver fatigue related to the client's overnight urinary incontinence. Which intervention will the nurse include?

Assist the client to the bathroom prior to bedtime.

Following a prolonged hospital stay, an older adult client has returned to the nursing home where the client normally resides. The client became incontinent of urine during the time in the hospital, a problem that nursing staff wish to now resolve. What action will the caregivers take in performing continence training?

Assist the client with toileting at timed intervals throughout the day.

What action should the nurse prioritize when trying to prevent an older adult client's risk for urosepsis?

Avoid the use of urinary catheters whenever possible.

The nurse is completing a physical assessment of an older adult female client focused on the reproductive system. Which action(s) will the nurse include in the assessment? Select all that apply.

Inspect the genitalia for lesions. Palpate the breasts. Assess for genital bleeding. Assess for genital discharge.

The nurse cares for an older adult client experiencing urinary retention. Which intervention should the nurse add to this client's plan of care?

Instruct to massage bladder area.

The older adult client has chronic low self-esteem related to urinary incontinence. Which goal is the most important to facilitate improved self-esteem?

The client develops or maintains positive view of self.

The nurse is performing a genitourinary assessment on an older adult client. Which finding(s) may affect the client's urinary function? Select all that apply.

The client has a history of a spinal cord injury. The client reports diminished thirst perception. The client reports consuming 2 to 3 caffeinated beverages per day.

The older adult client is at risk for injury related to urinary incontinence. Which goal is the priority?

The client is free from falls related to escaped urine.

The older adult client is at risk for altered skin integrity related to urinary incontinence. Which goal is the most important to facilitate balance among the client's physiologic needs?

The client stays dry and odor free.

Which action(s) will the nurse teach an older adult client to do to enhance voiding and prevent urinary retention? Select all that apply.

Void in an upright position. Massage the bladder area. Rock back and forth.

A client asks what can be done to reduce the incidence of vaginitis. What should the nurse instruct this client? Select all that apply.

Wear cotton underwear. Use lubricants with intercourse. Avoid sprays to the genital area. Keep the genital area clean and dry.

A middle-aged female client has severe scoliosis and reports not having sexual relations with her spouse. For which concern will the nurse plan care for this client?

altered body image perception

A client has been encouraged to reduce intake of high-caffeine beverages but admits to drinking several cups of black tea each day. The nurse should identify what problem-based care concern?

altered health maintenance

An older adult client admitted to the hospital for knee arthroplasty (replacement) developed postoperative pneumonia. While recovering, the client was placed on bed rest and became disoriented and incontinent. For which concern is the client at highest risk?

altered skin integrity

The nurse is caring for an older adult female client who has been diagnosed with vaginitis. On which problem-based care concern will the nurse focus?

altered skin integrity

The nurse plans care for an older adult client recovering from prostate cancer surgery. Which action should the nurse emphasize to prevent an injury and postoperative infection?

avoid strenuous activities for 3 to 4 weeks

An older adult client, residing in a long-term care facility, has been newly prescribed an antimuscarinic agent for urge urinary incontinence. Which action will the nurse take?

monitor the client closely for worsening cognitive impairment

An older adult client decides not to pursue testing for possible prostate cancer and refuses to have blood work and a biopsy performed. Which risk(s) may the client wish to avoid? Select all that apply.

pain bleeding infection urinary difficulties

The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older adult clients. Which unit-based protocol likely contributed to this outcome?

cranberry juice with breakfast

The nurse reviews a male client's health history. For which reason(s) will the nurse assess the client for erectile dysfunction? Select all that apply.

diabetes hypertension multiple sclerosis posttraumatic stress disorder

The nurse notes that an older adult client experiences urinary incontinence only when taking a sedative. For which type of incontinence should the nurse plan care for this client?

functional

The nurse notes that an older adult client's biopsy of vaginal tissue is positive for cancer. What care will the nurse expect to be prescribed for this client next?

identification of a primary site

A client with urinary retention receives intermittent urinary catheterization every 4 to 6 hours. For which concern is the client at risk for developing?

infection

The nurse notes that an older client has experienced signs of benign prostatic hypertrophy "for years." What additional diagnostic testing may be prescribed for this client?

kidney function evaluation

A client with benign prostatic hypertrophy is being treated with medication. The expresses concern that the medication is causing weight loss. What should the nurse suspect is occurring with this client?

metastatic prostate cancer

The staff nurse at a long-term care facility is training a newly hired nurse on how to promote the urinary function of older adult clients. Which behavior by the newly hired nurse requires further follow up by the staff nurse?

proactively using absorbent products for clients in case they experience incontinence

A registered nurse assesses an older adult client 24 hours after a retropubic suspension surgical procedure. The client is confused, exhibits muscle twitching, and reports being nauseated. Which laboratory data should the nurse assess?

sodium

An older adult client experiences urinary incontinence when laughing or sneezing. For which type of incontinence will the nurse plan care for this client?

stress

An older adult client receives a recommendation for weight reduction as an approach to help with urinary incontinence. For which type of incontinence is this intervention appropriate to recommend?

stress

The nurse identifies interventions to prevent the development of a urinary tract infection (UTI) in an older adult client. What assessment finding caused the nurse to add these interventions to the plan of care?

treatment for diabetes mellitus

An older adult client has developed urinary incontinence. The client states, "When I have to go, I go. I cannot make it to the bathroom before it leaks out." For which type of incontinence should the nurse develop a plan of care?

urge incontinence

The nurse suspects that an older client with urinary incontinence is experiencing low self-esteem. What observation did the nurse use to come to this conclusion?

wearing pajamas in the afternoon at home