chapter 37 fundamentals 168

a group of test that measure how urine flows, is stored, and is eliminated in the lower urinary tract; also used to identify abdominal voiding patterns in people with incontinence or the inability to void normally

urodynamic studies

the physical assessmnent of urinary functioning includes an examination of the ?

urinary bladder, urethralmeatus (if indicated), skin, and urine

involuntary loss of urine

urinary incontinence

Any involuntary loss of urine that causes a problem is referred to as what?

urinary incontinence.

A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? A. Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle. B. Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag. C. Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic. D. Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen.

A. Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle.

what remains relatively stable if the kidneys are functioning properly?

Body fluids

A nurse is preparing a brochure to teach patients how to prevent UTIs. Which teaching points would the nurse include? Select all that apply. A. Wear underwear with a synthetic crotch B. Take baths rather than showers C. Drink 8 to 10 8-oz glasses of water per day D. Drink a glass of water before and after intercourse and void afterward E. Dry the perineal area after urination or defecation from the front to the back F. Observe the urine for color, amount, odor, and frequency

C. Drink 8 to 10 8-oz glasses of water per day E. Dry the perineal area after urination or defecation from the front to the back F. Observe the urine for color, amount, odor, and frequency

What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? A. It can be left in place for a long period of time. B. The client can apply it himself with minimal supervision. C. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. D. A sterile urine specimen can be obtained from the drainage bag tubing.

C. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.

A client with chronic kidney disease reports not being able to urinate for the past 24 hours. A bladder scan shows no urine in the bladder. How does the nurse document this data? A. oliguria B. urinary retention C. anuria D. nocturia

C. anuria

A nurse caring for patients in a long-term care facility is often required to collect urine specimens from patients for laboratory testing. Which techniques for urine collection are performed correctly? Select all that apply. A. The nurse catheterizes a patient to collect a sterile urine sample for routine urinalysis. B. The nurse collects a clean-catch urine specimen in the morning from a patient and stores it at room temperature until an afternoon pick-up. C. The nurse collects a sterile urine specimen from the collection receptacle of a patient's indwelling catheter. D. The nurse collects about 3 mL of urine from a patient's indwelling catheter to send for a urine culture. E. The nurse collects a urine specimen from a patient with a urinary diversion by catheterizing the stoma. F. The nurse discards the first urine of the day when performing a 24-hour urine specimen collection on a patient.

D. The nurse collects about 3 mL of urine from a patient's indwelling catheter to send for a urine culture. E. The nurse collects a urine specimen from a patient with a urinary diversion by catheterizing the stoma. F. The nurse discards the first urine of the day when performing a 24-hour urine specimen collection on a patient.

A nurse is changing the stoma appliance on a patient's ileal conduit. Which characteristic of the stoma would alert the nurse that the patient is experiencing ischemia? A. The stoma is hard and dry. B. stoma is a pale pink color. C. The stoma is swollen. D. The stoma is a purple-blue color.

D. The stoma is a purple-blue color.

Drains the bladder for shorter periods; should be considered as an alternative to short-term or long-term indwelling urethral catheterization to reduce catheter-associated UTIs (Hooton et al., 2010).

Intermittent urethral catheters, (straight catheters

what focuses on maintaining and promoting normal urinary patterns, improving or controlling urinary incontinence, preventing potential problems associated with bladder catheterization, assisting with care of urinary diversions, and care of vascular access for hemodialysis and peritoneal dialysis?

Nursing interventions

what is essential for independence in self-care related to urinary elimination?

Patient education

continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation. Urination cannot be controlled due to an anatomic abnormality

total incontinence

what filters and excretes blood constituents that are not needed and retain those that are?

The kidneys

what help maintain the composition and volume of body fluids?

The kidneys

what is the basic structural and functional unit of the kidneys?

The nephron

what conveys urine from the bladder to the exterior of the body?

The urethra

what is a smooth muscle sac that serves as a temporary reservoir for urine?

The urinary bladder

what occurs when urine is produced normally but is not excreted completely from the bladder?

Urinary retention

24 hour urine output is less than 50

anuria

an _______ _______ is a bladder that is no longer controlled by the brain because of injury or disease also void by reflex only.

autonomic bladder

how is urine transported from each kidney?

by the ureters to the urinary bladder.

The introduction of a catheter (tube) through the urethra into the bladder for the purpose of withdrawing urine.; When it is deemed necessary, it should be performed using strict aseptic technique and left in place only as long as needed

catheterizing the bladder

what characteristic would you lookd for in urine?

color, odor, clarity, the oresence of any sediments

Non-invasive radiographic procedure whereby a body part can be scanned from different angles with an x-ray beam and a computer that calculates varying tissue densities and records a cross-sectional image.

computed tomography

the first voided urine of the day is usually more ______

concentrated

what are factoed that affect urination?

development considerations food and fluid intake psychological variables activity and muscle tone pathilogical conditions medications

Factors affecting the amount and quality of urine produced by the body and the manner in which it is excreted include what?

developmental considerations, food and fluid intake, psychological variables, activity and muscle tone, pathologic conditions, and medication use.

painful or difficult urination

dysuria

increased incidence of voiding

frequency

urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation.

funtional incontinence

presence of glucose in the urine

glycosuria

the voluntary control of urination develops as the ______ nerve centers develop after______

higher, infancy

the voluntary control of voiding is limited to what?

initiating, restraining, and interrupting

The radiographic examination of the kidney and ureter after a contrast material is injected intravenously. It is used to diagnose renal disease and urinary tract dysfunction

intravenous pyelogram

urinating is largely an _______ reflex act, but its control can be learned

involuntary

The nurse evaluates the effectiveness of a care plan to promote healthy urinary functioning by checking whether the patient has

met the individualized patient goals specified in the plan.

uurine loss with features of two or more types of incontinence.

mixed incontinence

awakening at night to urinate

nocturia

who is responsible for preparing the patient for diagnostic procedures related to urinary function and giving appropriate aftercare?

nurses

The data collected about the patient's urinary functioning may lead to one or more what?

nursing diagnoses

24 hour urine output is less than 400

oliguria

what does urine contain?

organic, inorganic, and liquid wastes

Involuntary loss of urine associated with overdistention and overflow of the bladder; The signal to empty the bladder may be underactive or absent, the bladder fills, and dribbling occurs, It may be due to a secondary effect of some drugs, fecal impaction, or neurologic conditions.

overflow incontinence (chronic retention of fluid)

excessive output of urine (diuresis)

polyuria

protein in the urine

proteinuria

pus in the urine

pyuria

experience emptying of the bladder without the sensation of the need to void. Spinal cord injuries may lead to this type of incontinence.

reflex incontinence

what increases metabolism and promotes optimal urine production and elimination?

regular excercise

Noninvasive procedure that involves the use of ultrasound to visualize the renal parenchyma and renal blood vessels;It is used to characterize renal masses and infections, visualize large calculi; detect malformed kidneys; provide guidance during other procedures, such as biopsy; and monitor the status of renal transplants and kidney development in children with congenital processes.

renal untrasound

The radiographic and endoscopic examination of the kidneys and ureters, with placement of ureteral catheter up to the level of the renal pelvis as part of the endoscopic examination; also Contrast material is then injected into the renal pelvis through the ureteral catheter, followed by radiographic images.

retrograde pyelogram

whan maintaining normal voiding habits what should you do?

schedule, urge to void, privacy, position, hygeine

occurs when there is an involuntary loss of urine related to an increase in intra-abdominal pressure; This commonly occurs during coughing, sneezing, laughing, or other physical activities. Childbirth, menopause, obesity, or straining from chronic constipation can also result in urine loss. The leakage usually does not occur when the person is supine.

stress incontinence

Nursing outcomes related to urinary elimination include the following:

the patient will produce urine output about equal to fluid intake; maintain fluid and electrolyte balance; empty the bladder completely at regular intervals; report ease of voiding, as appropriate; and maintain skin integrity.

The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order. 1. Inflate the balloon with the correct amount of sterile saline. 2. Clean each labial fold, then the area directly over the meatus. 3. Advance the catheter until there is a return of urine. 4. Discard used supplies. 5. Insert the lubricated catheter into the urethra.

2. Clean each labial fold, then the area directly over the meatus. 5. Insert the lubricated catheter into the urethra. 3. Advance the catheter until there is a return of urine. 1. Inflate the balloon with the correct amount of sterile saline. 4. Discard used supplies.

A nurse is administering intermittent closed catheter irrigation to a client. Place the following steps in the correct order. Use all options. 1. Unclamp or unfold the tubing and allow the irrigant and urine to flow into the drainage bag. 2. Remove the syringe from the access port. 3. Gently instill solution into the catheter. 4. Clamp or fold the catheter tubing below the access port. 5. Attach the syringe to the access port on the catheter using a twisting motion. 6. Cleanse the access port on the catheter with an antimicrobial swab

6. Cleanse the access port on the catheter with an antimicrobial swab 4. Clamp or fold the catheter tubing below the access port. 5. Attach the syringe to the access port on the catheter using a twisting motion 3. Gently instill solution into the catheter 2. Remove the syringe from the access port. 1. Unclamp or unfold the tubing and allow the irrigant and urine to flow into the drainage bag.

A client is diagnosed with frequent urinary tract infections. What would be an appropriate question for the nurse to ask the client? A. "How frequently do you urinate each day?" B. "Are you on any type of special diet at home?" C. "How often do you have a bowel movement?" D. "Are you on any blood pressure medications?"

A. "How frequently do you urinate each day?"

A nurse is caring for a patient who is taking phenazopyridine (a urinary tract analgesic). The patient questions the nurse: "My urine was bright orangish red today; is there something wrong with me?" What would be the nurse's best response? A. "This is a normal finding when taking phenazopyridine." B. "This may be a sign of blood in the urine." C. "This may be the result of an injury to your bladder." D. "This is a sign that you are allergic to the medication and must stop it."

A. "This is a normal finding when taking phenazopyridine."

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? A. 24-hour specimen B. intermittent specimen C. clean-catch specimen D. random specimen

A. 24-hour specimen

A nurse caring for patients in an extended-care facility performs regular assessments of the patients' urinary functioning. Which patients would the nurse screen for urinary retention? Select all that apply. A. A 78-year-old male patient diagnosed with an enlarged prostate B. An 83-year-old female patient who is on bedrest C. A 75-year-old female patient who is diagnosed with vaginal prolapse D. An 89-year-old male patient who has dementia E. A 73-year-old female patient who is taking antihistamines to treat allergies F. A 90-year-old male patient who has difficulty walking to the bathroom

A. A 78-year-old male patient diagnosed with an enlarged prostate C. A 75-year-old female patient who is diagnosed with vaginal prolapse E. A 73-year-old female patient who is taking antihistamines to treat allergies

The health care provider has ordered a 24-hour urine specimen collection for a client. Which nursing action is appropriate? Select all that apply. A. Ask client to void for the last time at exactly the 24-hour mark. B. Have client label own urine collection. C. Place urine in staff refrigerator. D. Discard first urine just before starting the test, then collect urine thereafter. E. Teach client to void only one time per hour.

A. Ask client to void for the last time at exactly the 24-hour mark. D. Discard first urine just before starting the test, then collect urine thereafter.

Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence? A. Boys may take longer for daytime continence than girls. B. Boys may walk by 1 year and should be continent by 3 years. C. Daytime continence is usually not achieved by boys until age 5. D. Incontinence after the age of 3 years is not normal.

A. Boys may take longer for daytime continence than girls.

Which symptom will have a great impact on the extracellular fluid for water conservation? A. Burns B. Small laceration C. Fracture D. Pain

A. Burns

A patient who has pneumonia has had a fever for 3 days. What characteristics would the nurse anticipate related to the patient's urine output? A. Decreased and highly concentrated B. Decreased and highly dilute C. Increased and concentrated D. Increased and dilute

A. Decreased and highly concentrated

The nurse is changing a stoma appliance on an ileal conduit. Which nursing action is recommended procedure? Select all that apply. A. Gently remove the appliance, starting at the top and keeping the abdominal skin taut. B. Clean skin around stoma with alcohol on a gauze pad. C. Apply faceplate by using firm, even pressure for approximately 60 seconds. D. Make sure skin around stoma is thoroughly dry by patting it dry. E. Apply a silicone-based adhesive remover by spraying or wiping as needed. F. Remove appliance faceplate by pulling appliance from skin rather than pushing.

A. Gently remove the appliance, starting at the top and keeping the abdominal skin taut. D. Make sure skin around stoma is thoroughly dry by patting it dry. E. Apply a silicone-based adhesive remover by spraying or wiping as needed.

A nurse is caring for a patient diagnosed with bladder cancer who has a urinary diversion. Which actions would the nurse take when caring for this patient? Select all that apply. A. Measure the patient's fluid intake and output. B. Keep the skin around the stoma moist. C. Empty the appliance frequently. D. Report any mucus in the urine to the primary care provider. E. Encourage the patient to look away when changing the appliance. F. Monitor the return of intestinal function and peristalsis.

A. Measure the patient's fluid intake and output. C. Empty the appliance frequently. F. Monitor the return of intestinal function and peristalsis.

A client with an emergently placed central venous catheter (CVC) is to have emergent hemodialysis. Upon assessment of the CVC the nurse visualizes redness, drainage, and odor to the area around the CVC. Palpation of the surrounding skin causes the client pain. Which intervention is the priority? A. Notifying the health care provider of the assessment findings B. Obtaining laboratory studies C. Placing the client as N.P.O. status D. Checking for blood return in the CVC

A. Notifying the health care provider of the assessment findings

A nurse will use a bladder scanner to assess a client with urinary frequency. How should the nurse best prepare the client for this procedure? A. Position the client in a supine position. B. Assess the client's need for analgesia. C. Have the client rest for 15 minutes before the assessment. D. Administer a diuretic, as ordered.

A. Position the client in a supine position.

A nurse is caring for a male patient who had a urinary sheath applied following hip surgery. What action would be a priority when caring for this patient? A. Preventing the tubing from kinking to maintain free urinary drainage B. Not removing the sheath for any reason C. Fastening the sheath tightly to prevent the possibility of leakage D. Maintaining bedrest at all times to prevent the sheath from slipping off

A. Preventing the tubing from kinking to maintain free urinary drainage

While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which sign/symptom would the nurse document as an abnormal finding? A. Reddened perineal skin B. Absence of discharge C. Presence of smegma D. Moist perineal skin

A. Reddened perineal skin

The nurse is inserting a urinary catheter into a 63-year-old male client and encounters resistance. What is the most likely cause of the resistance? A. The client has an enlarged prostate. B. The diameter of the catheter is too large. C. The client has an occult abscess in the urethra. D. The nurse failed to deflate the retention balloon after pretesting it for integrity.

A. The client has an enlarged prostate.

A client's BUN test results are significantly elevated. When reviewing the client's history, which finding is consistent with BUN elevation other than renal compromise? A. The client is dehydrated. B. The client has a history of osteoarthritis. C. The client is lactose intolerant. D. The client is on a low protein diet.

A. The client is dehydrated.

The health care provider has ordered an indwelling catheter inserted in a hospitalized male patient. What consideration would the nurse keep in mind when performing this procedure? 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 in into the meatus. D. Since it uses a closed system, the risk for UTI is absent.

A. The male urethra is more vulnerable to injury during insertion.

Use of an indwelling urinary catheter leads to the loss of bladder tone. A. True B. False

A. True

When collecting a urine sample from a client for examination, the nurse notes that the sample appears reddish-brown in color. What could cause this variation in color of the urine? A. blood B. dehydration C. stasis D. infection

A. blood

A client who has an indwelling catheter reports a need to urinate. which of the following actions should the nurse take? A. check to see whether the catheters is patent B. reassure the client that it is not possibe for them to urinate C. recatheterize the bladder with a larger-gauge catheter D. collect a urine specimen for analysis

A. check to see whether the catheters is patent

The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate? A. cloudy, foul odor B. strongly aromatic, amber C. light yellow, clear D. clear, dark amber

A. cloudy, foul odor

A 57-year-old man is suffering from polyuria. What can cause polyuria? A. diabetes insipidus B. renal calculi C.urinary tract infection D. renal disease

A. diabetes insipidus

A nurse is caring for a client who has a prescription for a 24 hour urine collection. which of the following actions should the nurse take? A. discard the first voiding B. keep the urine in a single container C. dispose of the last voiding D. ask the client to urinate into the toilet, stop mid stream,and finish urinating into specimen container

A. discard the first voiding

A nurse is reveiwing factors that increase the risk of urinary tract infections (UTIs) with a client who has recurrent UTIs. Which of the following factors should the nurse include? (select all that apply) A. frequent sexual intercourse B. lowering of testosterone levels C. wiping from front to back to clean the perineum D. location of the urethra closer to the anus E. frequent catheterization

A. frequent sexual intercourse D. location of the urethra closer to the anus E. frequent catheterization

A client has a cerebrovascular accident and is incontinent of bowel and bladder. Incontinence of urine in this client is related to a: A. neurogenic bladder. B. overactive bladder. C. enuresis. D. cystocele.

A. neurogenic bladder.

The nurse is planning care for a client with a newly placed urostomy. For what priority problems will the nurse address and provide interventions? Select all that apply. A. situational low self-esteem B. impaired urinary elimination C. reflex urinary incontinence D. urinary retention E. risk for infection

A. situational low self-esteem E. risk for infection

Which catheter would the nurse use to drain a client's bladder for short periods (5 to 10 minutes)? A. straight catheter B. Foley catheter C. indwelling urethral catheter D. suprapubic catheter

A. straight catheter

A nurse caring for a patient's hemodialysis access documents the following: "5/10/20 0930 AV fistula patent in right upper arm. Area is warm to touch and edematous. Patient denies pain and tenderness. Positive bruit and thrill noted." Which documented finding would the nurse report to the primary care provider? A. Positive bruit noted. B. Area is warm to touch and edematous. C. Patient denies pain and tenderness. D. Positive thrill noted.

B. Area is warm to touch and edematous.

A nurse is teaching a client who reports stress urinary incontinence. Which of the following instructions should the nurse include? (select all that apply) A. limit total daily fluid intake B. Decrease or avoid caffiene C. take calcium supplements D. avoid drinking alcohol E. Use the Cred manuever

B. Decrease or avoid caffiene D. avoid drinking alcohol

A nurse is caring for a client with an external condom catheter. Which guideline should be implemented when applying and caring for this type of catheter? A. Remove the catheter every 8 hours, or more often in humid weather. B. Fasten the condom securely enough to prevent leakage without constricting blood flow. C. Ensure the tip of the tubing is touching the tip of the client's penis. D. Wipe the penis thoroughly with an alcohol swab and dry thoroughly before application.

B. Fasten the condom securely enough to prevent leakage without constricting blood flow.

After surgery, a patient is having difficulty voiding. Which nursing action would most likely lead to an increased difficulty with voiding? A. Pouring warm water over the patient's fingers. B. Having the patient ignore the urge to void until her bladder is full. C. Using a warm bedpan when the patient feels the urge to void. D. Stroking the patient's leg or thigh.

B. Having the patient ignore the urge to void until her bladder is full.

A client is suspected of having a disease process affecting the functional unit of the kidney. Which stucture is most likely involved? A. Glomerulus B. Nephron C. Loop of Henle D. Bowman's capsule

B. Nephron

A nurse is ordered to catheterize a patient following surgery. Which nursing guideline would the nurse follow? A. The nurse would use different equipment for catheterization of male versus female patients. B. The nurse should use the smallest appropriate indwelling urinary catheter. C. The nurse should always sterilize the equipment prior to insertion. D. The nurse should choose a 12F, 5-mL or 10-mL balloon, unless ordered otherwise.

B. The nurse should use the smallest appropriate indwelling urinary catheter.

The nurse is choosing a collection device to collect urine from a nonambulatory male client? What would be the nurse's best choice? A. Bedpan B. Urinal C. Large urine collection bag D. Specimen hat

B. Urinal

A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample? A. evening B. first thing in the morning C. afternoon D. before bedtime

B. first thing in the morning

a nurse is praparing to initiate a bladder- retraining program for a client who has incintienance . which of the following actions should the nurse take? (select all that apply) A. restrict the clients intake of fluids during the daytime B. have the client record urination times C. gradually increase the urination intervals D. remind the client to hold urine until the next scheduled urination time E. provide a sterile container for urine

B. have the client record urination times C. gradually increase the urination intervals D. remind the client to hold urine until the next scheduled urination time

A client at the health care facility has been diagnosed with total urinary incontinence. How could the nurse describe the condition of the client? A. need to void is perceived frequently, with short-lived ability to sustain control of flow B. loss of urine without any identifiable pattern or warning C. loss of urine control because a toilet is not accessible D. loss of small amount of urine when intra-abdominal pressure rises

B. loss of urine without any identifiable pattern or warning

A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion? A. use of a catheter to collect urine in a sterile environment B. one or both of the ureters are surgically implanted elsewhere C. inability to control either urinary or bowel elimination D. hygiene measures used to keep meatus and adjacent area of the catheter clean

B. one or both of the ureters are surgically implanted elsewhere

A client reports to the nurse that after delivering a baby, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate? A. reflex B. stress C. urge D. total

B. stress

The nurse is caring for a client with a prescription for a midstream urine specimen. The nurse would provide which information to the client? A. "You will have a catheter put in to collect the urine." B. "Save all urine for the next 24 hours." C. "Void a small amount, stop, and discard it." D. "Void into the specimen hat in the toilet bowl."

C. "Void a small amount, stop, and discard it."

A nurse is ordered to perform continuous irrigation for a patient with a long-term urinary catheter. What rationale would the nurse expect for this order? A. Irrigation of long-term urinary catheters is a routine order. B. Irrigation is recommended to prevent the introduction of pathogens into the bladder. C. A blood clot threatens to block the catheter. D. It is preferred to irrigate the catheter rather than increase fluid intake by the patient.

C. A blood clot threatens to block the catheter.

The health care provider has prescribed an indwelling catheter for a client. When the nurse explains the procedure, the client refuses to allow placement of the catheter. Which action should the nurse take? A. Inform the client that the health care provider will be contacted. B. Gather appropriate supplies to teach the client to perform straight catheterization. C. Ask the client why he or she does not want a catheter. D. Continue to place the indwelling catheter because it has been prescribed.

C. Ask the client why he or she does not want a catheter.

A nurse assessing an older adult client finds that the client has had four urinary tract infections in the past year. Which physiologic change of aging would the nurse suspect is the cause? A. Diminished ability to concentrate urine B. Decreased bladder muscle tone C. Decreased bladder contractility D. Neurologic weakness

C. Decreased bladder contractility

The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate? A. Ask the client to bear down until the catheter is expelled. B. Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics. C. Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. D. Remove the catheter from the vagina and attempt to insert it into the bladder.

C. Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.

A nurse is caring for an alert, ambulatory, older resident in a long-term care facility who voids frequently and has difficulty making it to the bathroom in time. Which nursing intervention would be most helpful for this patient? A. Teach the patient that incontinence is a normal occurrence with aging. B. Ask the patient's family to purchase incontinence pads for the patient. C. Teach the patient to perform PFMT exercises at regular intervals daily. D. Insert an indwelling catheter to prevent skin breakdown.

C. Teach the patient to perform PFMT exercises at regular intervals daily.

A woman is reporting bladder urgency. It is most important to assess: A. weight. B. exercise. C. caffeine intake. D. vitamin supplements.

C. caffeine intake.

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? A. reddish-brown, clear B. aromatic, green C. dark brown, cloudy D. clear, light yellow

C. dark brown, cloudy

The nurse is inserting a urinary catheter into a female client and has begun to inflate the balloon, an action that has caused the client to wince and cry out in pain. Consequently, the nurse should: A. stop, deflate the balloon, withdraw the catheter 0.75 to 1.5 in (2 to 4 cm), and slowly reinflate. B. wait for 30 seconds, help the client to relax, and attempt inflation again. C. deflate the balloon, insert the catheter further, and slowly attempt reinflation. D. deflate the balloon, withdraw the catheter, and use a smaller sized catheter.

C. deflate the balloon, insert the catheter further, and slowly attempt reinflation.

The nurse observes that a client frequently experiences urine loss when being transferred from a chair to the bed. Which type of incontinence does the nurse identify that the client is experiencing? A. urge B. reflex C. functional D. total

C. functional

A 70-year-old client who has four children and six grandchildren states that she "wets" herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate? A. total B. urge C. stress D. reflect

C. stress

The health care provider has prescribed an indwelling catheter for a 48-year-old male client who is in traction with leg fractures. Which information will the nurse give the client when he states not wanting the indwelling catheter? A. "This is the only option for catheterization." B. "Indwelling catheters do not hurt, and I will be careful placing it." C. "This is what your health care provider has prescribed." D. "Let me talk to your health care provider about a condom catheter."

D. "Let me talk to your health care provider about a condom catheter."

Data must be collected to evaluate the effectiveness of a plan to reduce urinary incontinence in an older adult. Which information is least important for the evaluation process? A. The incontinence pattern B. State of physical mobility C. Medications being taken D. Age of the patient

D. Age of the patient

The nurse is preparing to irrigate a Foley catheter. What is the nurse's initial action? A. Gather equipment and supplies. B. Explain the procedure to the client. C. Assess urine characteristics. D. Check electronic health record for medical order.

D. Check electronic health record for medical order.

Urinalysis and urine culture testing have been ordered for a client who has an indwelling urinary catheter. The nurse observes that there is currently no urine in the client's catheter tube. What should the nurse do? A. Reposition the client supine. B. Attach a syringe to the access port and aspirate until a sample is obtained. C. Encourage the client to increase fluid intake for the next couple of hours. D. Clamp the tube below to access the port to allow urine to accumulate.

D. Clamp the tube below to access the port to allow urine to accumulate.

The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle exercises (Kegel exercises) will the nurse include? A. Relax muscles for at least 5 minutes between Kegels. B. Perform these exercises two times daily for a week. C. Loosen the internal muscles used to prevent or interrupt urination. D. Keep muscles contracted for at least 10 seconds.

D. Keep muscles contracted for at least 10 seconds.

A client who undergoes peritoneal dialysis is admitted to the hospital after an elective total-knee arthroplasty. Upon assessment the nurse visualizes redness, drainage, and odor to the area around the peritoneal dialysis catheter. Palpation of the abdomen causes the client pain. Which intervention is the priority? A. Sitting the client up in a greater than a 40-degree angle. B. Placing the client as N.P.O. status. C. Obtaining laboratory studies. D. Notifying the health care provider of the assessment findings.

D. Notifying the health care provider of the assessment findings.

A nurse who is right-handed is inserting a woman's indwelling urinary catheter. The nurse will use cotton balls and antiseptic solution to cleanse the woman's meatus and perineum. Which of the nurse's actions is most appropriate? A. Grasp a cotton ball with forceps in her left hand and spread the woman's labia with her right hand. B. Insert the catheter with her left hand while supporting the woman with her right hand. C. Perform hand hygiene between cleansing the woman's labia and inserting the catheter. D. Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.

D. Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.

direct visual exaination of the bladder, ureteral orfices, and urethra with a cystoscope; also used to veiw, diagnose, and treat disorders of the lower urinary tract, interior bladder, urethra, male prostatic urethra, and urethral orfices

cystoscopy

Nurses use different techniques for collecting urine specimens. The nurse needs to understand the rationale for?

the specific test ordered, as well as the correct collection procedure associated with the required test in order to ensure obtaining the appropriate urine sample.

what is urine?

the waste product excreted by the kidneys

appears suddenly and lasts for 6 months or less; It is usually caused by treatable factors, such as confusion secondary to acute illness, infection, and as a result of medical treatment, such as the use of diuretics or intravenous fluid administration.

transient incontinence

is the involuntary loss of urine that occurs soon after feeling an urgent need to void (urgency); These patients experience a loss of urine before getting to the toilet and an inability to suppress the need to urinate.

urge incontinence

strong desire to void

urgency

The process of emptying the bladder is known as:

urination, micturition, or voiding.

Nursing assessment of urinary elimination includes collection of data about the patient's:

voiding patterns, habits, and difficulties, along with a history of current or past urinary problems; physical examination of the bladder, if indicated, and urethral meatus; assessment of skin integrity and hydration; examination of the urine and measurement of urine volume; and correlation of these findings with the results of diagnostic tests and procedures for examining the urine and the urinary tract.