Chapter 66: Care of Patients with Urinary Problems

An emergency department nurse assesses a client with a history of urinary incontinence who presents with extreme dry mouth, constipation, and an inability to void. Which question should the nurse ask first?

"What medications are you taking?"

A nurse cares for a client who is scheduled for the surgical creation of an ileal conduit. The client states, "I am anxious about having an ileal conduit. What is it like to have this drainage tube?" How should the nurse respond?

"Would you like to speak with someone who has an ileal conduit?"

A nurse teaches a client about self-care after experiencing a urinary calculus treated by lithotripsy. Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)

-"Finish the prescribed antibiotic even if you are feeling better." -Drink at least 3 liters of fluid each day." -The bruising on your back may take several weeks to resolve."

A nurse assesses a client who has had two episodes of bacterial cystitis in the last 6 months. Which questions should the nurse ask? (Select all that apply.)

-"How much water do you drink every day?" -"Do you take estrogen replacement therapy?" -"Are you on steroids or other immune-suppressing drugs?"

A nurse teaches a client with a history of calcium phosphate urinary stones. Which statements should the nurse include in this client's dietary teaching? (Select all that apply.)

-"Limit your intake of food high in animal protein." -Read food labels to help minimize your sodium intake." -"Reduce your intake of milk and other dairy products."

A nurse teaches clients about the difference between urge incontinence and stress incontinence. Which statements should the nurse include in this education? (Select all that apply.)

-"Stress incontinence occurs due to weak pelvic floor muscles." -"Urge incontinence occurs due to abnormal bladder contractions."

A nurse teaches a female client who has stress incontinence. Which statements should the nurse include about pelvic muscle exercises? (Select all that apply.)

-"When you start and stop your urine stream, you are using your pelvic muscles." -"Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10." -"Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them."

A nurse assesses a client with a fungal urinary tract infection (UTI). Which assessments should the nurse complete? (Select all that apply.)

-Assess the medical history and current medical problems. -Obtain a current list of medications.

A nurse cares for clients with urinary incontinence. Which types of incontinence are correctly paired with their clinical manifestation? (Select all that apply.)

-Stress incontinence - Urine loss with physical exertion -Urge incontinence - Large amount of urine with each occurrence -Overflow incontinence - Constant dribbling of urine

A nurse teaches a client about self-catheterization in the home setting. Which statements should the nurse include in this client's teaching? (Select all that apply.)

-Wash your hands before and after self-catheterization." -"Use lubricant on the tip of the catheter before insertion." -Maintain a specific schedule for catheterization."

After teaching a client who has stress incontinence, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?

"I will limit my total intake of fluids."

A nurse cares for a postmenopausal client who has had two episodes of bacterial urethritis in the last 6 months. The client asks, "I never have urinary tract infections. Why is

"Low estrogen levels can make the tissue more susceptible to infection."

A nurse teaches a young female client who is prescribed amoxicillin (Amoxil) for a urinary tract infection. Which statement should the nurse include in this client's teaching?

"Use a second form of birth control while on this medication."

After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?

"An orange color in my urine should not alarm me."

A nurse teaches a client with functional urinary incontinence. Which statement should the nurse include in this client's teaching?

"Buy slacks with elastic waistbands that are easy to pull down."

A confused client with pneumonia is admitted with an indwelling catheter in place. During interdisciplinary rounds the following day, which question should the nurse ask the primary health care provider?

"Can we discontinue the indwelling catheter?"

A nurse assesses a client who presents with renal calculi. Which question should the nurse ask?

"Do any of your family members have this problem?"

A nurse obtains the health history of a client with a suspected diagnosis of bladder cancer. Which question should the nurse ask when determining this client's risk factors?

"Do you smoke cigarettes?"

A nurse cares for a client with urinary incontinence. The client states, "I am so embarrassed. My bladder leaks like a young child's bladder." How should the nurse respond?

"I can teach you strategies to help control your incontinence."

After teaching a client with a history of renal calculi, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?

"I should drink at least 3 liters of fluid every day."

A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of bacterial cystitis?

A 58-year-old female who is not taking estrogen replacement

A nurse plans care for clients with urinary incontinence. Which client is correctly paired with the appropriate intervention?

A 58-year-old postmenopausal client who is not taking estrogen therapy - Electrical stimulation

A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?

A 78-year-old female who is confused

A nurse cares for a client who has kidney stones from secondary hyperoxaluria. Which medication should the nurse anticipate administering?

Allopurinol (Zyloprim)

A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?

An 86-year-old male with a 50-pack-year cigarette smoking history

A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal calculi. The nurse notes an ecchymotic area on the client's right lower back. Which action should the nurse take?

Apply an ice pack to the site.

After delegating care to an unlicensed assistive personnel (UAP) for a client who is prescribed habit training to manage incontinence, a nurse evaluates the UAP's understanding. Which action indicates the UAP needs additional teaching?

Changing the client's incontinence brief when wet

A nurse cares for a client admitted from a nursing home after several recent falls. What prescription should the nurse complete first?

Obtain urine sample for culture and sensitivity.

A nurse assesses a male client who is recovering from a urologic procedure. Which assessment finding indicates an obstruction of urine flow?

Overflow incontinence

A nurse provides phone triage to a pregnant client. The client states, "I am experiencing a burning pain when I urinate." How should the nurse respond?

Make an appointment with your provider to have your infection treated."

A nurse assesses a client with bladder cancer who is recovering from a complete cystectomy with ileal conduit. Which assessment finding should alert the nurse to urgently contact the health care provider?

The ileostomy stoma is pale and cyanotic in appearance.

A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a "shift to the left" in a client's white blood cell count. Which action should the nurse take?

Notify the provider and start an intravenous line for parenteral antibiotics.

A nurse teaches a client who is starting urinary bladder training. Which statement should the nurse include in this client's teaching?

Try to consciously hold your urine until the scheduled toileting time."

A nurse plans care for a client with overflow incontinence. Which intervention should the nurse include in this client's plan of care to assist with elimination?

Use the Valsalva maneuver.