Post Lecture GU Quiz
A client passes a urinary stone, and laboratory analysis of the stone indicates that it is composed of calcium oxalate. On the basis of these data, which should the nurse specifically include in the dietary instructions? a. Avoid green, leafy vegetables such as spinach. b. Increase intake of meat, fish, plums, and cranberries. c. Avoid citrus fruits and citrus juices. d. Increase intake of dairy products.
a. Avoid green, leafy vegetables such as spinach. Oxalate is found in dark green foods such as spinach. Other foods that raise urinary oxalate are rhubarb, strawberries, chocolate, wheat bran, nuts, beets, and tea. The food items in options 1, 2, and 4 are acceptable to consume.
A client who has had a prostatectomy has been instructed in perineal exercises to gain control of the urinary sphincter. The nurse determines that the client demonstrates a need for further teaching when he states that he will perform which movement as part of these exercises? a. Bearing down as if having a bowel movement b. Tightening the muscles as if trying to prevent urination c. Tightening the rectal sphincter while relaxing abdominal muscles d. Contracting the abdominal, gluteal, and perineal muscles
a. Bearing down as if having a bowel movement The Valsalva maneuver (bearing down) is avoided after prostatectomy because it increases the risk of bleeding in the postoperative period. An acceptable exercise is to tighten the abdominal, gluteal, and perineal muscles as if trying to prevent urination. Another acceptable exercise is to tighten the rectal sphincter while relaxing the abdominal muscles; this prevents the Valsalva maneuver from occurring.
The nurse is providing dietary instructions to a client with an oxalate kidney stone. The nurse should instruct the client to avoid which food? a. Chocolate b. Prune juice c. Breads d. Poultry
a. Chocolate Clients with oxalate stones should avoid foods high in oxalate, such as tea, instant coffee, cola drinks, beer, rhubarb, beans, asparagus, spinach, cabbage, chocolate, citrus fruits, apples, grapes, cranberries, and peanuts and peanut butter. Large doses of vitamin C may help increase oxalate excretion in the urine.
The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? a. Decreased force in the stream of urine b. Nocturia c. Scrotal edema d. Occasional constipation
a. Decreased force in the stream of urine Decreased force in the stream of urine is an early symptom of benign prostatic hyperplasia. The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur. Constipation or scrotal edema is not associated with benign prostatic hyperplasia.
A client with uric acid calculi is placed on a low-purine diet. The nurse instructs the client to restrict the intake of which food? a. Fish b. Cranberries c. Fruit juice d. Plum juice
a. Fish Clients who form uric acid calculi should be placed on a low-purine diet. Their intake of fish and meats (especially organ meats) should be restricted. Dietary modifications also may help adjust urinary pH so that stone formation is inhibited. Depending on the primary health care provider prescription, the urine may be alkalinized by increasing the intake of bicarbonates or acidified by drinking cranberry, plum, or prune juice.
The nurse is monitoring the fluid balance of an assigned client. The nurse determines that the client has proper fluid balance if which 24-hour intake and output totals are noted? a. Intake 1800 mL, output 1750 mL b. Intake 2400 mL, output 2900 mL c. Intake 3000 mL, output 2000 mL d. Intake 1500 mL, output 800 mL
a. Intake 1800 mL, output 1750 mL For the client on a normal diet, the normal fluid intake is approximately 1200 to 1800 mL of measurable fluids per day. The client's output in the same period should be about the same and does not include insensible losses, which are extra. Insensible losses are offset by the fluid in solid foods, which also is not measured.
The nurse is providing instructions to a client who is scheduled for cystoscopy and possible biopsy under general anesthesia. Which information should the nurse include? a. Intravenous fluids may be started on the day of the procedure. b. Preprocedure sedatives are never administered with general anesthesia. c. Only a full liquid breakfast may be allowed on the day of the procedure. d. The procedure will take about 4 hours.
a. Intravenous fluids may be started on the day of the procedure. Client preparation for cystoscopy and possible biopsy includes informing the client that intravenous fluids will be started the day of the procedure to ensure adequate hydration and flow of urine. The procedure will take approximately 30 minutes to 1 hour. An informed consent is obtained from the client, and preprocedure sedatives are administered as prescribed. If a general anesthetic is to be used, the client is told that fasting is necessary after midnight before the procedure.
A client is admitted to the emergency department following a fall from a horse, and the primary health care provider (PHCP) prescribes the insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action? a. Notify the PHCP before performing the catheterization. b. Administer parenteral pain medication before inserting the catheter. c. Clean the meatus with soap and water before opening the catheterization kit. d. Use a small-sized catheter and an anesthetic gel as a lubricant.
a. Notify the PHCP before performing the catheterization. The presence of blood at the urinary meatus may indicate urethral trauma or disruption. The nurse notifies the PHCP, knowing that the client should not be catheterized until the cause of the bleeding is determined by diagnostic testing. The other options include performing the catheterization procedure and therefore are incorrect.
The nurse is monitoring the urine output of a client with a low serum protein level and urinary output less than 30 mL in the last hour. Based on these data, the nurse understands that low urinary output is caused by which force within the kidneys? a. Oncotic pressure b. Hydrostatic pressure c. Osmotic pressure d. Filtration pressure
a. Oncotic pressure The pulling pressure within the capillaries that is exerted by the plasma proteins is referred to as the oncotic pressure. Osmotic pressure is the movement of water along a pressure gradient. Filtration pressure is the pressure that is exerted with ultrafiltration, in which the pressure within the capillaries is greater than the pressure outside them; this results in fluids being pushed across the membrane into Bowman's capsule. Hydrostatic pressure in the capillaries allows fluid to be filtered out of the blood in the glomerulus.
The nurse is caring for an older client. Which finding should the nurse expect to note in this client while evaluating renal function? a. The glomerular filtration rate (GFR) diminishes b. Medications are metabolized in larger amounts c. Tubular reabsorption increases d. Urine-concentrating ability increases
a. The glomerular filtration rate (GFR) diminishes As part of the normal aging process, the GFR decreases, along with each of the other functional abilities of the kidney. Tubular reabsorption and urine-concentrating ability also decrease. The kidneys have decreased ability to metabolize medications.
The nurse is conducting an interview of an older client and is concerned about the possibility of benign prostatic hyperplasia (BPH). Which are characteristics of this disorder? Select all that apply. a. Enlarged prostate b. Nocturia c. Incontinence d. Decreased desire for sexual intercourse e. Nocturnal emissions
a., b., and c. Nocturia, incontinence, and an enlarged prostate are characteristics of BPH and need to be assessed for in all male clients over 50 years of age. Nocturnal emissions are commonly associated with prepubescent males. Low testosterone levels (not BPH) may be associated with a decreased desire for sexual intercourse.
The nurse is caring for a client with chronic kidney disease. The nurse plans care knowing that besides maintaining urinary elimination, the kidneys also are involved in what body processes? Select all that apply. a. Produce erythropoietin for red blood cell synthesis. b. Assist to regulate acid-base balance. c. Encourage immunosuppression. d. Convert vitamin D to an active form. e. Help regulate blood pressure. f. Stimulate liver to secrete enzymes.
a., b., d., and e. Besides maintaining urinary elimination, the kidneys are also involved with helping to regulate blood pressure, assisting in regulating acid-base balance, converting vitamin D to an active form, and producing erythropoietin for red blood cell synthesis. The kidneys do not encourage immunosuppression and do not stimulate the liver to secrete enzymes.
The nurse has given instructions about Kegel exercises to a female client with a cystocele. The nurse determines that the client needs further instruction if she makes which statement? a. "I should tighten my perineal muscles for up to 5 minutes, 3 or 4 times a day." b. "I should begin voiding and then stop the stream, holding residual urine for an hour." c. "I should tighten my perineal muscles for up to 10 seconds several times a day." d. "I should stop and start my stream of urine during a voiding."
b. "I should begin voiding and then stop the stream, holding residual urine for an hour." Kegel muscles strengthen the perineal floor and are useful in the prevention and management of cystocele, rectocele, and enterocele. Several ways to perform Kegel exercises are acceptable. One method entails starting and stopping the flow of urine during a single voiding for about 5 seconds. Also, these exercises may be done by holding perineal muscles taut for up to 10 seconds several times a day or for 5 minutes, 3 or 4 times a day. Residual urine should not be held in the bladder for long periods because this could promote urinary tract infection.
A home care nurse is making home visits to an older client with urinary incontinence who is very concerned about the incontinent episodes. Which finding by the nurse indicates that the client has an environmental barrier to normal voiding? a. Night light present in the hall between the bedroom and bathroom b. Bathroom located on the second floor, bedroom on the first floor c. Having 1 bathroom on each floor of the home d. Presence of hand railings in the bathroom
b. Bathroom located on the second floor, bedroom on the first floor Having the bathroom on the second floor and the bedroom on the first floor may pose a problem for the older client with incontinence. The need to negotiate the stairs and the distance both may interfere with reaching the bathroom in a timely fashion. It is more helpful to the incontinent client to have a bathroom on the same floor as the bedroom or to have a commode rented for use. Hand railings and night lights are helpful to the client in reaching the bathroom quickly and safely.
A client with benign prostatic hyperplasia undergoes a transurethral resection of the prostate. Postoperatively the client is receiving continuous bladder irrigations. The nurse assesses the client for manifestations of transurethral resection syndrome. Which assessment data would indicate the onset of this syndrome? a. Increased urinary output and anemia b. Bradycardia and confusion c. Tachycardia and diarrhea d. Decreased urinary output and bladder spasms
b. Bradycardia and confusion Transurethral resection syndrome is caused by increased absorption of nonelectrolyte irrigating fluid used during surgery. The client may show signs of cerebral edema and increased intracranial pressure, such as increased blood pressure, bradycardia, confusion, disorientation, muscle twitching, visual disturbances, and nausea and vomiting.
A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication? a. Antilipemics b. Decongestants c. Diuretics d. Antibiotics
b. Decongestants In the client with benign prostatic hyperplasia, episodes of urinary retention can be triggered by certain medications, such as decongestants, anticholinergics, and antidepressants. These medications lessen the voluntary ability to contract the bladder. The client should be questioned about the use of these medications if he has urinary retention. Diuretics increase urine output. Antibiotics and antilipemics do not affect ability to urinate.
A client has just had a Foley catheter removed and is to be started on a bladder retraining program. Which intervention will provide the most useful information about the client's ability to empty the bladder? a. Assisting the client to the bathroom every 2 hours b. Measuring postvoid residual using a bladder scan c. Calculating total fluid intake for the shift d. Recording the amount of the client's voiding
b. Measuring postvoid residual using a bladder scan Measuring postvoid residual gives specific information about the ability of the bladder to empty completely. Recording intake and output and assisting the client to the bathroom are general interventions but do not provide information about the client's ability to empty the bladder.
The nurse is admitting a client from the postanesthesia care unit who has had percutaneous nephrolithotomy for calculi in the renal pelvis. The nurse anticipates that the client's care will most likely involve monitoring which device? a. Suprapubic tube b. Nephrostomy tube c. Ureteral stent d. Jackson-Pratt drain
b. Nephrostomy tube A nephrostomy tube is put in place after percutaneous nephrolithotomy for calculi in the renal pelvis. The client also may have a Foley catheter to drain urine produced by the other kidney. The nurse monitors the drainage from each of these tubes and strains the urine to detect elimination of the calculous fragments. Options 1, 2, and 4 are incorrect.
A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs further teaching if the client states that he or she will take which action? a. Return to the clinic as requested for follow-up culture in 1 week. b. Take an antibiotic so as to prophylactically prevent symptoms of Chlamydia. c. Use latex condoms to prevent disease transmission. d. Reduce the chance of reinfection by limiting the number of sexual partners.
b. Take an antibiotic so as to prophylactically prevent symptoms of Chlamydia. Antibiotics are not taken prophylactically to prevent acquisition of chlamydial infection. The risk of reinfection can be reduced by limiting the number of sexual partners and by the use of condoms. In some cases, follow-up culture is requested in 4 to 7 days to confirm a cure. The remaining options are correct measures.
A client is experiencing the syndrome of inappropriate antidiuretic hormone (ADH) secretion. When explaining this disorder to the client and family, the nurse recalls that ADH works to reabsorb water in which parts of the nephron? a. The proximal tubule and the loop of Henle b. The distal tubule and the collecting duct c. The glomerulus and the calices d. The loop of Henle and the distal tubule
b. The distal tubule and the collecting duct The distal tubule and the collecting duct of the nephron require the presence of ADH for water reabsorption. The hormone increases the permeability of the membranes to allow water to flow more easily along the concentration gradient. The glomerulus filters but does not reabsorb. The calices are responsible for collecting the urine. The proximal tubule and the loop of Henle reabsorb water without the assistance of ADH.
The nurse is caring for a client who has just returned from having a cystoscopy. The nurse should recognize which as an abnormal assessment finding for this client? a. The client complains of burning when urinating. b. The nurse notes bright red urine output. c. The nurse notes pink-tinged urine output. d. The client reports having urinary frequency.
b. The nurse notes bright red urine output. The main purpose of a cystoscopy is to inspect the interior of the bladder with a tubular lighted scope (cystoscope). Pink-tinged urine is a normal finding after this procedure, but bright red urine indicates hemorrhaging and is not a normal finding. The remaining options are normal findings following this procedure.
The nurse has provided instructions to a client with a urinary tract infection regarding foods and fluids to consume that will acidify the urine. Which fluids should the nurse include in the client's teaching plan that will aid in acidifying the urine? Select all that apply. a. Carbonated drinks b. Prune juice c. Apricot juice d. Cranberry juice e. Milk
b., c., and d. Acidification of the urine inhibits multiplication of bacteria. Fluids that acidify the urine include prune, apricot, cranberry, and plum juice. Carbonated drinks should be avoided because they increase urine alkalinity. Two glasses of milk a day can make the urine more alkaline, which could aid in the development of kidney stones.
Which client is most at risk for developing a Candida urinary tract infection (UTI)? a. A male paraplegic on intermittent catheterization b. A man with diabetes insipidus c. A young woman on antibiotic therapy d. An obese woman
c. A young woman on antibiotic therapy Candida infections, which are fungal infections, develop in persons who are on long-term antibiotic therapy because an alteration of normal flora occurs. These infections also are commonly seen in clients with blood dyscrasias, diabetes mellitus, cancer, or immunosuppression and in those with a drug addiction.
A client has urinary calculi composed of uric acid. The nurse is teaching the client dietary measures to prevent further development of uric acid calculi. The nurse should inform the client that it is acceptable to consume which item? a. Steak b. Chicken liver c. Cottage cheese d. Shrimp
c. Cottage cheese With a uric acid stone, the client should limit intake of foods high in purines. Organ meats, sardines, herring, and other high-purine foods are eliminated from the diet. Intake of foods with moderate levels of purines, such as red and white meats and some seafood, also is limited. Avoiding the consumption of milk and dairy products is a recommended dietary change for calculi composed of calcium stones but is acceptable for the client with a uric acid stone.
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder? a. Hematuria and urgency b. Dysuria and proteinuria c. Dysuria and penile discharge d. Hematuria and pyuria
c. Dysuria and penile discharge Urethritis in the male client often results from chlamydial infection and is characterized by dysuria, which is accompanied by a clear to mucopurulent discharge. Because this disorder often coexists with gonorrhea, diagnostic tests are done for both and include culture and rapid assays. Hematuria is not associated with urethritis. Proteinuria is associated with kidney dysfunction.
The nurse is performing an assessment on a client after a cystoscopy. Which assessment finding indicates a need to notify the primary health care provider (PHCP)? a. A temperature of 99.4º F (37.4º C) b. A blood pressure of 120/82 mm Hg c. Grossly bloody urine with clots d. A bluish or green tinge to the urine
c. Grossly bloody urine with clots Grossly bloody urine with clots following cystoscopy is always an abnormal finding and should be reported to the HCP immediately. The client may have clear or blood-tinged urine after cystoscopy. If a contrast agent such as methylene blue is used, the urine may have an unusual bluish or green tinge. A blood pressure of 120/82 mm Hg and a temperature of 99.4°F (37.4°C) are not abnormal findings at this time.
The client diagnosed with benign prostatic hyperplasia (BPH) is scheduled for a transrectal ultrasound examination and a test to measure the level of prostate-specific antigen (PSA). The client says to the nurse, "I can't remember . . . can you tell me again why I need these tests to be done?" The nurse responds, knowing that these tests are done for which purpose? a. Specifically to predict the course of BPH b. Give an indication of whether intermittent self-catheterization is needed c. Help to rule out the possibility of cancer d. Pinpoint the likelihood of developing urinary obstruction
c. Help to rule out the possibility of cancer A transrectal ultrasound examination and PSA level determination help to rule out the possibility of prostate cancer. They do not specifically predict the course of BPH or the development of complications such as urinary obstruction. These tests have nothing to do with determining need for self-catheterization.
The nurse caring for a client immediately after transurethral resection of the prostate (TURP) notices that the client has suddenly become confused and disoriented. Which is the priority nursing action for this client? a. Increase the flow rate of the intravenous infusion. b. Reorient the client. c. Notify the primary health care provider (PHCP). d. Ensure that a clock and calendar are in the room.
c. Notify the primary health care provider (PHCP). The client who suddenly becomes disoriented and confused after TURP could be experiencing early signs of hyponatremia. This may occur because the flushing solution used during the operative procedure is hypotonic. If the solution is absorbed through the prostate veins during surgery, the client experiences increased circulating volume and dilutional hyponatremia. The nurse should notify the HCP of these symptoms. Reorienting the client and ensuring that a clock and calendar are visible may be helpful but do not correct the problem. The nurse does not increase the flow rate of an intravenous infusion without a prescription from the HCP. In addition, speeding up the flow rate could potentially worsen the problem, depending on the solution that is infusing.
A client with nephrolithiasis arrives at the clinic for a follow-up visit. Laboratory analysis of the stone that the client passed 1 week earlier indicates that the stone is composed of calcium oxalate. Based on these data, what food item does the nurse instruct the client to avoid? a. Lentils b. Lettuce c. Spinach d. Pasta
c. Spinach Many kidney stones are composed of calcium oxalate. Foods that raise urinary oxalate excretion include spinach, rhubarb, strawberries, chocolate, wheat bran, nuts, beets, and tea. Pasta, lentils, and lettuce are acceptable to consume.
The nurse has provided dietary instructions to a client with renal calculi who must learn about the foods that yield an alkaline residue in the urine. The nurse determines that education was effective if the client chooses which selections from a diet menu? a. Peanut butter sandwich, milk, and prunes b. Linguini with shrimp, tossed salad, and a plum c. Spinach salad, milk, and a banana d. Chicken, potatoes, and cranberries
c. Spinach salad, milk, and a banana In some client situations, the primary health care provider may prescribe a diet that consists of foods that yield either an alkaline or an acid residue in the urine. In an alkaline residue diet, all fruits are allowed except cranberries, blueberries, prunes, and plums. Options 2, 3, and 4 represent an acid residue diet.
The nurse has performed a nutritional assessment on a client with cystitis. The nurse should tell the client to consume which beverage to minimize recurrence of cystitis? a. Coffee b. Tea c. Water d. White wine
c. Water Water helps flush bacteria out of the bladder, and an intake of 6 to 8 glasses per day is encouraged. Caffeine and alcohol can irritate the bladder. Therefore, alcohol- and caffeine-containing beverages such as coffee, tea, and wine are avoided to minimize risk.
The ambulatory care nurse is providing instructions to a client after a cystoscopy. Which statement by the client indicates a need for further teaching? a. "I may have some burning on urination for the next few days." b. "I should increase my fluid intake." c. "I can apply heat to my lower abdomen." d. "If I notice any pink-tinged urine, I should contact the primary health care provider."
d. "If I notice any pink-tinged urine, I should contact the primary health care provider." The client is instructed that pink-tinged urine and burning on urination are expected for 1 to 2 days after the procedure. Increased fluid intake is encouraged. Application of heat to the lower abdomen, administration of mild analgesics, and the use of sitz baths may relieve discomfort. The client also is advised to avoid alcoholic beverages for 2 days after the test.
A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the primary health care provider (PHCP)? a. Pain rated as 2 on a 0 to 10 pain scale b. Red, bloody urine c. Urinary output of 200 mL higher than intake d. Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute
d. Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute Frank bleeding (arterial or venous) may occur during the first day after surgery. Some hematuria is usual for several days after surgery. A urinary output of 200 mL more than intake is adequate. A client pain rating of 2 on a 0 to 10 scale indicates adequate pain control. A rapid pulse with a low blood pressure is a potential sign of excessive blood loss. The PHCP should be notified.
The nursing student is caring for a client with benign prostatic hyperplasia (BPH). The nursing instructor asks the student to identify the clinical manifestations associated with this condition. The student needs further teaching if the student states that which finding is an early symptom of BPH? a. Decreased force of urine stream b. Difficulty initiating urine stream c. Nocturia d. Hematuria
d. Hematuria Hematuria is not an EARLY sign of BPH. Nocturia, decreased force of urine stream, and difficulty initiating urine stream are all early signs of BPH.
The nurse provides discharge instructions to a client after prostatectomy. What is the priority discharge instruction for this client? a. Avoid lifting any objects greater than 30 lb (13.6 kg). b. Contact the primary health care provider (PHCP) if small clots are noticed in the urine. c. Avoid driving a car for at least 1 week. d. Increase fluid intake to at least 2.5 L/day.
d. Increase fluid intake to at least 2.5 L/day. A daily intake of 2.5 L of fluid should be maintained to limit clot formation and prevent infection. Driving a car and sitting for long periods are restricted for at least 3 weeks. The client should be instructed to avoid lifting objects heavier than 20 pounds (9 kg) for at least 6 weeks. Passing small pieces of tissue or blood clots in the urine for up to 2 weeks after surgery is expected and does not necessitate contacting the HCP.
The nurse is planning teaching for a female client diagnosed with urethritis caused by chlamydial infection. Which information should the nurse plan to include in the teaching session? a. Discontinue antibiotics after 3 weeks of uninterrupted administration. b. Alter the perineal pH by using a spermicide with a condom. c. Identify sexual partners for the past 12 months so they can be treated. d. Keep follow-up appointments for repeat cultures in 4 to 7 days.
d. Keep follow-up appointments for repeat cultures in 4 to 7 days. Follow-up cultures are typically done in 4 to 7 days to evaluate the effectiveness of the medication. Using a spermicide does not change the perineal pH. The infection can be prevented by the use of latex condoms. Chlamydial infection is treated with antibiotics, which are not discontinued until the prescribed course is completed. All sexual partners during the 30 days before diagnosis should be notified, examined, and treated as necessary.
The nurse is monitoring a client who has just returned from surgery after transurethral resection of the prostate (TURP). The client has a 3-way Foley catheter in place for ongoing bladder irrigation. The nurse is observing the color of the client's urine and should expect which urine color during the immediate postoperative period? a. Tea-colored urine b. Bright red blood with small clots in the urine c. Dark pink urine d. Pale pink urine
d. Pale pink urine If the bladder irrigation is infusing at a sufficient rate, the urinary drainage through the Foley tubing should be pale pink. Dark pink urine indicates that the rate of the irrigation solution should be increased. Tea-colored urine is not seen after TURP but may be noted in a client with other renal disorders such as renal failure. Bright red bleeding and clots could indicate a complication, and if this is noted, it should be reported to the primary health care provider.
A client tells the nurse about a pattern of a strong urge to void, followed by incontinence before the client can get to the bathroom. Based on the data provided, which condition should the nurse suspect? a. Stress incontinence b. Total incontinence c. Reflex incontinence d. Urge incontinence
d. Urge incontinence Urge incontinence occurs when the client experiences involuntary loss of urine soon after experiencing urgency. Total incontinence occurs when loss of urine is unpredictable and continuous. Stress incontinence occurs when the client voids in increments of less than 50 mL under conditions of increased abdominal pressure. Reflex incontinence occurs at rather predictable times that correspond to when a certain bladder volume is attained.
A client with urolithiasis (struvite stones) has a history of chronic urinary tract infections. What should the nurse plan to teach the client to avoid? a. Foods that make the urine more acidic b. Fruits such as currants, blueberries, and cranberries c. Antibiotics d. Wearing synthetic underwear and pantyhose
d. Wearing synthetic underwear and pantyhose Urolithiasis (struvite stones) can result from chronic infections. They form in urine that is alkaline and rich in ammonia, such as with a urinary tract infection. Teaching should focus on preventing infections and ingesting foods to make the urine more acidic. Foods such as currants, blueberries, and cranberries are acidic. The client should wear cotton, not synthetic, underclothing to prevent the accumulation of moisture and to prevent irritation of the perineal area, which can lead to infection. Antibiotics are not associated with chronic urinary tract infections.
A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply. a. Peritoneal dialysis b. Intravenous opioid analgesics c. Analysis of the urinary stone d. Placement of a ureteral stent with ureteroscopy e. Insertion of a nephrostomy tube
e. and d. Urolithiasis is the condition that occurs when a stone forms in the urinary system. Hydronephrosis develops when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Priority treatment is to allow the urine to drain and relieve the obstruction in the ureter. This is accomplished by placement of a percutaneous nephrostomy tube to drain urine from the kidney and placement of a ureteral stent to keep the ureter open. Peritoneal dialysis is not needed, since the kidney is functioning. Stone analysis will be done later when the stone has been retrieved and analyzed. Opioid analgesics are necessary for pain relief but do not treat the obstruction.
