Urinary 37
A client is diagnosed with frequent urinary tract infections. What would be an appropriate question for the nurse to ask the client?
"How frequently do you urinate each day?
The experienced nurse is observing a new nurse who is preparing to catheterize a female client. Which statement by the new nurse requires immediate intervention by the experienced nurse?
"I will use clean gloves to handle the catheter and other equipment."sterile gloves required for catheterization
Use of an indwelling urinary catheter leads to the loss of bladder tone
true
The nurse is choosing a collection device to collect urine from a nonambulatory male client? What would be the nurse's best choice?
urinal
The nurse measures a client's residual urine by catheterization after the client voids. Which condition would this test verify?
urinary retention
A client is preparing to give a clean-catch specimen. Which instruction will the nurse provide?
After the initial stream is initiated, collect the sample.
The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response?
"Let's review the types of fluids that your child drinks in the morning." Bladder irritants such as caffeine can cause urge incontinence; it is appropriate to determine whether the child is consuming fluids that contain caffeine.
A client reports an episode of losing control of urination when a bathroom wasn't close by. The client states, "I'm worried this means that I'm starting to lose control of my bladder." What is the appropriate nursing response?
"Let's review your medication history and whether you consume bladder irritants."
A parent asks the nurse when his 18-month-old daughter will be ready for toilet training. Which statement best answers the parent's question regarding toilet training?
"One signal of preparedness is when your child is dry for at least 2 hours."
A woman informs the nurse that when she is experiencing stress it is difficult to void, and wonders why this happens. What is the nurse's best explanation?
"Stress causes the muscles to become tense."
The nurse is caring for a client with a prescription for a midstream urine specimen. The nurse would provide which information to the client?
"Void a small amount, stop, and discard it."
The nurse is assessing a female client who states that she notices an involuntary loss of urine following a coughing episode. What would be the nurse's best reply?
"You are experiencing stress incontinence. Do you know how to do Kegel exercises?"
Three days post-surgery for breast reconstruction, the nurse assesses that the client is ambulating several times daily. The health care provider has not yet written an order to discontinue the client's urinary catheter. What is the appropriate nursing action? Select all that apply.
- Contact the health care provider to ask for an order for catheter discontinuation. - Perform, or allow client to perform, perineal hygiene at least once daily.
A female client is diagnosed with recurrent urinary tract infections (UTIs) and the nurse is providing education about preventative methods. What information is important for the nurse to give to the client to prevent another UTI? Select all that apply.
- Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse.- Avoid clothing that is tight and restrictive on the lower half of the body.- Wear underwear with a cotton crotch.
The nurse is caring for a postoperative client just returning from surgical insertion of a peritoneal dialysis catheter. Which are the nurse's priority assessments of the peritoneal dialysis catheter insertion site? Select all that apply.
- odor - bleeding - drainage - pain
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.
- situational low self-esteem - risk for infection
Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine?
24-hour specimen
A nurse is assessing a client who is complaining of difficulty urinating. Which assessment would be a priority?
Asking the client when he or she had last urinated
A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take?
Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration.
The nurse is caring for a client who has a history of renal failure. What is an accurate step when caring for the client's hemodialysis access?
Auscultate over the site with a stethoscope to listen for a bruit
What accurately describes a practice guideline that the nurse should follow when inserting an indwelling catheter
Avoid irrigation unless needed to relieve an obstruction.
Which symptom will have a great impact on the extracellular fluid for water conservation?
BURNS
The health care provider notifies a client of a diagnosis of glycosuria. Which additional assessment information will the nurse obtain from the client next?
Blood sugar
Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence?
Boys may take longer for daytime continence than girls.
The nurse is teaching an older adult female client who must provide a urine specimen. Which is the proper method to instruct the client to use to obtain a clean-catch urine specimen?
Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet.
The nurse is preparing to irrigate a Foley catheter. What is the nurse's initial action?
Check electronic health record for medical order.
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.
Clean each labial fold, then the area directly over the meatus. Insert the lubricated catheter into the urethra. Advance the catheter until there is a return of urine. Inflate the balloon with the correct amount of sterile saline. Discard used supplies.
During the well-child checkup for 2-year-old twins (one boy, one girl), their mother asks the nurse about preparing to toilet train the children. What information can be provided to the parent? Select all that apply.
Daytime incontinence is not a concern while toilet training Children who are able to remain dry for a few hours at a time may be signaling readiness for toilet training. Children old enough to undress themselves will have increased abilities to toilet train.
A nurse is caring for a female client with an indwelling urinary catheter. Which action should the nurse take into consideration to reduce the client's risk of developing a urinary tract infection (UTI)?
Ensure that the catheter is removed as soon as possible.
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?
Fasten the condom securely enough to prevent leakage without constricting blood flow.
The nurse is caring for a client with a history of renal insufficiency and type 2 diabetes. Which prescription, if noted in the client's chart, would alert the nurse to discuss with the health care practitioner?
Gentamicin 70 mg intramuscular (IM) every 8 hours Gentamicin is known to be nephrotoxic, so the nurse will check with the health care practitioner before administering it
The nurse is preparing a client for a cystoscopy procedure. Which intervention would be part of the preparation for this?
Having the client sign a consent form for the procedure
What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence?
It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.
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?
Keep muscles contracted for at least 10 seconds.
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?
Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.
A nurse assesses the urine of a client who is using a bedpan and finds that it is a dark brown color. What medication might be causing this effect?
Levodopa
A nurse is maintaining a client's continuous bladder irrigation. When appraising the effectiveness of this therapy, the nurse should prioritize what assessment?
Monitoring the characteristics of the urinary output
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?
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?
Position the client in a supine position.
The nurse is preparing to assess a client's postvoid residual using a bladder scanner. Place the following steps in the correct order. Use all options.
Press the appropriate gender button. Position the scanner head with directional arrow pointing to the head. Press scanner head onto the skin 1 to 1.5 inches (2.5 to 3.75 cm) above the symphysis pubis. Aim the scanner head toward the coccyx and activate the scan. Verify that screen crossbars fall within the bladder image. Observe and record the volume measurement on the screen.
The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately?
Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well.
Which urinary care teaching will the nurse provide to a young adult female client?
Refrain from douching unless ordered by a health care provider.
A client who visits a health care facility for a routine assessment reports to the nurse being unable to control urinary elimination. This has resulted in the client soiling clothes and has led to a lot of embarrassment. Which nursing intervention will be appropriate to use with this client?
Regular toileting routine
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?
STRESS
Use of an indwelling urinary catheter leads to the loss of bladder tone.
TRUE
The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client?
The birth can cause perineal swelling.
The clinic nurse is collecting data from a female client with frequent, recurrent urinary tract infections who was discharged from the hospital. Which data collection would indicate to the nurse that the client is adhering to discharge instructions?
The client drinks two glasses of water before and after sexual intercourse.
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:
deflate the balloon, insert the catheter further, and slowly attempt reinflation.
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?
The client has an enlarged prostate.
The nurse caring for an older adult male client is determining whether the client can use a urinal to void. Which aspects of the client's medical history may contraindicate the use of a urinal?
The client is acutely confused and has been diagnosed with delirium.
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?
The client is dehydrated.
A nurse is assisting a client with the use of a bedpan. The nurse understands that which statement about bedpans is true?
The largest part of a regular bedpan should be placed under the client's buttocks.
The nurse mentor is observing a novice nurse preparing to insert an indwelling catheter for a female client with urinary retention. The mentor would intervene if which action by the novice nurse is noted?
The novice nurse selects an 18 French Foley catheter to insert.
The nurse is caring for a client with a Foley catheter in place who has a prescription for a sterile urine specimen for culture and sensitivity. The nurse implements which techniques to obtain the prescribed urine specimen?
The nurse uses a syringe to withdraw urine from the port. The nurse dons clean gloves and cleanses the port with aseptic solution.
Which statements about suprapubic catheters is true?
They are often preferred over an indwelling urethral catheter for long-term urinary drainage.
The nurse is teaching a client how to perform pelvic floor muscle exercises (Kegel exercises). Which teaching will the nurse include?
Tighten the internal muscles used to prevent or interrupt urination.
The nurse is observing the unlicensed assistive personnel (UAP) assist the client with the bedpan. The nurse would intervene if which action by the UAP is noted?
UAP positions the bedpan so the client's buttocks rest on the shallow end of the regular bedpan.
The nurse is choosing a collection device to collect urine from a nonambulatory male client? What would be the nurse's best choice?
Urinal
The nurse is reviewing the chart of an older adult client who exhibits signs of confusion. Which laboratory value would indicate to the nurse that intervention is needed?
Urine culture sensitivity - 100,000/mL
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?
Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.
A client with frequent urinary tract infections (UTIs) has returned to the ambulatory clinic with symptoms of another UTI. Which information is essential for the nurse to review with the client as a strategy to decrease future risk of UTI?
Voiding before and after sexual intercourse
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?
Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle.
A nurse is caring for an older adult client at his home. The client has had a condom catheter applied. Which describes a condom catheter?
a flexible sheath that is rolled around the penis
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?
anuria
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?
blood
A woman is reporting bladder urgency. It is most important to assess:
caffeine intake
A client could experience increased urination when using which classification of medication?
cholinergic
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?
cloudy, foul odor
A client has been n.p.o. after midnight for surgery. It is 11 a.m. and the nurse has asked her to void before being transferred to the surgical suite. The nurse should expect her urine to be what color?
dark amber
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?
dark brown, cloudy
The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate?
dehydration
A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample?
first thing in the morning
A client reports frequently experiencing urine loss when moving from the wheelchair to bed. Which type of incontinence does the nurse anticipate?
functional
A client reports that he is often unable to retain urine until he locates a toilet because his mobility is decreased. The nurse should recognize the characteristics of what type of incontinence?
functional
A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance?
intermittent urethral catheter
A client at the health care facility has been diagnosed with total urinary incontinence. How could the nurse describe the condition of the client?
loss of urine without any identifiable pattern or warning
A client is suspected of having a disease process affecting the functional unit of the kidney. Which stucture is most likely involved?
nephron
A client has a cerebrovascular accident and is incontinent of bowel and bladder. Incontinence of urine in this client is related to a:
neurogenic bladder.
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?
one or both of the ureters are surgically implanted elsewhere
The nurse is reviewing the urinalysis of a client suspected of having a urinary tract infection. The potential diagnosis will be supported by the presence of:
pus
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?
reddened perineal skin
Which catheter would the nurse use to drain a client's bladder for short periods (5 to 10 minutes)?
straight catheter
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?
stress
Which type of incontinence is caused by pelvic floor muscle weakness?
stress
A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing?
stress incontinence
The health care provider prescribes a long-term continuous drainage system to monitor a chronically ill client. What type of catheter would best suit this client's needs?
suprapubic catheter
