Chapter 45 315

Which type of urinary incontinence would the nurse suspect when preparing a patient for a procedure to increase the closing pressure of the urethra and increase the periurethral electromyography activity?

Stress incontinence

Three months after a traumatic vaginal delivery, the patient reports blood in her urine, dyspareunia, suprapubic discomfort, and discharge of pus from the genital organs. Treatment included surgical intervention (Spence procedure). For which potential postoperative complication would the nurse monitor?

Stress incontinence

Which intervention would the nurse implement when providing care for an adult patient recently diagnosed with polycystic kidney disease (PKD)?

Suggest genetic counseling resources for the patient's children

When a patient's clinical manifestations include hematuria, red blood cell casts, and proteinuria, which underlying cause would the nurse associate with this patient? Select all that apply.

Systemic lupus erythematosus (SLE) Acute poststreptococcal glomerulonephritis (APSGN)

When developing the plan of care for a patient with spondylosis, which type of urinary incontinence (UI) would influence the identification of appropriate nursing interventions?

Urge incontinence

Which clinical manifestation would the nurse associate with a urethral stricture?

Frequent urge to urinate

Which dietary recommendation would the nurse provide a patient newly diagnosed with nephrotic syndrome?

Moderate-protein diet

Which containment device would the nurse use when needing to direct a patient's urine into a drainage bag?

Penile sheath

Which diagnostic studies would the nurse anticipate scheduling for the patient who reports frequent urination, a feeling of incomplete bladder emptying, and dyspareunia after experiencing urethral instrumentation the previous week? Select all that apply.

Voiding cystourethrography MRI

When providing educational information regarding the postoperative period for a patient scheduled for a lithotripsy, which information would the nurse include prior to the procedure? Select all that apply.

Placement of a ureteral stent occurs at the end of the procedure. Your urine may appear bright red during the postoperative period. Removal of the ureteral stent occurs within two weeks after the procedure.

Which factors place a patient at risk for experiencing urinary stasis? Select all that apply.

Urinary retention Renal impairment Urinary tract calculi

When teaching a patient about preventing acute poststreptococcal glomerulonephritis, which intervention would the nurse present as most important?

Promote early diagnosis and treatment of sore throats and skin lesions.

Which precipitating factor is a common cause of pyelonephritis in patients admitted to the medical unit from a long-term care facility?

Urinary tract catheterization

Which actions would the nurse implement when managing a female patient's active urethritis symptoms? Select all that apply.

Provide the patient with a warm sitz bath Teach the patient how to correctly cleanse the perineal area. Obtain a culture and sensitivity analysis of a current urine sample.

Which information included in a patient's electronic medical record listed below would have likely caused nephrotic syndrome?

Diabetes

Which instruction to prevent recurrent urinary tract infections (UTIs) would the nurse provide female patients?

"Empty your bladder before and after sexual intercourse."

When assessing the cognitive-perceptual pattern of a patient diagnosed with a urinary tract infection, which questions would the nurse ask the patient? Select all that apply.

"Have you felt a burning discomfort when you urinate?" "Do you have any pain over your suprapubic area or low back?"

Which response would the nurse provide the patient who is two days postoperative an ileal conduit loop and reports the development of mucus in their urine?

"The development of mucus is a normal occurrence."

Which prescribed medication would the nurse teach the patient is the treatment for alkaline urine and development of struvite stones within the kidney?

Acetohydroxamic acid (Lithostat)

For the patient with renal calculi, on which problem would the nurse focus interventions when developing a plan of care?

Acute pain

Which intervention would the nurse include as a priority when developing a plan of care for the patient admitted with acute pyelonephritis?

Administer parenteral antibiotics as prescribed by the health care provider.

Which diagnosis would the nurse associate with a patient's clinical manifestations of hematuria, progressive uremia, and sensorineural deafness?

Alport syndrome

Which disorders are extrarenal causes of nephrotic syndrome? Select all that apply.

Amyloidosis Diabetes mellitus Hodgkin's lymphoma

Which action would the nurse implement immediately when a patient arrives via ambulance to the emergency department with penetrating renal trauma secondary to a motor vehicle accident?

Assess patient's cardiovascular system and monitor for signs of shock.

To avoid further complications, which dietary restrictions would the nurse teach a patient with uric acid stones? Select all that apply.

Avoid herring Avoid sardines

Per evidence-based practice guidelines, which guideline effectively reduces catheter-associated urinary tract infections (CAUTI)?

Avoid unnecessary catheterization and aim for early removal of urinary catheters

Which diagnostic studies would the health care provider prescribe to determine loss of kidney function secondary to fibrosis from significant anatomic abnormalities or recurrent upper urinary tract infections? Select all that apply.

Biopsy CT scan

For the patient scheduled for insertion of a suprapubic catheter, which disorder would the nurse associate with this intervention?

Bladder cancer

Which complications would the nurse associate with the long-term use of indwelling catheters? Select all that apply.

Bladder spasms Fistula formation Periurethral abscess

Which diagnostic test would the nurse anticipate scheduling for the patient experiencing recurrent infections from a suspected urinary tract obstruction?

CT scan

When a patient asks about the procedure to insert their suprapubic catheter, which response will the nurse use?

Catheter insertion is through a small incision in your abdominal wall.

Which outcome would the nurse establish as a priority when developing the plan of care for a patient with rapidly progressive glomerulonephritis (RPGN)?

Correction of fluid overload

When prescribed an angiotensin-converting enzyme (ACE) inhibitor, which potential side effect would affect the patient's lower urinary tract function?

Cough triggering stress urinary incontinence (UI)

Which medication would the nurse associate with treatment of a patient suspected of having a kidney disorder where the laboratory findings indicate a decreased serum albumin, decreased total serum protein, and an elevated serum cholesterol?

Cyclophosphamide (Cytoxan)

For which prescribed endourologic procedure would the nurse provide instructions when scheduling the removal of a patient's small stones?

Cystoscopy

Which disorder would the nurse associate with a patient's inability to urinate, lower abdominal pain, and a postvoid residual (PVR) volume of 150mL of urine?

Deficient detrusor contraction strength

Which mechanism would the nurse associate with the development of a patient's poststreptococcal glomerulonephritis?

Deposition of immune complexes and complement activation

Which type of lithotripsy is noninvasive but requires the patient to be anesthetized to ensure the same position is maintained throughout the procedure?

Extracorporeal shock-wave lithotripsy (ESWL)

Which prescribed medications would the nurse associate with the treatment of a patient reporting a full-bladder feeling and frequently leaking small amounts of urine during the day and night since they had a hemorrhoidectomy? Select all that apply.

Finasteride (Proscar) Bethanechol (Urecholine)

Which prescribed medication would the nurse expect to administer to a patient with a urinary tract infection (UTI) secondary to a fungal infection?

Fluconazole (Diflucan)

Which intervention is the nurse's priority when changing a patient's ileal conduit appliance?

Keep the skin free of urine.

Which risk factor would the nurse associate with the patient's development of urinary tract calculi?

Large intake of dietary proteins

Which medications are used to desensitize pain in the bladder wall? Select all that apply.

Lidocaine (Xylocaine) Dimethyl sulfoxide (DMSO) (Cryoserv)

Which instructions would the nurse provide when teaching nutritional therapy to a patient recovering from renal stones composed of calcium oxalate? Select all that apply

Limit consumption of colas. Consume at least 3 L of fluid daily. Limit intake of dried fruits and nuts.

Which therapeutic medical intervention would the nurse anticipate scheduling for a patient with renal calculi?

Lithotripsy

When teaching a patient and caregiver about strategies to prevent the recurrence of urinary tract infections, which instructions would the nurse include? Select all that apply.

Maintain an adequate fluid intake, daily. Urinate regularly, approximately every three to four hours during the day. Cleanse the perineal area with warm soapy water after each bowel movement

Which mediation would the nurse associate with treatment of a patient's voiding dysfunction by increasing the bladder's storage capacity?

Mirabegron (Myrbetriq)

When providing preprocedural instructions for a patient requiring anesthesia, which type of incontinence might the patient experience postoperatively?

Overflow incontinence

Which medication is beneficial when the patient with a lower urinary tract infection reports severe pain while urinating?

Phenazopyridine (Pyridium)

When teaching a patient about techniques to manage urinary incontinence, which instructions would the nurse to include? Select all that apply.

Practice timed voiding. Perform pelvic floor muscle training. Use incontinence protective pads.

Which situation places a patient at risk for developing a renal disorder that presents with fever, chills, flank pain, and costovertebral tenderness upon percussion?

Pregnancy-induced physiologic changes in the urinary system

For the patient who received a surgical intervention for involuntary passage of urine, which surgical procedure did the patient have when the nurse identified a bladder perforation postoperatively?

Pubovaginal sling placement

Which disorder includes the inflammation of renal parenchyma and the collecting system?

Pyelonephritis

Which medication would the nurse correlate with the treatment of a patient's frequent urine leakage of small amounts throughout the day and night, as well as a palpable and distended bladder upon assessment?

Tamsulosin (Flomax)

Which medications would the nurse associate with treatment of a patient's urethral sphincter resistance to urinary outflow? Select all that apply.

Terazosin (Hytrin) Doxazosin (Cardura)

For the patient who is unable to void urine, which strategies would the nurse implement to relieve the patient's urinary retention? Select all that apply.

The patient needs to sit in a tub of warm water. Teach the patient to drink small quantities of water frequently. Coach the patient to drink one cup of a warm beverage each day (tea or coffee).

Which factors would the nurse evaluate when preparing to administer the prescribed trimethoprim/sulfamethoxazole (TMP/SMX) treatment to a patient diagnosed with a urinary tract infection (UTI)? Select all that apply.

The patient will take this drug twice a day. E. coli is resistant to this combination of medications. The patient has an uncomplicated urinary tract infection.

Which diagnostic procedure would the nurse anticipate scheduling for a patient with a urinary tract infection, renal abscesses, and anatomic abnormalities?

Ultrasonography

For the patient at risk for ureter obstruction from edema while recovering from a lithotripsy procedure, which urinary drainage catheter would the nurse expect to identify and assess?

Ureteral catheter

In women, which disorder of the urinary system is caused by Trichomonas?

Urethritis

Which urinary disorder commonly occurs in Jewish men?

Uric acid stones

Which information would the nurse provide a patient experiencing an inflammation of the urethra? Select all that apply.

"Avoid sexual intercourse until the symptoms subside." "Take warm sitz baths to relieve bothersome symptoms." "Properly cleanse the perineal area after bowel movements and urinating."

To promote patient safety, which instructions would the nurse provide a patient with interstitial cystitis (IC)? Select all that apply.

"Continue the medications as prescribed." "Avoid clothing that creates suprapubic pressure." "Take the full course of antibiotics to ensure that bacteria have been eradicated."

Which patient statements indicate understanding of content related to self-management of urinary tract calculi? Select all that apply.

"I will most likely have pain upon urination." "I will likely have discomfort until the stone passes." "I will need to strain all urine until the stone has passed.

Which therapeutic response would the nurse use when a patient discovers the bladder cancer has spread to the liver and lungs, begins to cry, and states, "I'm tired of the constant pain and being a burden to my daughter. I'm so scared and do not want to live like this, would you?"

"I'm hearing you say that you feel helpless and afraid. Can you tell me more about how this makes you feel?"

Which medication is the only oral agent approved for the treatment of interstitial cystitis?

Pentosan (Elmiron)

Which information in the patient's chart would the nurse need to correct before completing the written discharge instructions for a patient with urethritis?

Use vaginal deodorant sprays

Which medication would the nurse associate with treatment of a patient's fever, chills, pain while urinating, and urgency, as well as the presence of blood and bacteria identified on the patient's urinalysis report?

Vancomycin (Vancocin)

Which medications would the nurse associate with the patient with interstitial cystitis and complaining of a burning pain within the bladder? Select all that apply.

Verapamil (Calan) Diltiazem (Cardizem) Imipramine (Tofranil)

Which evidence-based practice guidelines would the nurse implement when striving to prevent hospital-acquired urinary tract infections (UTIs)? Select all that apply.

Avoid unnecessary catheterization. Wash hands before and after contact with each patient. Perform routine and thorough perineal hygiene for all hospitalized patients.

Which prescribed medication would the nurse associate with the patient who smokes one pack of cigarettes each day and has a history of a cough, bilateral crackles, and hematuria?

Azathioprine (Imuran)

When asked to explain the potential cause of a patient's urge incontinence, which disorders would the nurse recall? Select all that apply.

Brain tumor Carcinoma in situ

When providing care for a patient with polycystic kidney disease (PKD), the nurse would assess for the presence of which serious complication of the disease?

Cerebral aneurysm

Which clinical manifestations would the nurse associate with acute pyelonephritis?

Chills and flank pain

When preparing discharge instructions, which renal problem would the nurse associate with the patient's scleroderma and subsequent hypertension?

Chronic glomerulonephritis

Escherichia coli is resistant to which medications? Select all that apply.

Ciprofloxacin (Cipro) Trimethoprim (Primsol) Sulfamethoxazole (Gantanol)

When developing the plan of care for a patient with a bladder outlet obstruction, which common cause would the nurse associate with this disorder?

Enlarged prostate

Which essential nursing assessments would the nurse perform when providing care for a patient hospitalized with nephrotic syndrome?

Daily weights and measurement of the patient's abdominal girth

When assessing an older male patient who reports burning on urination and "foul-smelling" urine, the health care provider would suspect that which clinical manifestation placed the patient at risk for developing a urinary tract infection (UTI)?

Development of benign prostatic hyperplasia (BPH)

When providing discharge instructions for a patient with a β-hemolytic streptococcal infection, which potential complication would the nurse teach the patient regarding adherence to the aggressive treatment plan?

Glomerulonephritis

Which clinical manifestations would the nurse expect to document when admitting a patient with a urethral diverticulum? Select all that apply.

Gross hematuria Postvoid dribbling Urinary incontinence

Which predisposing factor would the nurse associate with the development of small renal calculi trapped within a patient's ureter?

Hyperoxaluria

Which clinical manifestations would the nurse expect to identify when assessing a patient hospitalized with glomerulonephritis? Select all that apply.

Hypertension

When providing care for a patient with glomerulonephritis, the nurse would monitor for the presence of which commonly recurring clinical manifestations?

Hypertension and edema

When other measures to treat a patient's severe and debilitating suprapubic pain, hesitancy, and incontinence from interstitial cystitis are unsuccessful, which procedure would the nurse anticipate integrating into a patient's plan of care?

Ileal conduit diversion

When teaching home care to the caregiver of a patient with a history of urinary calculi and limited mobility, which instructions would the nurse include? Select all that apply.

Monitor the patient's urinary output. Help the patient to assume a sitting position, if possible. Change the patient's position every two hours, around the clock.

Which bacteria would the nurse associate with a patient who presents with frequent urination, dysuria, low-grade fever, and fatigue, and who has a diagnosis of bacterial infection of the kidney?

Mycobacterium tuberculosis

Which clinical manifestations would the nurse use to determine the location of the urinary tract infection (UTI) when the male patient's urinalysis reported a high microorganism count? Select all that apply.

Pain location Urethral discharge

Which clinical manifestations would the nurse evaluate when a patient presents with lower abdominal discomfort and a suspected lower urinary tract infection? Select all that apply.

Pain while urinating Increased frequency of urination Feeling pressure within the suprapubic region

When providing postoperative care for a patient recovering from pelvic surgery, the nurse would monitor for the development of which potential complications? Select all that apply.

Paralytic ileus Thrombophlebitis Small bowel obstruction

For the patient with bilateral ureteral obstructions, which precautions would the nurse implement when implementing prescribed irrigations via a newly placed nephrostomy tube? Select all that apply.

Perform irrigations utilizing strict aseptic precautions. Assess for patency and do not kink, compress, or clamp the catheter. Assess the patient for any complaints of excessive pain in the affected area.

Which prescribed medication would the nurse expect to administer to a patient reporting painful urination secondary to bladder tumors?

Phenazopyridine (Pyridium)

Which medical interventions would the nurse associate with the treatment plan of a patient presenting with hematuria, flank pain, and a palpable abdominal mass? Select all that apply.

Radical nephrectomy Radiofrequency ablation

Which diagnostic study would the health care provider prescribe to detect metastases of cancer from renal tumors?

Radionuclide isotope scanning

Which nursing interventions would the nurse implement when providing postoperative care for a patient who experienced a nephrectomy secondary to a renal tumor? Select all that apply.

Record urine output. Weigh the patient daily. Monitor abdominal distention Provide adequate pain relief through analgesics.

Which complications would the nurse expect to identify when assessing a patient who overdosed on tolterodine (Detrol) therapy for urge incontinence? Select all that apply.

Reduced diaphoresis Blurred vision Gastrointestinal cramping

Which patient statements indicate an understanding of self-management techniques in reducing the incidence of overflow incontinence? Select all that apply.

Regular bowel movements and avoiding constipation will help me to dribble less." "These Kegel exercises feel funny, but I'll be glad when I can control my pelvic floor muscles." "By practicing the Valsalva maneuver, I should be able to empty my bladder more completely."

When admitting a patient with fibromuscular hyperplasia and suspected partial obstruction of the left renal artery, which prescribed diagnostic tool would the nurse anticipate preparing the patient to obtain a definitive diagnosis?

Renal arteriogram

Which disorder would the nurse associate with the underlying cause of a patient's renal vein thrombosis?

Renal cell cancer

Which instructions would the nurse provide a patient with nephrotic syndrome, when teaching interventions to manage renal disorder? Select all that apply.

Restrict dietary salt intake. Clean edematous skin carefully. Avoid exposure to infected persons.

Which assessment finding would the nurse question after reviewing the electronic medical record of a patient who has acute pyelonephritis?

Right lower quadrant rebound tenderness

The nurse would determine patient understanding of the dietary requirements associated with their nephrotic syndrome when the patient selects which food items?

Salad made of fresh vegetables

Which immune diseases cause glomerulonephritis? Select all that apply.

Scleroderma Goodpasture syndrome Systemic lupus erythematosus (SLE)

When performing a physical examination on a patient suspected of having urinary tract calculi, the nurse would associate the presence of which clinical manifestation with the suspected diagnosis?

Sharp pain in the flanks

Which surgical procedure would the nurse associate as treatment for a patient who has frequent urination, accidental loss of urine, and dyspareunia?

Spence procedure

When managing a patient's urinary calculi, which stone characteristics and standardized criteria would indicate the need for the health care provider to perform a lithotripsy? Select all that apply.

Stones that are 9 mm in diameter Stones causing impaired renal function Stones associated with symptomatic infection

For a patient with obstructing urinary calculi, which interventions to ensure treatment effectiveness and patient safety would the nurse implement after noting the patient received tamsulosin (Flomax) and opioids to relieve colic pain in the emergency room? Select all that apply.

Strain all urine voided by the patient. Avoid letting the patient ambulate unattended. Encourage the patient to change positions and move frequently

Which information included in a patient's electronic medical record would increase the patient's risk for glomerulonephritis?

Streptococcal sore throat

Which term would the nurse use to explain a patient's complaints of urinary incontinence while coughing or sneezing to the patient and their caregiver?

Stress incontinence

When assessing a patient with bladder cancer, which procedural factors would the nurse associate with the need for this patient to have scheduled a radical cystectomy? Select all that apply.

The tumor is invasive. The tumor involves the trigone. Metastasis does not go beyond the bladder area.

Which role would the registered nurse (RN) have when a patient requires insertion of a urinary catheter?

To choose the appropriate type and size of catheter

When providing care for a patient with urinary incontinence (UI), which rationale supports the nursing intervention of inserting a urethral plug into the patient's urethra?

To mechanically obstruct urine leakage

When developing a patient's plan of care, which potential complications would the nurse associate with intermittent bladder catheterization? Select all that apply.

Urethritis Urethral stricture Creation of false passage

Which surgical procedure would the nurse associate with the treatment of a patient's obstructive urethral stricture?

Urethroplasty

When developing the plan of care for a patient with interstitial cystitis, which type of urinary incontinence (UI) would influence the nursing interventions?

Urge incontinence

Which diagnostic assessment reports would the nurse review when preparing to provide care for a patient with acute pyelonephritis? Select all that apply.

Urinalysis with urine culture and sensitivity CT scan of kidneys Complete blood count (CBC) and differential white blood cell (WBC) count

After notifying the health care provider, which prescribed intervention would the nurse implement when providing care for a patient whose nephrostomy tube is not draining?

Use 5 mL of sterile saline to irrigate the affected tube.

Which interventions would the nurse implement when providing care for a patient with a ureteral catheter? Select all that apply.

Verify placement and patency of the catheter frequently. Check drainage amounts and characteristics every one to two hours.

Which clinical manifestations would the nurse assessing a patient with renal calculi expect to identify?

Vomiting and flank pain

Which interventions would the nurse implement when providing care for a patient with nephrotic syndrome? Select all that apply

Weigh the patient daily, in a consistent manner. Avoid exposure to people with known infections. Instruct the patient to consume a low-sodium, moderate-protein diet.

When teaching a female patient measures to prevent recurrent urinary tract infection (UTI), which instructions would the nurse include? Select all that apply.

Wipe the perineal area from front to back after urinating. Empty the bladder before and after sexual intercourse. Cleanse with warm soapy water after each bowel movement.

Which question has the most importance when the nurse admits a patient with a diagnosis of acute glomerulonephritis?

"Have you recently had strep throat?"

When assessing the cognitive-perceptual pattern during a health history interview, which questions would the nurse ask the patient diagnosed with renal calculi? Select all that apply.

"Do you experience pain in your genitalia?" "Do you experience colicky pain in your abdomen?"

Which instructions would the nurse provide the patient who has a diagnosis of acute pyelonephritis? Select all that apply.

"Drink at least eight glasses of fluid every day." "Take the full course of antibiotics to ensure that the bacteria are eradicated."

Which medication would the nurse expect to explain and administer to the patient with type 2 diabetes mellitus who has developed a second urinary tract infection (UTI) within one month of the previous infection?

Ciprofloxacin (Cipro)

When collecting a urine sample for analysis and a culture with sensitivity (C&S) from a patient admitted with suprapubic pain and dysuria, which instruction would the nurse provide the patient?

Clean your periurethral area, begin voiding, and then catch a sample of your urine.

When teaching prevention of urinary tract infections (UTIs) to a group living in a retirement village, one individual asks how much fluid should be drunk each day. When considering the fluid obtained from food and the patient weighs 140 pounds (63.6 kg), how many ounces of fluid would this patient need to drink each day? Fill in the blank using a whole number. __ ounces

56 (Divide the weight in pounds by 2, then multiply this number by 80% because 20% of a person's fluid is obtained from food. So, 140/2 = 70, 70 x.80 = 56 ounces to be drunk each day, or seven 8-ounce glasses of water.)

Which treatment plan would the nurse anticipate teaching a patient who reports accidental urine loss, urgency, and increased nocturnal frequency; and the health care provider infers the condition is due to an overactive detrusor muscle?

Containment devices

Which instruction would the nurse verify for patient understanding prior to their discharge home with a renal calculus?

Continue to strain all urine at home for stones.

Which questions would the nurse ask when assessing the patient's risk for developing urinary tract infections (UTIs)? Select all that apply.

Do you hold your urine for long periods of time?" "Do you have a recent history of urinary calculi or stones?" "Have you had any condition that required urinary catheterization?"

Which organism would the nurse present as the primary cause of health care-associated urinary tract infections (UTIs) when providing evidenced-based practice guidelines for the nursing staff?

Escherichia coli

Which term would the nurse use to document a patient's involuntary or accidental urine loss?

Incontinence

For the patient scheduled for a lithotripsy procedure to remove renal calculi, which postoperative care instructions would the nurse provide prior to the procedure? Select all that apply.

Initially, your urine will be a bright-red color. You will need to take antibiotics per the prescription.

Which disorder would the nurse associate with a patient's clinical manifestations of urgency, urinating approximately 10 times within a 24-hour period, and eliminating 150 mL per void?

Interstitial cystitis

Which prescribed device would the nurse explain when providing care for a patient diagnosed with minor pelvic organ prolapse?

Intravaginal support device

Which antiincontinence device would the nurse discuss with a patient experiencing minor pelvic organ prolapse?

Intravaginal support devices

Which potential strategy would the nurse discuss with the patient regarding a medical history of prostate cancer surgery and stating, "I involuntarily pass urine while coughing, laughing, and sneezing"?

Pelvic floor muscle exercises

Based on the assessment findings listed below, which information would be symptomatic of a urinary stone?

Renal colic

For the patient recovering from a retropubic colposuspension procedure, for which potential complication would the nurse monitor the patient?

Vaginal prolapse