Hinkle Ch 55

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease?

Incontinence

Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

Kidney

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?

Pyridium The urinary analgesic agent phenazopyridine (Pyridium) is used specifically for relief of burning, pain, and other symptoms associated with UTI.

Which laboratory value supports a diagnosis of pyelonephritis?

Pyuria

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

"Make sure to eat enough fiber to prevent constipation."

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

Cipro

The nurse is educating a patient who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection?

Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.

Which of the following is a cause of a calcium renal stone?

Excessive intake of vitamin D

Which metabolic defects are associated with stone formation?

Hyperparathyroidism

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

Low purine

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:

Loss of motor control of the detrusor muscle. Spinal cord injury patients commonly experience reflex incontinence because they lack neurologically mediated motor control of the detrusor and the sensory awareness of the urge to void. These patients also experience hyperreflexia in the absence of normal sensations associated with voiding.

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?

Maintain skin and stoma integrity

A client with a history of chronic cystitis comes to an outpatient clinic with signs and symptoms of this disorder. To prevent cystitis from recurring, the nurse recommends maintaining an acid-ash diet to acidify the urine, thereby decreasing the rate of bacterial multiplication. On an acid-ash diet, the client must restrict which beverage?

Milk

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

painless hematuria

Which is the procedure of choice for men with recurrent or complicated UTIs?

Transrectal ultrasonography

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?

Uric Acid

Which characteristic is seen with a healthy stoma?

pink stoma

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

Assessing present voiding patterns The guidelines for initiating bladder retraining include assessing the client's present intake patterns, voiding patterns, and reasons for each accidental voiding. Lowering the client's fluid intake won't reduce or prevent incontinence. The client should be encouraged to drink 1.5 to 2 L of water per day. A voiding schedule should be established after assessment.

The nurse caring for a client with a urinary diversion notices mucus around the stents and in the client's urine. Which is the appropriate nursing intervention?

Document presence of mucus in the urine. The nurse should document the presence of mucus in the urine, as this is a normal finding in urinary diversions.

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Acute pain Ureterolithiasis typically causes such acute, severe pain that the client can't rest and becomes increasingly anxious. Therefore, the nursing diagnosis of Acute pain takes highest priority.

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include?

Implement a 2- to 3-hour voiding schedule

Which of the following is classified as a upper urinary tract infection (UTI)? Select all that apply.

Acute pyelonephritis Renal abscess

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?

Change in cognitive functioning The most common objective finding is a change in cognitive functioning, especially in those with dementia; these clients usually exhibit even more profound cognitive changes with the onset of a UTI.

Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor?

Eat plenty of cheese and eggs. To help control odor, the client should use pouches with carbon filters or other odor barriers or add a few drops of liquid deodorizer or diluted white vinegar to the pouch. Foods such as cranberry juice, yogurt or buttermilk may help to decrease odor while foods such as asparagus, cheese, and eggs may impart an odor to the urine.

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

Peritonitis Clinical manifestations of peritonitis include abdominal pain and distention, absence of bowel sounds, nausea and vomiting, fever, changes in vital signs.

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

Permanent drainage with a urethral catheter Permanent drainage with a urethral catheter carries the greatest risk. It may also increase the risk for bladder stones, renal diseases, bladder infections, and urosepsis, a severe systemic infection by microorganisms in the urinary tract invading the bloodstream. Clean intermittent catheterization has the fewest complications and is the preferred treatment for urinary retention. The Credé voiding procedure is used in the case of clients who have lost control over their nervous systems, secondary to injury or disease.

A female patient visits her primary health care provider with a complaint of frequency of urination and incontinence when she sneezes. The health care provider suspects the patient is experiencing cystitis. The nurse knows that this is most likely due to which of the following?

Reflux of urine from the urethra into the bladder With urethrovesical reflux, coughing, sneezing, or straining causes the bladder pressure to increase, which may force urine from the bladder into the urethra. When the pressure returns to normal, the urine flows back into the bladder, bringing into the bladder bacteria from the anterior portions of the urethra.

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

Risk for infection Percutaneous nephrolithotomy is an invasive procedure for the removal of renal calculi. The client would be at risk for infection.