Porth Patho CH 27
A nurse is caring for a patient in spinal shock. Which of the following interventions is appropriate in relation to the patient's urinary status?
Perform intermittent catheterization
Which clients have an increased risk for developing UTIs? A client who is or is diagnosed with: Select all that apply.
Elderly Prostate disease Neurogenic disorders Urinary obstruction
The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which of the following statements?
"Alterations in bladder function can only occur when there is incontinence."
A 24 year-old man is currently in a rehabilitation facility following a spinal cord injury at level T2. He is discussing his long term options for continence management. Which of the following statements by the client demonstrates he has a clear understanding of the issue?
"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."
The nursing instructor who is teaching about incontinence in the elderly recognizes a need for further instruction when one of the students makes which of the following statements?
"Frequency is not a major problem for the elderly."
A patient has a postvoid residual (PVR) volume of 40 mL. Which of the following information would the nurse teach the patient?
"This is a normal value."
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?
Administration of a-adrenergic agonistic drugs as ordered
A client who is suspected of having acute renal failure would first be assessed by which of the following blood tests? Select all that apply.
Blood urea nitrogen Creatinine
Which of the following accurately describes the etiology of stress incontinence?
An increase in intra-abdominal pressure which results in involuntary urination
A nurse is assessing a patient with suspected urine retention. Which of the following assessments help to confirm this diagnosis? Select all that apply.
Bladder distension Hesitancy Straining when initiating urination Frequency
A nurse correctly identifies which of the following to be approved treatments for a client who is admitted with a diagnosis of neurogenic bladder? Select all that apply.
Catheterization Bladder training Meds to manipulate bladder function Surgery
The nurse is conducting pre-operative teaching for a patient with bladder cancer who is scheduled to undergo surgical creation of an alternative bladder reservoir. The nurse determines that the patient is understanding the pre-operative teaching when the patient identifies the surgical treatment as which of the following?
Cystectomy
The nurse is caring for a patient with a sacral cord injury that resulted in loss of the perception of bladder fullness and loss of voluntary urination. When planning care for the patient, the nurse should include nursing interventions for which of the following?
Flaccid bladder dysfunction
The nurse is teaching a client about the different treatments used with bladder cancer. Which type of therapy does she inform the client can be done by instilling directly into the bladder?
Immunotherapuetic agents
A nurse is caring for a patient admitted for chemotherapy due to bladder cancer. Which route would the nurse anticipate that the chemotherapy will be administered when the goal is to minimize systemic side effects?
Intravesical
The nursing students are studying about common causes of congenital obstructions in the lower urinary tract. Which of the following do they correctly identify as sites of congenital obstruction? Select all that apply.
Meatal stenosis in boys Damage to sacral nerves Just inside the external urinary meatus in girls
A patient is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which of the following assessment data obtained by the nurse would indicate that the patient should be screened for this disease?
Patient reports that he occasionally has blood in his urine but has no pain with it.
A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises, because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?
Stress incontinence
A patient is describing difficulty with urinating and informs the nurse that every time she coughs or laughs, she urinates and has begun to wear a thin pad. Which of the following types of urinary incontinence is the patient describing?
Stress incontinence
An older adult states that he awakens at least three times each night to void. When assessing the client, what potential causative factor should the nurse prioritize?
The client takes his prescribed beta blocker and diuretic each evening at bedtime.
Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?
The stretch receptors in the bladder wall become hypersensitive.
A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:
Urge incontinence
The nurse understands that medications although very beneficial to clients can also have harmful effects. When working with elderly clients the nurse should recognize which of the following is a common result of potent, fast-acting diuretics?
Urge incontinence
The nursing instructor, while teaching about incontinence in older adults, informs the students that which of the following is true?
Urinary incontinence is a common problem in older adults, both male and female.
Which of the following clinical manifestations would tell a nurse that a patient is having progressive decompensation related to obstruction of urinary outflow?
When tested for residual urine volume, 1400 mL of urine is obtained when patient is catheterized.
