Urinary Elimination

A patient reports signs and symptoms associated with urge incontinence. Which action should the nurse teach the patient to employ to gain better bladder control?

. 2. Avoid products with caffeine.

nurse is caring for a 3-week-old infant. Which assessments regarding the number of diapers the infant soils daily should cause concern?

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A nurse is caring for an older adult female who says, "Why am I always getting bladder infections?" Which response by the nurse is most appropriate?

1. "Women have a shorter urethra than men do, and that makes women more susceptible than men to bladder infections."

While all of the following clinical manifestations are important to report to a primary health-care provider, which is most important?

1. Anuria

A nurse is caring for a patient with a diagnosis of UTI. Which clinical indicators identified during a nursing assessment support the medical diagnosis? Select all that apply.

1. Dysuria 2. Hematuria 4. Urgent sensation to void

A patient with a history of urinary tract infections asks the nurse for suggestions to limit their occurrence. Which should the nurse encourage the patient to ingest to inhibit the growth of microorganisms that can cause a bladder infection? Select all that apply.

1. Eggs 2. Meats 4. Cranberry juice 5. Whole-grain breads

. A home-care nurse is caring for a cognitively intact woman who has arthritis that affects her hands and slows her mobility. The patient tells the nurse about having a few episodes of urinary incontinence that were upsetting. The nurse identifies that the patient is experiencing functional incontinence. Which nursing interventions in the plan of care are specific to limiting episodes of incontinence in this patient? Select all that apply.

1. Encourage wearing clothing with Velcro closures instead of buttons and zippers. 2. Suggest purchasing a lift chair if economics permit 4. Teach to position a commode nearby. 6. Suggest voiding every 2 hours.

. A primary health-care provider orders a 24-hour urine test. Which actions should be implemented by the nurse when conducting this test? Select all that apply

1. Have the patient void one last time at the end of the 24 hours and add it to the volume being collected. 4. Discard the first voiding and then collect the urine for the next 24 hours. 5. Store the collected urine for 24 hours in a large collection container.

A nurse is caring for a patient who has an indwelling urinary catheter. Which nursing actions are important to include in this patient's plan of care? Select all that apply.

1. Obtain the vital signs routinely. 2. Cleanse the perineal area several times a day. 3. Monitor the tubing for kinks and obstructions. 4. Assess the urine for color, cloudiness, and volume.

A nurse is caring for a patient with an indwelling urinary retention catheter. The primary health-care provider orders a urine specimen for culture and sensitivity. What should the nurse do when collecting this specimen?

1. Place the urine specimen in a sterile urine container.

A patient's specific gravity is 1.032. For what additional clinical indicators should the nurse assess the patient? Select all that apply

1. Presence of thirst 3. Decreased skin turgor 4. Rapid, weak pulse rate

. A nurse is caring for a group of patients with a variety of urinary retention catheters. Which of the following nursing interventions are common to all types of urinary catheters? Select all that apply

1. Provide perineal care three times a day and whenever necessary. 2. Position the collection container below the level of the pelvis. 4. Hang the collection bag on the bed frame.

. A nurse is caring for a patient who has a urinary retention catheter. The primary health-care provider orders a urine culture and sensitivity. Which step ensures that the collected specimen is sterile?

1. Swab the specimen port with an antiseptic swab.

A nurse is caring for a patient who is scheduled for a cystoscopy. Which information should the nurse include when teaching the patient about what to expect after the procedure?

1. Urinary retention may occur after the procedure due to urethral edema.

A hospitalized 70-year-old adult has a computed tomography (CT) scan with contrast at 11 a.m. The patient has an IV running at 125 mL per hour and ingested 50 percent of lunch with a cup of coffee and 4 oz of soup at 12 noon. The nurse is going on a break at 1 p.m. and provides the following information to the nurse accepting responsibility for the patient. Which information about the patient is of most concern to the nurse accepting responsibility for the patient?

1. Urine output - 100 mL

Which of the following is essential to ensure reliable bedside dipstick testing of urine? Select all that apply

1. Use the correct reagent. 2. Ensure adequate lighting. 3. Ensure that the kit is not past the expiration date.

A nurse identifies that a patient may be experiencing urinary retention. Which clinical indicators support this inference? Select all that apply.

1. Voiding small amounts of urine several times hourly 2. Abdominal palpation indicating bladder distention 3. Tenderness over the symphysis pubis on palpation

. Place these interventions in the order that they should be performed when collecting a urine specimen from an infant.

1. Wash the hands and don clean gloves. 3. Wash the genital area and allow the area to dry. 2. Apply a collection device over the genitals. 4. Remove the collection bag once the infant urinates. 5. Send the entire bag in a specimen container to the laboratory.

. A nurse is caring for a patient who is having urine collected for a 24-hour urine test. During the afternoon of the testing period, the patient forgets and accidentally voids into the toilet but tells the nurse right away. What should the nurse do?

2. Identify the time and begin a new test.

A nurse is caring for a patient receiving continuous bladder irrigation (CBI). Which nursing action is essential when caring for this patient?

2. Increase the irrigation solution flow rate until the return flow is pink and free from clots.

A postoperative patient has an indwelling catheter that has not drained urine in 3 hours. What should the nurse do first?

2. Milk the tubing to dislodge any mucus or sediment in the catheter.

A nurse is caring for an older adult who is receiving oxybutynin (Ditropan) to reduce the occurrence of bladder spasms related to a UTI. For which side effect should the nurse assess the patient?

2. Palpitations

A nurse is caring for a group of patients. Which patient should cause the most concern about potential urinary retention?

2. The patient who just had a retention catheter removed

. A nurse is to perform a onetime bladder catheterization. The nurse verifies the primary health-care provider's order, washes the hands, and identifies the patient. Place the following steps of the procedure in the order in which they should be performed.

3. Assess the patient for a latex allergy. 4. Unwrap the catheter kit creating a sterile field. 1. Don sterile gloves. 6. Clean the urethral meatus with the solution. provided in the kit. 2. Lubricate the catheter tip. 5. Advance the catheter 1 inch after urine begins to flow.

A nurse is assessing a patient with the diagnosis of urinary tract infection (UTI). Which clinical indicator identified by the nurse supports this medical diagnosis?

3. Cloudy urine

. A nurse is caring for a postoperative patient with a urinary retention catheter. The nurse reviews the surgeon's orders, reviews the last nursing progress note, and performs a physical assessment of the patient. Which action should the nurse perform first?

3. Empty the patient's urine collection chamber hourly.

Which nursing intervention is most effective when assisting a patient to completely empty the bladder?

3. Encourage the patient to attempt to double void.

A nurse is caring for a patient with a history of experiencing residual urine after voiding. The nurse uses a bladder ultrasound scanner (BUS) to detect the amount of urine that remains in the bladder after the patient voids. What action should the nurse implement that is essential to this test?

3. Explain that no discomfort will be experienced as the transducer is moved on the surface of the skin.

A patient has urinary retention and the primary health-care provider orders a straight catheterization. The draining volume reaches 750 mL without completely emptying the bladder. What alternative does the nurse have to help prevent bladder spasms?

3. Release the remaining urine in the bladder slowly over 20 minutes.

A nurse is assessing a patient and is concerned that the patient may be experiencing urinary retention. Which clinical indicators support this conclusion? Select all that apply.

3. Reports of abdominal pressure 4. Lower abdominal distention on palpation 5. Voiding small amounts of urine at a time

A nurse receives an order to initiate continuous bladder irrigation. Which catheter should the nurse choose to perform the procedure correctly?

3. Triple-lumen catheter

A patient is scheduled for thoracic surgery and is told by the surgeon that after surgery a catheter will be placed in the bladder. After the surgeon leaves, the patient asks the nurse, "Why am I going to have a tube in my bladder when I am having surgery in my chest?" Which response by the nurse is most appropriate?

4. "Hourly urine production is monitored with a urinary catheter. It is an effective way to assess kidney and circulatory function."

A patient reports concern about not having urinated in several hours. The patient reports the sensation of the need to void and has moderate abdominal distention. What should the nurse do first?

4. Have the patient assume an upright position for voiding.

A nurse is obtaining a health history from a patient. The patient states that she is embarrassed about episodes of incontinence when she sneezes or exercises and that she no longer attends an exercise program for this reason. She now walks several miles a day to lose the 50 lb she gained when pregnant with her fifth child. Based on this information, which nursing intervention will best help the patient to address the underlying cause of her lack of urine control?

4. Teach the patient Kegel exercises.

A nurse is caring for a female patient who has a history of frequent urinary tract infections. What should the nurse teach the patient to do?

4. Urinate when the urge to urinate is perceived.

A nurse is assisting a female patient who is experiencing numerous daily episodes of urge incontinence to gain better bladder control. Which outcome reflects achievement of a goal associated with this patient's urge incontinence?

4. Uses deep, slow breathing until the sensation to void subsides, increasing intervals between voiding.

A nurse is caring for a 75-year-old male patient with an indwelling catheter. The nurse identifies that the patient has had no additional urine in the bag over a 2-hour period. Place the nurse's actions in the order in which they should be performed

5. Milk the patient's catheter 4. Palpate over the patient's bladder. 3. Encourage the patient to drink fluids. 2. Continue to assess the patient over the next hour. 1. Obtain an order to irrigate the patient's catheter.

A nurse is applying a condom urinary catheter. Place the following steps in the order in which they should be implemented.

6. Provide perineal care and dry thoroughly. 1. Hold the penis and place the catheter beyond the glans, leaving at least a 1-inch space at the tip of the penis. 2. Unroll the condom along the full length of the shaft of the penis. 4. Secure the condom with gentle compression. 3. Wrap the external adhesive strip in a spiral along the shaft. 5. Hang the collection bag from the bed frame.

primary health-care provider prescribes nitrofurantoin (Macrodantin) 100 mg twice a day by mouth for a patient with a urinary tract infection. The pharmacy sends up unit dose packages labeled 25 mg per capsule. The primary nurse on the 12-hour day shift checks the medication drawer to ensure that there are enough capsules for the next 24 hours. How many tablets should be available for disbursement to the patient?

8 capsules

A patient has a urinary retention catheter in place. The nurse must obtain a sterile urine specimen for culture and sensitivity. Where should the nurse place the clamp to allow urine to collect in the tubing so that the nurse can collect a specimen?

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