urinary elimination

The experienced nurse is observing a new nurse who is preparing to catheterize a 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."

Three days after surgery for breast reconstruction, 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(s)? 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.

urological stent

-relieve obstructions and provide a path for the flow of urine -commonly inserted during a cystoscopic procedure &in most cases the patient receives only a local anesthetic &sedation -temporary or permanent

Specific Gravity of Urine

1.010 - 1.030 Higher the number, the dryer the person

The nurse has an order to obtain a urine specimen from a hospitalized client with an indwelling catheter. Which supply(ies) will the nurse gather? Select all that apply.

10-ml (milliliter) syringe sterile gloves sterile specimen container antiseptic swab

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine?

24-hour specimen

anuria

<50 mL/day

straight catheter

A straight tube inserted to drain urine then immediately removed

retention catheter

A type of urinary catheter that remains in place. Also called an indwelling or Foley catheter.

A nurse is working primarily with older adult clients. Which lifespan considerations should the nurse keep in mind when working with this population? Select all that apply. a. Older men may experience urinary hesitancy and difficulty starting the urinary stream. ​ b. Older adults may try to manage incontinence by restricting intake of fluids. ​ c. Because of decreased arterial perfusion, kidney function progressively decreases later in life. ​ d. Urinary incontinence is a normal part of aging.

ABC

A nurse in the emergency room is teaching a patient how to collect a midstream urine specimen. What instructions will the nurse give the patient? Select all that apply. a. Wash your hands with soap and water. b. Open the container and place the lid face down on the counter. c. Separate your labia and wipe with the antiseptic towelettes in the kit. d. Without letting go of the labia, void a small amount into the toilet or collection hat. e. Lean the collection container against the urinary opening and void into the container. f. Void an ounce, then remove the container and finish voiding in the toilet.

ACDE

A nurse caring for older adults in an extended-care facility performs regular assessments of the patients' urinary functioning. Which patients would the nurse identify as at risk for urinary retention? Select all that apply. a. Patient who is diagnosed with an enlarged prostate b.Patient who is on bedrest c. Patient who is diagnosed with vaginal prolapse d. Older adult patient with dementia e. Patient who is taking antihistamines to treat allergies f. Patient who has difficulty walking to the bathroom

ACE

A nurse in the gynecology clinic is preparing an educational brochure to teach patients how to prevent UTIs. Which teaching points would the nurse include? Select all that apply. a. Wear underwear with a cotton crotch. b. Take baths rather than showers. c. Drink of six to eight 8-oz glasses of liquid per day. d. Urinate before and after intercourse. e. After defecation, dry the perineal area from the front to the back. f. Observe the urine for color, amount, odor, and frequency.

ACEF

A nurse is caring for a male patient who had a urinary sheath applied following hip surgery. What nursing interventions are appropriate to include when caring for this patient? Select all that apply. a. Preventing the tubing from kinking to maintain free urinary drainage b. Changing the sheath weekly and provide hygiene c. Fastening the sheath tightly to prevent the possibility of leakage d. Having the patient maintain bedrest to prevent the sheath from slipping off e. Leaving 1 to 2 inches (2.5 to 5 cm) beyond the tip of the penis f. Ensuring the device does not restrict blood flow.

AEF

A urinary catheter has been placed in a client with a bladder neck obstruction that led to urinary retention. Which intervention will the nurse prioritize to minimize the client's risk for catheter-associated urinary tract infection (CAUTI)?

Advocate for removal of the catheter as soon as it becomes unnecessary.

The health care provider has prescribed an indwelling catheter for a client. When the nurse explains the procedure, the client refuses to allow placement of the catheter. Which action should the nurse take next?

Ask the client why they do not want a catheter.

The nurse is caring for a client who has a history of acute kidney injury. 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.

A nurse on a pediatric surgical unit notes a 10-year-old child has developed nocturnal enuresis. What health concern will the nurse plan for? a. Constipation b. Bedwetting after the age of toilet training c. Patient who is manipulative d. Infection

B

A nurse receives a prescription to catheterize a patient following surgery. What nursing action reflects correct technique? a. Planning to use different equipment for catheterization of male versus female patients b. Selecting the smallest appropriate size indwelling urinary catheter c. Sterilizing the equipment prior to insertion d. Avoiding filling the balloon with sterile water to prevent pressure on tissues

B

A nursing student hears in report that their patient is receiving a nephrotoxic medication. The student plans care to include what action? a. Teaching the patient to expect increased voiding b. Assessing for kidney damage c. Preventing urinary incontinence d. Observing for nocturia

B

9. Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis?​Select all that apply.​​ a) aundice and flank pain ​ ​ b) Costovertebral angle tenderness and fever​ ​ c) Malaise and burning sensation on urination​ ​ d) Polyuria and nocturia​

B, C

The nurse is caring for a female client with frequent urinary tract infections (UTIs). What does the nurse include in the client's teaching plan to decrease the incidence of UTIs?

Be sure to urinate after you have sexual intercourse.

A nurse is caring for an alert, ambulatory, older adult with urinary frequency who has difficulty making it to the bathroom in time. Which nursing intervention is most appropriate to include in the care plan for this patient? a. Explaining that incontinence is an expected occurrence with aging b. Asking the patient's family/caregivers to purchase incontinence pads for the patient c. Teaching the patient how to perform PFMT exercises at regular intervals d. Inserting an indwelling catheter to prevent skin breakdown

C. Pelvic floor exercise may help a patient regain control of the micturition. incontinence is not a normal consequence of aging

A client is preparing to give a clean-catch urine specimen. Which instruction will the nurse provide?

Collect the sample after allowing initial urine to flow into the toilet.

The UAP reports that a client on furosemide has voided 4000 mL in a 24-hour period. What is the appropriate nursing action?

Contact the health care provider to decrease furosemide. Voiding over 3000 mL/day is considered abnormal.

A nurse has been asked to speak about health promotion topics for a group of women older than 40 years of age. The nurse states that exercises may help with urinary urgency. Which exercise instruction will the nurse provide to the group?

Contract the pubic muscles for 3 seconds, then relax.

An older adult client informs the nurse that they are experiencing urinary incontinence. The client has no other health problems, and states, "I don't want anybody to know about this problem." How will the nurse promote the client's self-esteem?

Discuss the use of protective undergarments to avoid embarrassment from incontinence.

The nurse is assessing a client with a urinary sheath catheter. After removing the catheter, the nurse observes a break in skin integrity on the penis. What actions by the nurse would be appropriate at this time? Select all that apply.

Do not reapply the urinary sheath Allow the skin to be open to air as much as possible Arrange for a consult with a wound nurse

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

What is an advantage of using an external condom catheter for a 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.

Which statement should the nurse convey to the parent of a 3-year-old male child who has not achieved urinary continence?

Male children may take longer for daytime continence than female children.

A client with an emergently placed central venous catheter (CVC) is to have emergent hemodialysis. Upon assessment of the CVC the nurse visualizes redness, drainage, and odor to the area around the CVC. Palpation of the surrounding skin causes the client pain. Which intervention is the priority?

Notifying the health care provider of the assessment findings

10. Which of the following is a recommended guideline when catheterizing the female urinary bladder? ​​​

Once urine drains, advance the catheter another 2 to 3 inches​ to ensure balloon is clear of the urethra​.

The client is preparing to obtain a clean-catch midstream urine specimen. Place in order the steps needed to complete the diagnostic test. Use all options.

Provide instruction to the client. Clean the area surrounding the urinary meatus with the provided cloth. Void a small amount into toilet or bedpan. Void into the provided collection device. Secure the lid on the specimen container. Submit collected specimen to the health care professional.

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

detrusor muscle

Smooth muscle that compresses the urinary bladder and expels urine into the urethra.

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.

A client's blood urea nitrogen (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.

The nurse is assessing a client with an older arteriovenous (AV) graft for hemodialysis access in the left arm. The client reports significant pain to the distal left arm. Capillary refill in the left hand is greater than 4 seconds. Which should the nurse assess before contacting the health care provider?

Thrill and bruit There is increased risk for the AV graft to clot and create a circulatory emergency

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.

potential complications of urinary catheterization?

UTI urethral injury allergy to latex hematuria

A nurse is caring for a client who has urinary incontinence associated with a flaccid neurogenic bladder. The nurse will implement in-and-out catheterization because the client has reflex urinary incontinence.

When the volume of urine reaches a certain point it overcomes the sphincter, this is known as reflex urinary incontinence.

The health care provider has ordered an indwelling catheter to be inserted to relieve urinary retention in a male patient with prostate enlargement. What consideration will the nurse keep in mind when performing this procedure? a. The male urethra is more vulnerable to injury during insertion. b. In the hospital, a clean technique is used for catheter insertion. c. The catheter is inserted 2 to 3 inches into the meatus. d. Since it uses a closed system, the risk for UTI is absent.

a

central venous catheter

a blood-vessel access device usually inserted into the subclavian or jugular vein with the distal tip resting in the superior vena cava just above the right atrium; used for long-term intravenous therapy or parenteral nutrition

24 hour specimen

a urine specimen consisting of all urine voided in a 24-hour period

A patient who has pneumonia has had a fever for 3 days. What characteristics would the nurse anticipate related to the patient's urine output? a. Decreased amount and highly concentrated b. Decreased amount and very pale like water c. Increased amount and very concentrated d. Increased amount and dilute appearing

a.

A nurse is caring for a patient who is taking phenazopyridine (a urinary tract analgesic) for a UTI. The patient states, "My urine was bright orange-red today; I think I'm bleeding. Something is terribly wrong." How will the nurse best respond? a. "The medication causes a red-orange tinge to the urine; it is expected." b. "I will test your urine for blood." c. "This may be the result of an injury to your bladder." d. "I'll hold the medication and let the provider know you are allergic to the drug."

a. Phenazopyridine, a urinary tract analgesic, can cause orange or orange-red urine;

A nurse caring for a patient who just began hemodialysis assesses the patient's AV fistula. Nursing documentation includes: "5/10/25 0930 AV fistula in the right forearm negative for thrill and bruit. Patient denies pain and tenderness." Which finding is essential for the nurse report to the health care provider? a. Thrill and bruit are absent. b. Area is without redness or swelling. c. Patient denies pain and tenderness. d. Trace edema of the fingers is present.

a. the nurse palpates and auscultates over the access site, feeling for a thrill or vibration and listening for the bruit or swishing sound. Presence of the thrill and bruit are normal findings, indicating patency of the access

diabetic nephropathy

accumulation of damage to the glomerulus capillaries due to the chronic high blood sugars of diabetes mellitus first sign in (albumin) protein in urine

A nurse is caring for a patient who has a urinary diversion (urostomy) after cystectomy (removal of the bladder) to treat bladder cancer. What interventions are indicated for this patient? Select all that apply. a. Measuring the patient's fluid intake and output b. Keeping the skin around the stoma moist c. Emptying the appliance frequently d. Reporting any mucus in the urine to the primary care provider e. Encouraging the patient to look away when changing the appliance f. Monitoring the return of intestinal function and peristalsis

acf

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

A 57-year-old client is suffering from polyuria. What can cause polyuria?

arginine vasopressin deficiency-D (central diabetes insipidus)

A postoperative patient is having difficulty voiding and reports suprapubic pressure. What action can the nurse take to promote voiding? a. Pouring cold water over the patient's fingers and perineum b. Assessing bladder residual using the bladder scanner c. Immediately encouraging the patient to void d. Recommending an indwelling catheter

b

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 nurse is caring for a patient with an enlarged prostate who has had an indwelling catheter for several weeks. A prescription for continuous bladder irrigation (CBI) is written after the patient developed hematuria post cystoscopy. The nurse teaches the patient the purpose of CBI is to prevent what situation? a. Catheter infection due to long-term use b. Need to flush the catheter of organisms post procedure c. Blood clots that could block the catheter d. Need for increased fluid intake

c

A client is reporting bladder urgency. Which will the nurse assess?

caffeine intake

For which client will the nurse plan interventions addressing a neurogenic bladder?

client recovering from a stroke Neurologic injury after a stroke or spinal cord injury can disrupt normal patterns of urinary elimination.

A client has burning upon urination. The urinalysis indicates pyuria. Which is the next action the nurse will take?

contact HCP

A nurse is changing the stoma appliance on a patient's ileal conduit. Which finding requires the nurse to follow up with the provider? a. Stoma is moist. b. Skin around the stoma is irritated. c. Urine is leaking from the stoma. d. Stoma is a purple-black color.

d

A new graduate nurse and their preceptor must collect several urine specimens for laboratory testing. Which techniques for urine collection by the graduate nurse are performed incorrectly, requiring the preceptor to intervene? Select all that apply. a. Catheterizing a patient to collect a sterile urine sample for routine urinalysis b. Collecting a clean-catch urine specimen in the morning and storing it at room temperature until an afternoon pick-up c. Collecting a sterile urine specimen from the collection bag of a patient's indwelling catheter d. Collecting about 3 mL of urine from a patient's indwelling catheter to send for a urine culture e. Planning to collect a sterile specimen from a patient with a urinary diversion by catheterizing the stoma f. Discarding the first urine of the day when performing a 24-hour urine specimen collection on a patient

d e f The graduate nurse incorrectly collects urine by taking a sample from an indwelling catheter for culture (D), catheterizing a patient with a urinary diversion (E), and discarding the first urine in a 24-hour collection (F).

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

The nurse is preparing to place a Foley catheter for a female client who will soon have surgery. Into what position will the nurse place the client?

dorsal recumbent

anticholinergics-

dry everything up

reflex incontinence

emptying of the bladder without the sensation of the need to void

catheter care

every 8 hrs

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 The first urine is usually more concentrated because the client does not usually consume fluid during the night and the effects of diet and activity are minimized.

A client reports that they are often unable to retain urine until they locate a toilet because their mobility is decreased. The nurse should recognize the characteristics of what type of incontinence?

functional

neurogenic bladder

impairment of bladder control due to brain or nerve conduction

suprapubic catheter

indwelling catheter inserted directly in the bladder through an abdominal incision above the pubic bone that includes a collection system that allows urine to be drained into a bag; used in patients requiring long-term catheterization

pyelonephritis

inflammation of renal pelvis and kidney; common type of kidney disease symptoms are pain in back and pain when peeing

cystitis

inflammation of the urinary bladder. It is often caused by infection and is usually accompanied by frequent, painful urination.

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 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 An intermittent urethral catheter (straight catheter) is a catheter inserted through the urethra into the bladder to drain urine for a short period of time (5 to 10 minutes).

The nurse has entered a client's room to empty the client's urine collection bag at the end of a busy shift. The nurse realizes that the client's urine output is 75 mL over the past 8 hours. The nurse would recognize that the client is experiencing:

oliguria

14. The nurse has entered a client's room to empty the client's urine collection bag at the end of a busy shift. The nurse realizes that the client's total urine output is 350 mL over the past 24 hours. The nurse would recognize that the client is experiencing:​​

oliguria <400 mL over 24 hrs

pyuria

pus in the urine

An older adult client tells the nurse that they have trouble controlling their urine. The client states, "The urine starts dripping even before I feel like I have to go." The nurse interprets this as:

reflex incontinence

uncircumcised patient

retract foreskin to clean

urge incontinence

state in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void

​ cholinergics-

stimulate detrusor muscle ie. more peeing

A 70-year-old client who has four children and six grandchildren states that they "wet" themself when they sneeze or laugh. They report that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate?

stress

An older adult female client tells the nurse, "Whenever I sneeze or cough, I urinate a little bit. It's very embarrassing." The nurse interprets the client's statement as indicating which type of incontinence?

stress

The nurse is caring for a client who has been experiencing nausea, vomiting, and diarrhea for 3 days. Which urine characteristics does the nurse anticipate?

strong aromatic, dark amber urine

mixed incontinence

the combination of stress incontinence and urge incontinence

functional incontinence

the person has bladder control but cannot use the toilet in time

urinary diversions

ureters are surgically attached to a stoma in the ileum

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 caring for a male client who has a urinary obstruction and is not a candidate for surgery. Which intervention will the nurse prepare the client for?

urological stent Urologic stents relieve urinary obstructions and provide a path for the flow of urine.

A nurse is preparing to measure a client's urine output. Which interventions would be of highest priority?

wearing gloves while handling urine

stress incontinence

when urine leaks during exercise and certain movements that cause pressure on the bladder; laughing, sneezing, jumping, running, coughing