ATI Skills Module~Urinary Elimination

The client replies, "I think I can cough up mucus for you now. Just give me the cup." Which of the following responses is appropriate?

"Actually, lets do it first thing in the morning. I'll bring you the cup then."

"I will remove it as soon as your bladder has emptied, which should only take a few minutes."

"As I insert the tube, it will help it to go in if you bear down as though you are urinating"

As you begin to explain the procedure of straight catheterization to the patient, she appears distraught and asks how long she will have to "put up with having a tube inside me." You correctly reply,

"I will remove it as soon as your bladder has emptied, which should only take a few minutes."

The client says that he is relieved that the collection procedure is over and that he hopes he won't have to repeat it. Which of the following is an appropriate response to the client's statement?

"I wish I could tell you that this was your final sputum collection, but it is not."

An assistive personnel (AP) is collecting a 24-hour urine specimen from a client. Which of the following statements by the AP indicates that the specimen collection will have to be restarted?

"The client just told me that they forgot to put the urine in the container."

When explain the test results to the client, she asks if it is absolutely definite that she is not pregnant. Which of the following is an appropriate reply?

"To be sure, ask your primary care provider to perform a blood test."

After performing hand hygiene, you apply gloves and offer the client the necessary supplies to use to clear their nose and throat and rinse their mouth. The client says "I'd rather do that after I cough up the specimen. It doesn't make sense to me to do it now." Which of the following responses is appropriate?

"We want to get a specimen that has only the bacteria from your lungs, not the usual organisms in the mouth"

The result of the blood glucose is 52mg/dL. Which of the following actions should you take?

- have your client drink 4 oz of orange juice- ask the provider about sending a stat venous blood sample to the laboratory to confirm hypoglycemia- retest the client's capillary blood glucose 15 minutes after intervention

A nurse is planning to obtain a urinary specimen from a client's closed urinary system. Identify the correct sequence of steps that the nurse should take.

1. Wipe the port with an alcohol swab or agency specified antiseptic. 2. Attach a syringe to the collection port of the indwelling catheter. 3. Withdraw 3 to 30 ml of urine. 4. Transfer the urine to a sterile specimen container. 5. Transport the specimen to the lab.

The kidneys filter

7 liters of fluid per hour 99% of which is reabsorbed

A nurse is caring for a group of newly admitted clients. For which of the following clients should the nurse expect to receive a prescription for urinary catheterization?

A client who is in the ICU for a GI bleed.

A nurse is caring for a group of newly admitted clients. For which of the following clients should the nurse suspect to receive a prescription for urinary catheterization? -A client who has a persistent urinary tract infection. -A client who has urge incontinence. -A client who is in the ICU for a gastrointestinal bleed. -A client who has incontinence due to cognitive decline.

A client who is in the ICU for a gastrointestinal bleed.(The nurse should expect a prescription for urinary catheterization for this client because precise measurement of urinary output is crucial for managing fluid balance in clients who are critically ill.)

Loop colostomy

A loop of the bowel is brought thru the abdomen to the skin surface and temporarily supported by a plastic bridge or rod. A transverse loop colostomy is typically created as an emergency procedure to relieve an intestinal obstruction or perforation It has 2 openings thru the stoma. The proximal end drains stool while the distal portion drains mucus Transverse loop colostomies are typically temporary

A nurse is replacing the ostomy appliance for a patient whose newly created colostomy is functioning After removing the pouch, which of the following actions should the nurse take first?A. Measure the stoma.B. Cover the stoma with gauze.C. Remove the backing on the skin barrierD. Cleanse the stoma and the peristomal skin.

A. Cleanse the stoma and the peristomal skin.Rationale: First action nurse should take is to remove any effluent adhering to the stoma & peristomal skin to facilitate assessment of area

A nurse is obtaining health history from a patient who has a colostomy. The patient reports frequent episodes of loose stools over the last month but has no signs of infection or bowel obstruction. The patient reports that they have avoided participation in social activities because they are concerned about leakage. Which of the following should the nurse recommend? A. Consume foods that are low in fiber content. B. Take an ounce of mineral oil twice a day. C. Add buttermilk and cranberry juice to the diet. D. Increase water intake to 3 to 3.5 L per day.

A. Consume foods that are low in fiber content.Rationale: The nurse should recommend that pt consume foods low in fiber to help thicken stool.Ex: rice, noodles, white bread, & cheese

nurse is teaching a patient who has bladder cancer about urinary diversion options. The nurse should inform the patient that which of the following options will allow them to have some control over urinary elimination?A. Kock's pouchB. Ileal conduitC. Cutaneous ureterostomyD. Nephrostomy

A. Kock's pouchRationale: A Kock's pouch is a continent ileal bladder conduit that does not require an external drainage collection device because pt self-catheterizes every 2-4 hrs to remove urine. This device will allow pt to have some control over urinary elimination

The patient's abdomen is distended and firm without active bowel sounds. You suspect internal hemorrhage and call the surgeon immediately. The patient is transferred back to the surgical suite. You will now receive additional information on your other three patients. Which patient will you see next? Please select from the options below. A.The patient reporting pressure around his bladder B.The patient to be discharged to home today with a leg bag

A.The patient reporting pressure around his bladder A - CORRECTYes. You have selected the correct res ponse. This is the patient you should see next. Bladder pressure can be serious, and this is the patient you should see next. The problem may be due to interference with the patency of the indwelling urinary catheter, the patient's position, or infection. You must now assess the cause and take the appropriate actions to correct it.

You note that the patient has copious green exudate coming from his urethra, but you find no other signs of irritation that would lead you to believe that the urinary catheter has injured the patient. You call the provider, who asks you to obtain a specimen for gram stain and culture. You collect the specimen and send it to the laboratory for analysis. After giving the patient perineal care, you are ready to see your remaining patient. You now see the patient who needs his indwelling catheter removed. Using appropriate technique and providing for the patientís privacy during the procedure, you remove it. You document the time so that you know when the patient is due to void, and you provide the patient with a urine collection device. You ask the patient to save the first urine he passes and to notify you when he has done so. Later in the day, the unit clerk tells you that the laboratory results for two of your pati

A.the local office of the state's health department. A - CORRECT.Yes. You have selected the correct response. Healthcare professionals in every state in the U.S. must report every diagnosed case of Neisseria gonorrhoeae so each patient receives adequate follow-up care and anyone who has had sexual relations with the patient is identified and treated.

Angioensin 1 is converted by

ACE into angiotensin II

A nurse obtains a capillary blood glucose result of 180 mg/dL from a client who has diabetes mellitus. Which of the following actions should the nurse take?

Administer insulin according to the patient's sliding scale orders.

What strategies should I use to help keep clients from developing catheter-associated UTIs

Always use sterile technique when placing a foley catheter Give appropriate and thorough peri care Assess equipment carefully to ensure a closed system, and intervene to prevent prolonged catheter use

A nurse is providing perineal care for a female client who has an indwelling urinary catheter. Which of the following areas should the nurse cleanse last?

Anus

A nurse is providing perineal care for a female client who has an indwelling urinary catheter. Which of the following areas should the nurse cleanse last? -Urethral meatus -Labia minora -Perineum -Anus

Anus

Colostomy placement locations-Ascending colon

Ascending colon-R abdomen. Output is typically liquid to semi liquid and is very irritating to the surrounding skin

Which of the following actions should a nurse take to assess a client who had a stroke for complications secondary to inadequate swallowing?

Auscultate the client's lungs.(Silent aspiration are a common complication of swallowing impairment.)

A nurse is teaching a patient who has a new ileostomy about preventing the excoriation and breakdown of the peristomal skin after they have returned home. Which of the following instructions should the nurse include? A. Apply hydrocortisone cream to the skin when changing the appliance. B. Empty the pouch when it is less than half full. C. Wash the peristomal skin frequently with deodorizing soap and water . D. Choose a time shortly after a meal for replacing the pouch.

B. Empty the pouch when it is less than half full. Rationale: Nurse should instruct pt to empty pouch when it is between 1/3 to 1/2 full because waiting to empty pouch until it is more than 1/2 full increases risk of leakage. Leakage of Ileostomy effluent is irritating to peristomal skin.

You call the patient's provider, who asks you to obtain a clean-catch specimen for urinalysis and urine culture. You collect the specimen and send it to the laboratory for analysis. You are ready to see another patient. Which patient will you see next?Please select from the options below. A. The patient who is 1 day postoperative and needs his indwelling urinary catheter removed this morning B .The patient with an indwelling urinary catheter who has green exudate seeping from his urethra

B. The patient with an indwelling urinary catheter who has green exudate seeping from his urethra B - CORRECT. Yes. You have selected the correct response. This is the patient you should see next. Discharge from the urethra can have many causes, including infection or irritation from the catheter. Your nursing assessment can help you determine the appropriate interventions for this patient.

A nurse is providing preoperative teaching for a patient who is scheduled for creation of a sigmoid colostomy. Which of the following info should the nurse include in the teaching? A. Expect the effluent from the sigmoid colostomy to be loose and continuous. B. Use irrigation to help establish a regular bowel pattern. C. Change the stoma's appliance every other day. D. Expect effluent from the newly created stoma within 24 hr after surgery.

B. Use irrigation to help establish a regular bowel pattern.

Now that you have inserted the urinary catheter into the bladder and inflated the balloon, you must obtain a urine sample to send to the laboratory for urinalysis, culture, and sensitivity. The correct steps for obtaining a urine sample from a closed system are to Please select from the options below. A.disconnect the collection bag from the drainage tubing, cleanse the end of the tube with an aseptic solution, and allow urine to flow from the tube into a specimen bottle. B.collect 5 to 10 mL of urine into a sterile specimen container before emptying urine from the collection bag into the commode. C.allow all the urine to collect in the bag and then empty the bag and collect urine from the collection port.

B. collect 5 to 10 mL of urine into a sterile specimen container before emptying urine from the collection bag into the commode.

After inserting the catheter, you do not observe any return of urine. Abdominal palpation suggests that your patient's bladder remains distended you Please select from the options below. A.remove the catheter and repeat the procedure with a sterile, larger-diameter catheter. B.slowly advance the catheter tip while gently rotating the tubing. C.apply gentle pressure to the distended abdomen and observe for urine return

B. slowly advance the catheter tip while gently rotating the tubing.

Which patient will you see next? Please select from the options below. A.The patient who is 1 day postoperative and needs his indwelling urinary catheter removed this morning B.The patient with a condom catheter who reports pain each time he urinates C.The patient with an indwelling urinary catheter who has green exudate seeping from his urethra

B.The patient with a condom catheter who reports pain each time he urinates B - CORRECTYes. You have selected the correct response. This is the patient you should see next. Dysuria, or painful urination, is most likely due to infection or presence of renal calculi (stones). You'll have to collect a urine specimen to help determine the cause. Since the patient currently needs to urinate, this is the ideal time to obtain the specimen.

A 73 year old woman is admitted to the hospital from a long-term care facility. She has been febrile, and nursing staff noticed a foul odor from her urine. ASSESSMENT On assessment, you note a pale, thin woman who has tremors and is diaphoretic. She is alert to person but not to place or time. She is unable to localize any discomfort. She has a tympanic temperature of 102.3° F (39.1° C), an irregular pulse rate of 124/minute, a respiratory rate of 18 breaths/minute, and a blood pressure is 94/62. You note mild bladder distention. You have cleansed the urethral meatus three times and are about to insert the catheter. Your patient repositions herself, causing the labia to close briefly over the urethra you Please select from the options below. A.restrain the client and start the procedure over, using a new sterile catheterization kit. You have cleansed the urethral meatus three times and are about to insert the c

B.ask an assistive personnel to assist and then don sterile gloves and re-cleanse the meatus with sterile gauze and sterile antiseptic. B - CORRECTYes. You have selected the correct response. The meatus has become contaminated by coming into contact with the client's hands. The nursing assistant can help orient the patient. The appropriate next step is to cleanse the meatus again.

Your patient's provider orders daily bladder irrigation to clear the urine of bacterial debris and blood clots. You follow protocol and attach a Y tube to the catheter and start bladder irrigation. The irrigant solution flows easily into the bladder, but shortly after you begin, the patient reports lower abdominal pain and cramping Please select from the options below. A.slow the irrigant solution and continue the procedure. B.stop the procedure and evaluate for an occlusion. C.assure the patient that some discomfort is expected with this procedure. D.hasten the procedure by increasing the rate of flow of the irrigant.

B.stop the procedure and evaluate for an occlusion. B - CORRECT.Yes. This is the correct choice. With this patient's history and the possible development of clots, you should assess that the catheter has not become obstructed.

A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions should the nurse instruct the client to perform during the insertion procedure?

Bear down

A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions should the nurse instruct the client to perform during the insertion procedure? -Bear down -Take deep breaths -Sip water -Tighten the perineum

Bear down(The nurse should instruct the client to bear down as if to void because this relaxes the external sphincter and aids in the insertion procedure.)

Now that you have determined that you must see your postoperative patient first, you enter his room. Immediately, he reports severe abdominal pain. Which of the following nursing assessments should you perform? Please select from the options below. A.Obtain orthostatics. B.Palpate bilateral pedal pulses. C.Auscultate and palpate the abdomen. D.Measure the patient's jugular venous pressure.

C. Auscultate and palpate the abdomen. C - CORRECT Yes. You have selected the correct response. The patient reports severe abdominal pain and may be hemorrhaging. For this patient, the hemorrhage is most likely in the abdominal cavity where the surgery took place, so auscultate the abdomen immediately for decreased bowel sounds and palpate it for increased firmness and discomfort. You might not find other objective signs of hemorrhage, such as tachycardia, hypotension, decreased urine output, agitation, and pale or diaphoretic skin until the patient's hemoglobin is well below 10.0 gm/dL.

You are in the process of providing routine catheter care for this patient 2 days after admission. As you start to cleanse the tissue surrounding the catheter, you note that the area is wet and erythematous. It appears that urine is leaking from around the catheter's insertion site. You also note some bladder distention. Which of the following actions should you take first? Please select from the options below. A.Deflate the balloon and remove the catheter. B.Call the provider and notify the charge nurse of your findings. C.Examine the catheter and the drainage tube along their entire path.

C. Examine the catheter and the drainage tube along their entire path.

A nurse is reinforcing teaching with a patient who has colon cancer & is scheduled for a procedure to remove their entire large intestine & rectum. The nurse should reinforce with the client that they are scheduled for which of the following types of ostomy procedure? A. Cecostomy B. Loop colostomy C. Ileostomy D. Descending colostomy

C. Ileostomy Rationale: After removing the entire large intestine & rectum, provider will create an ileostomy to divert feces from the small intestine to the abdominal surface & into an ostomy pouch.

A nurse is reinforcing teaching w/ a pt about replacing an ostomy pouching system. The client reports that they occasionally experience pain when removing the skin barrier. Which of the following techniques should the nurse suggest? A. Lift up on both sides of the skin barrier simultaneously. B. Release one corner of the barrier and pull it quickly over the stoma. C. Push the skin away from the barrier while removing it. D. Gently roll the barrier end-over-end across the stoma.

C. Push the skin away from the barrier while removing it. Rationale: If pt is experiencing pain w/ initial release of barrier, nurse should suggest removing barrier by starting in one corner & gently pulling it across the stoma while pushing skin away from barrier. This technique can help prevent skin stripping.

A nurse is caring for a client who has diabetes Mellitus is having difficulty obtaining a capillary fingerstick blood sample for point-of-care blood glucose monitoring. Which of the following actions should the nurse take to help increase blood flow to the client's finger? A. Elevate the hand on a pillow B. Pierce the skin in the middle of the finger pad. C. Wrap the finger in a warm cloth D. Firmly milk the puncture site.

C. wrap the finger in a warm cloth

You review the laboratory values of the patient with sediment in his urine and find these results: Normal Values Patient's Values Sodium 135-145 mEq/mL 150 mEq/mL Glucose 70-100 mg/dL 90 mg/dL Potassium 3.5-5.0 mEq/mL 4.7 mEq/mL BUN 5-20 mg/dL 31 mg/dL Creatine 0.5-1.5 mg/dL 1.2 mg/dL You notify the patient's provider about the laboratory results, which indicate mild dehydration. Which is the fluid of choice to correct mild dehydration? Please select from the options below. A.dextrose 5% in 0.45% sodium chloride B.0.45% sodium chloride C.0.9% sodium chloride D.3% sodium chloride

C.0.9% sodium chloride C - CORRECT.Yes. You have selected the correct response. The patient has mild dehydration; 0.9% sodium chloride (normal saline) is an isotonic fluid that increases the intravascular supply. This is especially important for this patient's kidneys and will help resolve his electrolyte imbalance.

Today you are working on a medical-surgical unit. Each of your four patients has an indwelling urinary catheter and is resting in bed. You will now receive report on each patient. Which of your four patients should you manage first? Please select from the options below. A.The patient who is 1 day postoperative and needs his indwelling urinary catheter removed this morning B.The patient with a condom catheter who reports pain each time he urinates C.The patient with dementia who pulled off his condom catheter D.The patient with an indwelling urinary catheter who has green exudate seeping from his urethra

C.The patient with dementia who pulled off his condom catheter C - CORRECTYes. You have selected the correct response. This is the patient you should see first. When a condom catheter is removed traumatically, tissue damage can result. Also, a condom catheter can impair circulation to the penis if it is applied incorrectly, and that might be why the patient removed it. Since the patient has dementia and might not be able to answer your questions reliably, your immediate nursing assessment is imperative. When deciding which patient to see first, you can use the nursing process as a guide. It is usually best to see patients who require a nursing assessment before patients who need routine interventions. Base your assessment priorities on immediate potential or actual immediate threats to airway, breathing, and circulation. Or, use Maslow's hierarchy to plan care by meeting physiological and safety needs prior to higher-level needs.

A nurse is assessing a client's indwelling urinary catheter drainage at the end of the shift and notes the output is considerably less than the fluid intake. Which of the following actions should the nurse take first?

Check the catheter for kinks.

A nurse is assessing a client's indwelling urinary catheter drainage at the end of the shift and notes the output is considerably less than the fluid intake. Which of the following actions should the nurse take first?-Irrigate the catheter.-Assess for peripheral edema.-Palpate for bladder distention.-Check the catheter for kinks.

Check the catheter for kinks.(The nurse should identify that output that is considerably less than intake is a sign that the catheter is blocked. Therefore, the first action the nurse should take is to check the tubing for kinks and ensure the client's urine flow is not obstructed.)

A nurse is teaching a patient about extended-wear skin barriers. Which of the following strategies should the nurse instruct the patient to use for maximal adherence? A. Use an oil-based lotion on the peristomal area. B. Apply the skin barrier while the skin is slightly moist. C. Leave the residue from the previous appliance on the skin. D. Press gently around the barrier for 30 seconds to 1 min.

D. Press gently around the barrier for 30 seconds to 1 min. Rationale: The nurse should instruct the client to press gently around to barrier for 30 seconds to 1 min because the pressure-sensitive tackifiers and heat-sensitive polymers of the skin barrier require adequate pressure and warmth (from the fingers) to ensure adherence.

Documentation for catheter care

Date and time of catheterization type of catheter used size of catheter amount of fluid used to inflate balloon urinary output catheter patency urine quality, quantity, odor Clients alertness, orientation, abdominal assessment, skin assessment Client and family teaching done

A nurse is preparing to remove a client's indwelling urinary catheter. Which of the following actions should the nurse take?

Deflate the balloon completely before removal.

A nurse is preparing to remove a client's indwelling urinary catheter. Which of the following actions should the nurse take? a. Pull the catheter out as soon as possible b. Deflate the balloon completely before removal c. Cut the inflation port to deflate the balloon d. tell the client to expect to feel a tugging sensation upon removal

Deflate the balloon completely before removal.(Removing an indwelling urinary catheter while inflation solution remains in the balloon is likely to cause trauma to the urethral canal. Therefore, the nurse should deflate the balloon completely prior to removing an indwelling urinary catheter.)

A nurse is caring for a client who has impaired swallowing due to a cerebrovascular accident. Which of the following interventions should the nurse use to assist the client with feeding?

Elevate the head of the bed 45 to 90 degrees. (The client's head should be sufficiently elevated to prevent aspiration.)

Common manifestations of UTI

Elevated WBC count, urine with pungent odor, sediment in the urine, confusion or alteration in mental status, change in urination pattern and fever

3 types of colostomy

End colostomy Loop colostomy Double-barrel colostomy

Is there a difference in incidents of UTI in male and female clients?

Females are at higher risk because they have a shorter urethra to the anus than male clients

Which of the following actions should you take to obtain an adequate specimen?

Have the client dangle his hands prior to a repeat puncture

A nurse is caring for a client who needs to collect a midstream urine specimen. Which of the following actions should the nurse take?

Have the client urinate a small amount of urine before starting the collection.

A nurse is applying a condom catheter for a client who is uncircumcised. Which of the following actions should the nurse take? Stretch the sheath portion of the condom catheter along the length of the penis. Secure the sheath portion with adhesive tape. Leave a space between the penis and sheath portion tip. Reposition the foreskin after application.

Leave a space between the penis and sheath portion tip. (The nurse should leave a space of 2.5 to 5 cm (1 to 2 in) between the tip of the penis and the end of the catheter. This space helps prevent irritation of the tip of the penis and allows full drainage of urine.)

ADH

High amounts limit urine production while low levels of ADH generate large amounts of urine. Produced in the posterior pituitary gland

What are the indications for urinay catheterization?

Inability to void because of retention the need to close hemodynamic monitoring postsurgical recovery

A nurse is caring for a client who has a suspected urinary tract infection (UTI). Which of the following urinalysis results should the nurse identify as a manifestation of a UTI?

Leukocyte esterase

A nurse is preparing a male client for intermittent urethral catheterization. Which of the following actions should the nurse take?

Lift the penis perpendicular to the body.

Is there a difference in the incidence of UTI among different types of catheters?

Indwelling because of prolonged time in place.

A nurse is applying a condom catheter for a client who is uncircumcised. Which of the following actions should the nurse take?

Leave a space between the penis and sheath portion tip.

Autonomic dysreflexia

Syndrome affecting clients with spinal cord injuries above thoracic level. A stimulus from the ans causes hypertension, bradycardia, severe

A nurse is preparing a male client for intermittent urethral catheterization. Which of the following actions should the nurse take? -Grasp the penis at its base. -Lift the penis perpendicular to the body. -Hold the penis parallel to the client's body. -Lift the penis to a 45° angle to the client's body.

Lift the penis perpendicular to the body. (Lifting the penis to a position perpendicular to the body, or at a 90° angle, while applying light traction straightens the urethral canal to facilitate catheter insertion.)

A nurse is teaching a client about home collection of a stool specimen for fecal occult blood testing. Which of the following instructions should the nurse include?

Obtain specimens from three different stools.

Your client proceeds to cough and tries to expectorate some mucus into cup, but produces only saliva after several attempts. Which of the following actions should you take next?

Perform chest physiotherapy

Now that you have determined that you must see the patient who pulled off his condom catheter first, you enter his room. You note that the skin barrier around the catheter had come loose, resulting in the catheter sliding off without any tissue damage when the patient removed the catheter. Before replacing the condom catheter, which of the following nursing actions should you perform? Please select from the options below. A.Cleanse the glans penis with povidone-iodine. B.Apply bacitracin ointment to the meatus. C.Provide perineal care with soap and water

Provide perineal care with soap and water. C - CORRECTYes. You have selected the correct response. It is appropriate to perform perineal care while the condom catheter is off. Then, allow the area to dry, reapply the skin barrier, and attach a new condom catheter.

Although you plan to implement all of the following actions to raise the client's blood sugar, which is your highest priority?

Provide the client with a snack that contains carbohydrates and protein within the next hour.

Which of the following clients should you visit first?

The client reporting lightheadedness and a headache

End colostomy

The damaged section of bowel is removed and the working end is brought thru the abdomen to the skin surface. When a colostomy is to be permanent, and end stoma is created

No one is available to take the client's urine specimen to the laboratory at the adjacent hospital immediately. Which of the following actions should you take?

Refrigerate the specimen until it can be transported to the laboratory

Renin

Regulates blood flow, glom filtration and BP Also activates angiotensinogen called angiotensin I`

A nurse is caring for a client who has a stage III pressure injury on the sacral area. Which of the following actions should the nurse take when obtaining a wound culture specimen from the pressure injury?

Rotate a sterile swab in the area of drainage.

A nurse caring for a group of clients in an ambulatory care clinic is collecting urine for several prescribed diagnostic tests. For which of the following tests is a random sample voided into a clean cup appropriate?

Routine urinalysis

A nurse is collecting a blood specimen for culture from a client. Which of the following actions should the nurse take?

Rub the client's arm at the selected site prior to venipuncture.

Coude catheter

Selected for ease of insertion when enlargement of the prostate gland is suspected (Hard tip). Used for clients who have prostatic hyperplasia (enlargement) Has a curved tip to allow for easier insertion.

Urine collection in bladder amount of 250-400 mL

Signal sent to brain to indicate need to urinate

HISTORY Today you are working on a medical-surgical unit. Each of your four patients has an indwelling urinary catheter. You will now receive report on each patient. Which of your four patients should you manage first? Please select from the options below. A.The patient with a spinal cord injury who has sediment in his urinary drainage bag B.The patient newly admitted to the unit after kidney surgery with bloody urine output C.The patient reporting pressure around his bladder D.The patient to be discharged to home today with a leg bag

The patient newly admitted to the unit after kidney surgery with bloody urine output B - CORRECT Yes. You have selected the correct response. This is the patient you should see first. You should base your assessment priorities on immediate potential or actual threats to airway, breathing, and circulation. In this example, the postoperative patient is at risk for hemorrhage due to the possibility of intraoperative injury to the large vessels surrounding the kidney (aorta, inferior vena cava). Therefore, you should assess this patient's bleeding first.

Colostomy placement locations-Transverse colon-

Transverse colon-Mid abdomen. This location is used for a temporary ostomy, with the stoma constructed as a loop. Output is pasty

A nurse is teaching a client about collecting stool specimens for fecal occult blood testing. Which of the following should the nurse instruct the client to avoid before and during the testing period?

poultry

Urine Dipstick

Urine reagent test strip

Does urinary catheterization always require a provider's order

YEs

straight catheter

a catheter that drains the bladder and then is removed

Anastomosis

a surgical connection between two hollow or tubular structures

indwelling Foley catheter

a urinary tract catheter with a balloon at one end that prevents the catheter from leaving the bladder

A nurse is preparing to insert an indwelling urinary catheter. Which of the following actions should the nurse instruct the client to perform during the insertion procedure?

bear down

Double Barrel colostomy

bowel is surgically cut and both ends are brought through the abdomen

suprapubic catheter

catheter inserted into the bladder through a small abdominal incision above the pubic area

Indications for ostomy surgery include:

congenital anomalies bladder, colon, and rectal cancer inflammatory bowel diseases (Crohn's disease, ulcerative colitis) inherited disorders such as familial adenomatous polyposis obstruction of the ureter stab or gunshot wounds to the abdomen

Condom catheter

external catheter that has an attachment on the end that fits over the penis; also called a Texas catheter

Each nephron contains

glomerulus, pct, descending loop of Henle, ascending loop of henle and collecting tubule

urinary retention catheter

if a patient has a catheter, remember to clamp before injection and then unclamp for post release image Commonly used post-operatively because they have multiple lumens to allow for the drainage of urine, irrigation of the bladder, and instillation of medications into the bladder

Angiotensin II

increases Blood volume and blood pressure

Common causes of hematuria include

mechanical injury of urethra urinary calculi (stones) genitourinary cancers UTI pyelonephritis (infection of the kidney) glomerulonephritis (infection of the glomerular structure in the kidney

Guaiac

test for blood in stool

Micturtion

urination