ch 66 evolve

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A male client being treated for bladder cancer has a live virus compound instilled into his bladder as a treatment. What instruction does the nurse provide for post procedure home care?

"Do not share your toilet with family members for the next 24 hours."

The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows a correct understanding of what the nurse has taught?

"I need to be drinking at least 1.5 to 2.5 liters of fluids every day."

The nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client comment indicates that the teaching was effective?

"I need to drink 2½ liters of fluid every day."

The nurse is questioning a female client with a urinary tract infection (UTI) about her antibiotic drug regimen. Which statement by the client indicates a need for further instruction?

"I take my medication only when I have symptoms."

A client is admitted for extracorporeal shock wave lithotripsy (ESWL). What information obtained on admission is most critical for a nurse to report to the primary health care provider before the ESWL procedure begins?

"I take over-the-counter naproxen (Aleve) twice a day for joint pain."

The nurse is teaching a client who is scheduled for a neobladder and a Kock pouch. Which client statement indicates a correct understanding of these procedures?

"I will have to drain my pouch with a catheter."

The nurse is teaching the importance of a low purine diet to a client admitted with urolithiasis consisting of uric acid. Which statement by the client indicates that teaching was effective?

"I will no longer be able to have red wine with my dinner."

The nurse is teaching a client with a neurogenic bladder to use intermittent self-catheterization for bladder emptying. Which client statement indicates a need for further clarification?

"I will use a new, sterile catheter each time I do the procedure."

A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, "I only took the first dose because after that, I felt better." How does the nurse respond?

"Not completing your medication can lead to return of your infection."

An older adult woman confides to the nurse, "I am so embarrassed about buying adult diapers for myself." How does the nurse respond?

"That is tough. What do you think might help?"

A 53-year-old postmenopausal woman reports "leaking urine" when she laughs and is diagnosed with stress incontinence. What does the nurse tell the client about how certain drugs may be able to help with her stress incontinence?

"They may be used to improve urethral resistance."

The nurse is educating a female client about hygiene measures to reduce her risk for urinary tract infection (UTI). What does the nurse instruct the client to do?

"Wipe from front to back."

The nurse is teaching a client about pelvic muscle exercises. What information does the nurse include?

"You know that you are exercising correct muscles if you can stop urine flow in midstream."

A client with a urinary tract infection is prescribed trimethoprim/sulfamethoxazole (Bactrim). What information does the nurse provide to this client about taking this drug? SATA

- "Be certain to wear sunscreen and protective clothing." - "Drink at least 3 liters of fluids every day." - "Take this drug with 8 ounces (236 ml) of water." - "You will need to take all of this drug to get the benefits."

What information will the nurse provide to a client who is scheduled for extracorporeal shock wave lithotripsy? SATA

- "Your urine will be strained after the procedure." - "Be sure to finish all of your antibiotics." - "Remember to drink at least 3 liters of fluid a day to promote urine flow."

Which clients with long-term urinary problems does the nurse refer to community resources and support groups? SATA

- A 32-year-old with a cystectomy - A 44-year-old with a Kock pouch - A 78-year-old with urinary incontinence

An older adult client diagnosed with urge incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect?

- Dry mouth - Constipation - Increased intraocular pressure

The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? SATA

- Dysuria - Frequency - Nocturia - Urgency

A client diagnosed with urge incontinence is started on tolterodine (Detrol). What interventions does the nurse suggest to alleviate the side effects of this anticholinergic drug?

- Encourage increased fluids. - Increase fiber intake. - Use hard candy for dry mouth.

Which interventions are helpful in preventing bladder cancer? SATA

- Showering after working with or around chemicals - Stopping the use of tobacco - Wearing gloves and a mask when working around chemicals and fumes

Which clients with an indwelling urinary catheter does the nurse reassess to determine whether the catheterization needs to be continued or can be discontinued? SATA

- Three-day postoperative client - client in the step-down unit - Incontinent older adult in long-term care

The nurse in the urology clinic is providing teaching for a female client with cystitis. Which instructions does the nurse include in the teaching plan? SATA

- Try to take in 64 ounces (2 liters) of fluid each day. - Be sure to complete the full course of antibiotics. - If urine remains cloudy, call the clinic.

The nurse receives the change-of-shift report on four clients. Which client does the nurse decide to assess first?

A 28-year-old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours

Which client does the nurse manager on the medical unit assign to an experienced LPN/LVN?

A 55-year-old with incontinence who has intermittent catheterization prescribed

A client who is admitted with urolithiasis reports "spasms of intense flank pain, nausea, and severe dizziness." Which intervention does the nurse implement first?

Administer morphine sulfate 4 mg IV.

What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)?

Drink about 3 liters of fluid daily.

A cognitively impaired client has urge incontinence. Which method for achieving continence does the nurse include in the client's care plan?

Habit training

Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized clients?

Periodically reevaluating the need for indwelling catheters

Which nursing activity illustrates proper aseptic technique during catheter care?

Positioning the collection bag below the height of the bladder

A client who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). What action does the nurse take with this client?

Refers the client to the clinic nurse practitioner for immediate follow-up

The certified Wound, Ostomy, and Continence Nurse or enterostomal therapist teaches a client who has had a cystectomy about which care principles for the client's postdischarge activities?

Stoma and pouch care

Which type of incontinence benefits from pelvic floor muscle (Kegel) exercise?

Stress

A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F (37.8°C). Which drug does the primary health care provider prescribe?

Trimethoprim/sulfamethoxazole (Bactrim)

3A client is referred to a home health agency after being hospitalized with overflow incontinence and a urinary tract infection. Which nursing action can the home health RN delegate to the home health aide (unlicensed assistive personnel [UAP])?

Using a bladder scanner (with training) to check residual bladder volume after the client voids


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