Chapter 49 Management of Patients with Urinary Disorders PrepU

The nurse is evaluating the effectiveness of discharge teaching for the client with an ileal conduit. Which statement by the client indicates the need for further teaching by the nurse? Select all that apply. "I might notice a strong urine odor if I eat eggs, cheese, or asparagus." "I cannot wait until I can have surgery to get rid of this ostomy." "I will need to change the appliance every day." "I will need to monitor the skin around my ostomy for irritation." "I will need to catheterize myself every 2 to 3 hours."

"I cannot wait until I can have surgery to get rid of this ostomy." "I will need to change the appliance every day." "I will need to catheterize myself every 2 to 3 hours." Explanation: An ileal conduit is a permanent urinary diversion. In an ileal conduit, urine output is continuous and collected in an ileostomy bag, making self-catheterization unnecessary. The appliance usually remains in place as long as it is watertight. The skin surrounding the ostomy needs to be monitored for irritation and breakdown. The urine can acquire a strong odor from foods such as asparagus, cheese, and eggs.

Which of the following nursing assessments and interventions should the nurse implement immediately prior to initiating hemodialysis? 1. Determine current medications being taken by client. 2. Assess AV fistula for bruit. 3. Calculate total urine output for the night. 4. Assess dietary intake. 5. Obtain blood glucose level. 6. Obtain client's weight. 7. Assess hydration status. 8. Obtain serum electrolytes. 9. Obtain client's blood pressure reading. A, 1, 2, 5, 9. B. .2, 3, 8. C. 1, 2, 6, 9. D. 1,2, 6, 8, 9.

D. 1,2, 6, 8, 9. NO rationale Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 15th ed., Philadelphia, Wolters Kluwer, 2022, Chapter 49: Management of Patients with Urinary Disorders.

A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands that this drug is an effective treatment for which reason? Select all that apply. Increases contraction of the detrusor muscle Increases bladder neck resistance Reduces bladder spasticity Decreases involuntary bladder contractions

Increases bladder neck resistance Decreases involuntary bladder contractions Explanation: Some tricyclic antidepressant medications (amitriptyline, nortriptyline, and amoxapine) are useful in treating incontinence because they decrease bladder contractions and increase bladder neck resistance. Anticholinergic drugs such as oxybutynin chloride (Ditropan) reduce bladder spasticity and involuntary bladder contractions. Bethanechol (Urecholine) helps to increase contraction of the detrusor muscle, which assists with emptying of the bladder.

The nurse provides care for a client who is prescribed bladder retraining following urinary catheterization. Complete the following sentence by choosing from the lists of options. The nurse should first ask the client toDropdown Item 1 then perform the prescribed Dropdown Item 2. urinate bladder scan defecate urinary catheterization drink laboratory testing

Urinate and bladder scan Explanation: Postcatheterization detrusor instability can be managed with the implementation of bladder retraining with the client. When implementing bladder retraining for a client who experiences postcatheterization detrusor instability, the nurse first asks the client to urinate.Once the client voids, the nurse then performs the prescribed bladder scan. Bladder retraining involves urination, not defecation. The client is instructed to drink a measured amount of fluid from 8 am to 10 pm with the implementation of bladder retraining to avoid bladder overdistention; however, the client is not instructed to drink at specific times during this process. After the client is asked to void, urinary catheterization is not performed unless the bladder scan indicates a residual greater than 300 ml. Laboratory testing is not completed as part of bladder retaining; however, the nurse should measure the volumes of urine voided and palpate the bladder at repeated intervals to assess for distention.

A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is: placement of small amounts of collagen in urethral walls to aid the closing pressure. a procedure that increases storage capacity of the bladder. implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination. a procedure that increases support to the bladder by tightening the vaginal wall under the urethra.

placement of small amounts of collagen in urethral walls to aid the closing pressure. Explanation: Periurethral bulking is the placement of small amounts of collagen in urethral walls to aid the closing pressure. Bladder augmentation is a procedure that increases storage capacity of the bladder. Implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination is one type of surgery done to improve urinary control. Anterior repair is a procedure that increases support to the bladder by tightening the vaginal wall under the urethra.