GENITOURINARY

Which clinical manifestations would the nurse associate with a patient's diagnosis of an upper urinary tract infection (UTI)? Select all that apply. 1 Chills 2 Fever 3 Afebrile 4 Flank pain 5 Clear, yellow urine

1 Chills 2 Fever 4 Flank pain --- Upper UTI symptoms present with fever, chills, and flank pain. The patient will not be afebrile, and urine will likely be cloudy, not clear and yellow.

When a patient is suspected of having a urinary tract infection, which initial diagnostic study would the nurse review to identify the presence of white blood cells in a patient's urine? 1 Ultrasound 2 Sensitivity testing 3 Dipstick urinalysis 4 Clean-catch urine sample

3 Dipstick urinalysis

Which response would the nurse provide the patient who is two days postoperative an ileal conduit loop and reports the development of mucus in their urine? 1 "The development of mucus is a normal occurrence." 2 "You will need to catheterize your stoma to remove the mucus." 3 "I will call the health care provider to verify the desired stoma outflow." 4 "Your lack of fluid intake thickened the drainage; increase your intake of fluids."

1 "The development of mucus is a normal occurrence." --- Mucus is a normal production of the intestinal liner. This will not cause any disruption in flow of the urine. Mucus in the urine is not caused by a decrease in fluid intake and is not necessary for the health care provider to assess the stoma because this is a normal finding. Catheterizing the stoma will not remove the mucus.

Which evidence-based practice guidelines would the nurse implement when striving to prevent hospital-acquired urinary tract infections (UTIs)? Select all that apply. 1 Avoid unnecessary catheterization. 2 Perform intermittent catheterization every four hours. 3 Wash hands before and after contact with each patient. 4 Wash around catheter insertion site with betadine daily. 5 Perform routine and thorough perineal hygiene for all hospitalized patients.

1 Avoid unnecessary catheterization. 3 Wash hands before and after contact with each patient. 5 Perform routine and thorough perineal hygiene for all hospitalized patients. --- The patient should not be catheterized unless absolutely necessary. Hand hygiene is the primary method of preventing the spread of infection in the hospital setting. Routine perineal care daily with soap and water is evidence-based practice to prevent UTI. Betadine should not be applied to the catheter insertion site daily. Intermittent catheterization may be less likely to cause a UTI than an indwelling catheter, but any catheterization places the patient at risk for hospital-acquired UTIs.

Which clinical manifestations would the nurse associate with acute pyelonephritis? 1 Chills and flank pain 2 Hemoptysis and rhonchi 3 Hematuria and proteinuria 4 Pain and lower urinary tract symptoms (LUTS)

1 Chills and flank pain --- The clinical manifestations of acute pyelonephritis vary from mild fatigue to the sudden onset of chills and flank pain. Hemoptysis and rhonchi are pulmonary symptoms of Goodpasture syndrome. Hematuria and proteinuria are clinical manifestations of acute glomerulonephritis. Pain and LUTS are the two primary clinical manifestations of interstitial cystitis, or pain bladder syndrome.

Which medication would the nurse expect to explain and administer to the patient with type 2 diabetes mellitus who has developed a second urinary tract infection (UTI) within one month of the previous infection? 1 Ciprofloxacin (Cipro) 2 Fosfomycin (Monurol) 3 Nitrofurantoin (Macrodantin) 4 Trimethoprim/sulfamethoxazole (Bactrim)

1 Ciprofloxacin (Cipro)

Which term would the nurse use to document a patient's involuntary or accidental urine loss? 1 Dysuria 2 Intermittency 3 Incontinence 4 Postvoid dribbling

3 Incontinence --- Involuntary or accidental urine loss or leakage is referred to as incontinence. Dysuria refers to painful or difficult urination. Intermittency is the interruption of the urinary stream while voiding. Postvoid dribbling is urine loss after completion of voiding.

Which outcome would the nurse establish as a priority when developing the plan of care for a patient with rapidly progressive glomerulonephritis (RPGN)? 1 Correction of fluid overload 2 Correction of hypertension 3 Correction of anemia and blood loss 4 Administration of parenteral antibiotics

1 Correction of fluid overload --- With progressive renal failure, there is an increase in fluid retention. The patient will exhibit hypertension because of the kidney damage and fluid overload. Patients will have anemia, but there will be no identification of acute blood loss with the hematuria, and this outcome is not a priority in treatment at this point for this patient. Not all forms of RPGN are a result of inflammatory or infectious diseases. The treatment includes corticosteroids, cyclophosphamide, and plasmapheresis to suppress the immune response.

Which information included in a patient's electronic medical record listed below would have likely caused nephrotic syndrome? 1 Diabetes 2 Depression 3 Hypothyroidism 4 Hypercholesterolemia

1 Diabetes --- Nephrotic syndrome is often caused by a systemic disease such as diabetes. Depression is not a common cause for nephrotic syndrome. Hypothyroidism is not a common cause for nephrotic syndrome. Hypercholesterolemia is not a documented cause for nephrotic syndrome.

Which disorder would the nurse associate with a patient's clinical manifestations of urgency, urinating approximately 10 times within a 24-hour period, and eliminating 150 mL per void? 1 Interstitial cystitis 2 Glomerulonephritis 3 Acute pyelonephritis 4 Goodpasture syndrome

1 Interstitial cystitis --- Interstitial cystitis is a chronic, painful inflammatory disease of the bladder characterized by symptoms of urgency, frequency, and pain in the bladder and pelvis. The urinary frequency of 10 voids in a 24-hour period with 150 mL at each voiding deviates from the normal value of 8 voids in a 24-hour period with at least 200 mL in each voiding and indicates that the patient has urinary frequency. Glomerulonephritis is the inflammation of the glomeruli that affects both kidneys equally. Acute pyelonephritis is the inflammation of renal parenchyma and the collecting system. Goodpasture syndrome is an autoimmune disease characterized by circulating antibodies against the glomerular and alveolar membrane.

Which medications are used to desensitize pain in the bladder wall? Select all that apply. 1 Lidocaine (Xylocaine) 2 Vancomycin (Vancocin) 3 Clotrimazole (Lotrimin) 4 Azathioprine (Imuran) 5 Dimethyl sulfoxide (DMSO) (Cryoserv)

1 Lidocaine (Xylocaine) 5 Dimethyl sulfoxide (DMSO) (Cryoserv) --- Instillations of heparin and hyaluronic acid are often administered with lidocaine, which rapidly desensitizes the pain receptors in the bladder wall due to their alkalinized anesthetic effect. DMSO is directly instilled into the bladder through a small catheter, and it desensitizes the pain receptors in the bladder wall. Vancomycin combined with an aminoglycoside such as tobramycin is beneficial in the treatment of acute pyelonephritis. Clotrimazole is used for treating trichomonas infection associated with urethritis. Azathioprine is used in the treatment of Goodpasture syndrome.

Which actions would the nurse implement when managing a female patient's active urethritis symptoms? Select all that apply. 1 Provide the patient with a warm sitz bath. 2 Suggest that the patient use a vaginal deodorant spray daily. 3 Teach the patient how to correctly cleanse the perineal area. 4 Inform the patient that she may resume sexual intercourse activities. 5 Obtain a culture and sensitivity analysis of a current urine sample.

1 Provide the patient with a warm sitz bath. 3 Teach the patient how to correctly cleanse the perineal area. 5 Obtain a culture and sensitivity analysis of a current urine sample. --- The nurse should provide a warm sitz bath because the bath can temporarily help to relieve bothersome symptoms of urethritis. A urine sample should be collected and cultured to detect the causative organism of urethritis so specific treatment can be planned. The nurse should teach the patient to cleanse the perineal area by wiping from front to back, to reduce the risk of infection from the anus. The patient should be instructed not to use vaginal deodorants because these can further irritate the genital area. The nurse should tell the patient to avoid sexual intercourse until the symptoms subside.

Which actions would the nurse implement when managing a female patient's active urethritis symptoms? Select all that apply. 1 Provide the patient with a warm sitz bath. 2 Suggest that the patient use a vaginal deodorant spray daily. 3 Teach the patient how to correctly cleanse the perineal area. 4 Inform the patient that she may resume sexual intercourse activities. 5 Obtain a culture and sensitivity analysis of a current urine sample.

1 Provide the patient with a warm sitz bath. 3 Teach the patient how to correctly cleanse the perineal area. 5 Obtain a culture and sensitivity analysis of a current urine sample. --- The nurse should provide a warm sitz bath because the bath can temporarily help to relieve bothersome symptoms of urethritis. A urine sample should be collected and cultured to detect the causative organism of urethritis so specific treatment can be planned. The nurse should teach the patient to cleanse the perineal area by wiping from front to back, to reduce the risk of infection from the anus. The patient should be instructed not to use vaginal deodorants because these can further irritate the genital area. The nurse should tell the patient to avoid sexual intercourse until the symptoms subside.

Which disorder includes the inflammation of renal parenchyma and the collecting system? 1 Pyelonephritis 2 Interstitial cystitis 3 Urethral diverticula 4 Glomerulonephritis

1 Pyelonephritis ---- Pyelonephritis is an inflammation of the renal parenchyma and the collecting system. Interstitial cystitis is a chronic, painful inflammatory disease of the bladder. Urethral diverticula are the localized outpouchings of the urethra. Glomerulonephritis is the inflammation of the glomeruli.

Based on the assessment findings listed below, which information would be symptomatic of a urinary stone? 1 Renal colic 2 Constipation 3 Epigastric pain 4 Irregular heart rate

1 Renal colic --- A classic symptom of a urinary stone is renal colic or severe pain. Constipation is not commonly related to a urinary stone. Epigastric pain may be associated with an inflamed gallbladder, not a urinary stone. An irregular heart rate is not related to a urinary stone.

In women, which disorder of the urinary system is caused by Trichomonas? 1 Urethritis 2 Interstitial cystitis 3 Urethral diverticula 4 Chronic pyelonephritis

1 Urethritis --- Urethritis is an inflammation of the urethra from a bacterial or viral infection, which may be caused by Trichomonas and monilial infection in women and chlamydial infection and gonorrhea in men. Interstitial cystitis is a chronic, painful inflammatory disease of the bladder. It is also called painful bladder syndrome. The symptoms of interstitial cystitis are urinary urgency, frequency, and pain in the bladder. Urethral diverticula are localized outpouchings of the urethra. They are usually caused by enlargement of obstructed periurethral glands. Chronic pyelonephritis is associated with small, atrophic, and shrunken kidneys. It is usually caused by recurring infection of the upper urinary tract.

Which information in the patient's chart would the nurse need to correct before completing the written discharge instructions for a patient with urethritis? 1 Use vaginal deodorant sprays. 2 Take metronidazole (Flagyl) as prescribed. 3 Clean the perineal area from front to back. 4 Avoid sexual intercourse for at least seven days.

1 Use vaginal deodorant sprays. --- A patient with urethritis should avoid using vaginal deodorant sprays. A patient with urethritis should take metronidazole (Flagyl) as prescribed, clean the perineal area from front to back, and avoid sexual intercourse for at least seven days.

Which instructions would the nurse provide the patient who has a diagnosis of acute pyelonephritis? Select all that apply. 1 "Avoid using vaginal deodorant sprays." 2 "Drink at least eight glasses of fluid every day." 3 "Avoid clothing that creates suprapubic pressure." 4 "Avoid sexual intercourse until symptoms subside." 5 "Take the full course of antibiotics to ensure that the bacteria are eradicated."

2 "Drink at least eight glasses of fluid every day." 5 "Take the full course of antibiotics to ensure that the bacteria are eradicated." --- The nurse should encourage the patient to drink at least eight glasses of fluid every day during and after treatment of acute pyelonephritis. A full course of antibiotics should be taken to ensure that the bacteria are eradicated. Avoiding the use of vaginal deodorant sprays is one of the interventions to be followed in patients with urethritis. The patient with interstitial cystitis should avoid clothing that creates suprapubic pressure, including pants with tight belts. Sexual intercourse should be avoided until symptoms subside in patients with urethritis.

When teaching a patient and caregiver about strategies to prevent the recurrence of urinary tract infections, which instructions would the nurse include? Select all that apply. 1 Drink freshly squeezed lemon juice, daily. 2 Maintain an adequate fluid intake, daily. 3 Wipe from back to front after having a bowel movement or urinating. 4 Urinate regularly, approximately every three to four hours during the day. 5 Cleanse the perineal area with warm soapy water after each bowel movement.

2 Maintain an adequate fluid intake, daily. 4 Urinate regularly, approximately every three to four hours during the day. 5 Cleanse the perineal area with warm soapy water after each bowel movement. --- It is necessary to maintain an adequate fluid intake and to urinate regularly. Delaying urination when there is an urge to urinate increases the chances of bacterial infection. Cleansing the perineal area with warm, soapy water after a bowel movement reduces the risk of infection. It is important to wipe from front to back to avoid the risk of getting fecal matter near the urethra. Acidic foods and drinks like lemon juice, orange juice, and tomatoes irritate the bladder and should be avoided.

Which medication is the only oral agent approved for the treatment of interstitial cystitis? 1 Penicillin (Amoxicillin) 2 Pentosan (Elmiron) 3 Nortriptyline (Allegron) 4 Amitriptyline (Elavil)

2 Pentosan (Elmiron) --- Pentosan is the only oral agent used in the treatment of interstitial cystitis. Penicillin is used in the treatment of streptococcal infection as seen in acute poststreptococcal glomerulonephritis. Nortriptyline and amitriptyline are tricyclic antidepressants that may be used to reduce burning pain and urinary frequency.

Which urinary disorder commonly occurs in Jewish men? 1 Bladder cancer 2 Uric acid stones 3 Urinary tract calculi 4 Urinary incontinence

2 Uric acid stones --- Uric acid stones are most common in Jewish men who have a family history or incidence of gout. Bladder cancer is more common in Caucasian men. Urinary tract calculi are more common in Caucasians than in African Americans. Urinary incontinence is underreported because culturally it is seen as a social hygiene problem causing patient embarrassment.

Which factors place a patient at risk for experiencing urinary stasis? Select all that apply. 1 Constipation 2 Urinary retention 3 Diabetes mellitus 4 Renal impairment 5 Urinary tract calculi

2 Urinary retention 4 Renal impairment 5 Urinary tract calculi

Which medication would the nurse associate with treatment of a patient's fever, chills, pain while urinating, and urgency, as well as the presence of blood and bacteria identified on the patient's urinalysis report? 1 Metronidazole (Flagyl) 2 Vancomycin (Vancocin) 3 Doxycycline (Vibramycin) 4 Dimethyl sulfoxide (Rimso-50)

2 Vancomycin (Vancocin) --- The symptoms of fever, chills, pain while urinating, and urgency with the presence of blood (hematuria) and bacteria in the urine (pyuria) indicate acute pyelonephritis. Vancomycin (a broad-spectrum antibiotic), combined with an aminoglycoside such as tobramycin, is beneficial in the treatment of acute pyelonephritis. Doxycycline is used in the treatment of chlamydial infections associated with urethritis. Metronidazole is used for treating trichomonas infection. Dimethyl sulfoxide is instilled into the bladder for the treatment of interstitial cystitis.

When teaching a female patient measures to prevent recurrent urinary tract infection (UTI), which instructions would the nurse include? Select all that apply. 1 Urinate every six hours. 2 Wipe the perineal area from front to back after urinating. 3 Empty the bladder before and after sexual intercourse. 4 Use vaginal douches or sprays to clean the perineal area. 5 Cleanse with warm soapy water after each bowel movement.

2 Wipe the perineal area from front to back after urinating. 3 Empty the bladder before and after sexual intercourse. 5 Cleanse with warm soapy water after each bowel movement. --- The nurse should instruct the patient to wipe from front to back after urinating to avoid contamination by other structures because this can increase the risk of UTIs. Emptying the bladder before and after sexual intercourse will help to keep the perineum clean and reduce the risk of UTIs. Cleansing the perineum with warm, soapy water after each bowel movement to clean the anal region will reduce the risk of UTIs. Regular urination may prevent bacteria from growing; therefore the patient should be encouraged to void every two to three hours. Vaginal douches or sprays to clean the perineal area should be avoided because these contain harsh chemicals and substances that can cause irritation and can increase the risk of urinary infection.

Which questions would the nurse ask when assessing the patient's risk for developing urinary tract infections (UTIs)? Select all that apply. 1 "Is your work putting too much stress on you?" 2 "Have you ever received a blood transfusion?" 3 "Do you hold your urine for long periods of time?" 4 "Do you have a recent history of urinary calculi or stones?" 5 "Have you had any condition that required urinary catheterization?"

3 "Do you hold your urine for long periods of time?" 4 "Do you have a recent history of urinary calculi or stones?" 5 "Have you had any condition that required urinary catheterization?" --- Urinary calculi cause obstruction that favors the growth of organisms and can lead to frequent UTIs. If strict aseptic precautions are not followed, urinary catheterization also aids the entry of causative organisms into the urinary system. People who delay urination for prolonged periods of time (common in professionals like teachers, traffic police, doctors, and so on) are more susceptible to developing UTIs. Receiving a blood transfusion and stressful work situations do not increase the risk for developing a UTI.

Which therapeutic response would the nurse use when a patient discovers the bladder cancer has spread to the liver and lungs, begins to cry, and states, "I'm tired of the constant pain and being a burden to my daughter. I'm so scared and do not want to live like this, would you?" 1 "Should I call the clergy for you? It sounds like you want someone to talk to about all of this." 2 "You have had high spirits, and you look like you're feeling all right. You probably still have a lot of time left." 3 "I'm hearing you say that you feel helpless and afraid. Can you tell me more about how this makes you feel?" 4 "I know that you're tired and upset, but you have to keep fighting for your daughter. She loves you so much."

3 "I'm hearing you say that you feel helpless and afraid. Can you tell me more about how this makes you feel?"

Which patient statements indicate an understanding of self-management techniques in reducing the incidence of overflow incontinence? Select all that apply. 1 "I'd really like to read some materials about smoking cessation programs." 2 "Taking oxybutynin will increase my bladder tone, which will lead to fewer leaks." 3 "Regular bowel movements and avoiding constipation will help me to dribble less." 4 "Intermittent catheterization will increase the likelihood that I will have nocturnal enuresis." 5 "These Kegel exercises feel funny, but I'll be glad when I can control my pelvic floor muscles." 6 "By practicing the Valsalva maneuver, I should be able to empty my bladder more completely."

3 "Regular bowel movements and avoiding constipation will help me to dribble less." 5 "These Kegel exercises feel funny, but I'll be glad when I can control my pelvic floor muscles." 6 "By practicing the Valsalva maneuver, I should be able to empty my bladder more completely."

When collecting a urine sample for analysis and a culture with sensitivity (C&S) from a patient admitted with suprapubic pain and dysuria, which instruction would the nurse provide the patient? 1 After drinking 1 liter of water, wash your hands and collect the urine sample. 2 When you complete your breakfast, immediately collect the next voided urine. 3 Clean your periurethral area, begin voiding, and then catch a sample of your urine. 4 Use the antiseptic cloth to clean your periurethral area before collecting the sample.

3 Clean your periurethral area, begin voiding, and then catch a sample of your urine. --- A clean-catch, or midstream, sample should be collected to prevent contamination of urine with bacteria present in the vagina or penis. Clean the periurethral area, begin to void, and catch a midstream sample of urine. The periurethral area should be cleaned, but the use of antiseptic should be avoided because it can contaminate the sample and provide a false positive. A sample should not be collected directly after a meal or after drinking a liter of water because food and water can affect the normal chemical composition of a patient's urine.

Which organism would the nurse present as the primary cause of health care-associated urinary tract infections (UTIs) when providing evidenced-based practice guidelines for the nursing staff? 1 Pseudomonas 2 Streptococcus 3 Escherichia coli 4 Methicillin-resistant Staphylococcus aureus (MRSA)

3 Escherichia coli --- E. coli is the most reported organism, and Pseudomonas is second. Catheter-associated UTIs are the most frequent hospital-acquired UTI. MRSA and Streptococcus are not usually the organisms in hospital-acquired UTIs.

Which prescribed medication would the nurse expect to administer to a patient with a urinary tract infection (UTI) secondary to a fungal infection? 1 Ampicillin (Omnipen) 2 Norfloxacin (Noroxin) 3 Fluconazole (Diflucan) 4 Phenazopyridine (Pyridium)

3 Fluconazole (Diflucan) --- Fluconazole is used in patients with UTIs secondary to fungi. Ampicillin is used to treat uncomplicated UTIs. Norfloxacin is a fluoroquinolone that is used to treat complicated UTIs. Phenazopyridine is a urinary analgesic that is used to relieve discomfort caused by dysuria.

Which clinical manifestation would the nurse associate with a urethral stricture? 1 Foamy urine 2 Hyperlipidemia 3 Frequent urge to urinate 4 Sharp pain in flank area

3 Frequent urge to urinate --- Urethral strictures can be asymptomatic or can cause numerous symptoms, which range from mild to severe. Some of the possible symptoms and complications include sudden and frequent urges to urinate, difficulty urinating, inability to urinate or completely empty the bladder, and pain during urination. Hyperlipidemia is one of the clinical manifestations of nephrotic syndrome. Foamy urine is a symptom of glomerulonephritis. Sharp pain in the flank area is a primary (and usually the first) symptom of a kidney stone.

Which bacteria would the nurse associate with a patient who presents with frequent urination, dysuria, low-grade fever, and fatigue, and who has a diagnosis of bacterial infection of the kidney? 1 Klebsiella 2 Escherichia coli 3 Mycobacterium tuberculosis 4 β-hemolytic streptococci

3 Mycobacterium tuberculosis --- Frequent urination, pain while urinating (dysuria), and low-grade fever are clinical manifestations of renal tuberculosis caused by mycobacterium tuberculosis bacilli that infect the kidneys. Klebsiella makes the urine alkaline and contributes to the formation of struvite stones. β-hemolytic streptococci cause streptococcal sore throat and impetigo, resulting in acute poststreptococcal glomerulonephritis. Escherichia coli is the most common pathogen that causes urinary tract infections.

Which prescribed medication would the nurse expect to administer to a patient reporting painful urination secondary to bladder tumors? 1 Ciprofloxacin (Cipro) 2 Fluconazole (Diflucan) 3 Phenazopyridine (Pyridium) 4 Nitrofurantoin (Macrodantin)

3 Phenazopyridine (Pyridium) --- A patient with bladder tumors usually experiences increased frequency and dysuria. A urinary analgesic such as phenazopyridine relieves discomfort caused by pain during urination (dysuria) by exerting an analgesic effect on the urinary tract mucosa. Fluconazole is the preferred therapy in patients with urinary tract calculi secondary to fungi. Ciprofloxacin is an antibiotic used to treat complicated urinary tract infection (UTI). Nitrofurantoin is a first-line drug that is used to treat initial uncomplicated UTI.

Which surgical procedure would the nurse associate as treatment for a patient who has frequent urination, accidental loss of urine, and dyspareunia? 1 Cystoscopy 2 Cystolitholapaxy 3 Spence procedure 4 Electrohydraulic lithotripsy

3 Spence procedure --- Frequent urination, accidental loss of urine, and pain during sexual intercourse are the clinical manifestations of urethral diverticula. A Spence procedure is performed for marsupialization (creation of permanent opening) of the diverticular sac into the vagina in patients with urethral diverticula. Cystoscopy is a procedure used to remove small stones from the kidneys. Cystolitholapaxy is a procedure that is used to break up large stones. Electrohydraulic lithotripsy is used in conjunction with an ureteroscope to pulverize a stone.

Which information included in a patient's electronic medical record would increase the patient's risk for glomerulonephritis? 1 Tuberculosis 2 Trichomonas 3 Streptococcal sore throat 4 Benign prostatic hyperplasia

3 Streptococcal sore throat --- Streptococcal sore throat is a risk factor for glomerulonephritis. Tuberculosis is a risk factor for genitourinary tuberculosis. Trichomonas is a risk factor for urethritis. Benign prostatic hyperplasia is a risk factor for a urinary tract infection.

Which instruction to prevent recurrent urinary tract infections (UTIs) would the nurse provide female patients? 1 "Restrict purines in your diet." 2 "Wipe back to front after urinating." 3 "Schedule a follow-up urine culture." 4 "Empty your bladder before and after sexual intercourse."

4 "Empty your bladder before and after sexual intercourse." --- The patient should empty the bladder before and after sexual intercourse to prevent recurrent urinary infections. Restricting dietary purines is important for reducing the risk of renal calculi formation. A patient with acute pyelonephritis should have a follow-up urine culture. Female patients should wipe front to back to avoid contamination with E coli.

When assessing the cognitive-perceptual pattern of a patient diagnosed with a urinary tract infection, which questions would the nurse ask the patient? Select all that apply. 1 "Are you experiencing hesitancy?" 2 "Do you follow urinary hygiene practices?" 3 "Have you experienced any vomiting and/or chills?" 4 "Have you felt a burning discomfort when you urinate?" 5 "Do you have any pain over your suprapubic area or low back?"

4 "Have you felt a burning discomfort when you urinate?" 5 "Do you have any pain over your suprapubic area or low back?" --- While assessing the effect of urinary tract infections on the cognitive-perceptual pattern, the nurse should ask the patient if he or she has any suprapubic or low back pain or if he or she has experienced any burning discomfort when urinating. Asking the patient about hesitancy helps to assess the effect of the urinary tract infection on the elimination pattern. Interviewing the patient about vomiting and chills helps to assess the effect that urinary tract infections have on the nutrition-metabolic pattern. Gaining information about urinary hygiene practices helps to assess health perception-health management.

Per evidence-based practice guidelines, which guideline effectively reduces catheter-associated urinary tract infections (CAUTI)? 1 Empty the catheter's collection reservoir every hour. 2 Administer topical and oral antibiotics prophylactically. 3 Clean the sample port of the urinary catheter with alcohol prior to accessing. 4 Avoid unnecessary catheterization and aim for early removal of urinary catheters.

4 Avoid unnecessary catheterization and aim for early removal of urinary catheters. --- Evidence-based practice guidelines indicate patients who have fewer days with an indwelling urinary catheter have significantly less incidence of CAUTI than those patients with more urinary drainage days. Emptying the catheter's collection reservoir periodically is necessary; however, emptying the reservoir hourly does not decrease incidence of CAUTI. Administration of prophylactic antibiotics is not encouraged, as this only strengthens an organism's bacterial resistance to the drugs. Cleaning the sample port of a urinary catheter is good nursing practice but not the most effective way to reduce CAUTI.

Which diagnostic test would the nurse anticipate scheduling for the patient experiencing recurrent infections from a suspected urinary tract obstruction? 1 Sensitivity testing 2 Dipstick urinalysis 3 Clean-catch urine sample 4 CT scan

4 CT scan --- A CT scan (urography) or ultrasound may be obtained when there are recurrent urinary tract infections or when an obstruction of the urinary tract is suspected. Sensitivity testing is used to determine the bacteria's susceptibility to a variety of antibiotic drugs. Dipstick urinalysis is used to identify nitrites, white blood cells, and leukocyte esterase. A clean-catch urine sample is preferable for obtaining cultures.

When assessing an older male patient who reports burning on urination and "foul-smelling" urine, the health care provider would suspect that which clinical manifestation placed the patient at risk for developing a urinary tract infection (UTI)? 1 Progressive sedentary lifestyle changes 2 Recent use of broad-spectrum antibiotics 3 High-purine diet for three months to lose weight 4 Development of benign prostatic hyperplasia (BPH)

4 Development of benign prostatic hyperplasia (BPH)

Which type of lithotripsy is noninvasive but requires the patient to be anesthetized to ensure the same position is maintained throughout the procedure? 1 Laser lithotripsy 2 Electrohydraulic lithotripsy (EHL) 3 Percutaneous ultrasonic lithotripsy (PUL) 4 Extracorporeal shock-wave lithotripsy (ESWL)

4 Extracorporeal shock-wave lithotripsy (ESWL) --- ESWL is noninvasive, but anesthesia is used to maintain the patient's position. The other types of lithotripsy are invasive. Laser lithotripsy uses an ureteroscope and small fiber to reach the stone. Electrohydraulic lithotripsy positions a probe directly on the stone; then continuous saline irrigation flushes are used to rinse the stone out. Percutaneous ultrasonic lithotripsy places an ultrasonic probe in the renal pelvis via a percutaneous nephroscope inserted through an incision in the flank.

When other measures to treat a patient's severe and debilitating suprapubic pain, hesitancy, and incontinence from interstitial cystitis are unsuccessful, which procedure would the nurse anticipate integrating into a patient's plan of care? 1 Lithotripsy 2 Marsupialization 3 Transurethral incision 4 Ileal conduit diversion

4 Ileal conduit diversion --- Severe suprapubic pain, hesitancy, and incontinence are symptoms of a painful inflammatory disease called interstitial cystitis. Ileal conduit surgical urinary diversion is used for severe debilitating pain in patients with interstitial cystitis when other measures are not successful in relieving pain. Lithotripsy is a procedure used for eliminating calculi from the urinary tract. Marsupialization is used for the creation of a permanent opening of the diverticular sac into the vagina. Transurethral incision of the diverticular neck is performed in patients with urinary diverticula.

Which medication is beneficial when the patient with a lower urinary tract infection reports severe pain while urinating? 1 Nystatin (Mycostatin) 2 Clotrimazole (Lotrimin) 3 Amitriptyline (Elavil) 4 Phenazopyridine (Pyridium)

4 Phenazopyridine (Pyridium) --- Pain while urinating is called dysuria. Phenazopyridine is a urinary analgesic used to relieve severe discomfort caused by dysuria due to its topical analgesic effect on the urinary tract mucosa. Nystatin is prescribed for monilial infections. Clotrimazole is used for treating Trichomonas infection associated with urethritis. Amitriptyline is a tricyclic antidepressant used for reducing burning pain and urinary frequency.

Which assessment finding would the nurse question after reviewing the electronic medical record of a patient who has acute pyelonephritis? 1 Urinary urgency 2 Temperature 101° F 3 Nausea and vomiting for past 24 hours 4 Right lower quadrant rebound tenderness

4 Right lower quadrant rebound tenderness --- Acute pyelonephritis symptoms would be flank pain, not right lower quadrant rebound tenderness. The clinical manifestations for acute pyelonephritis include a fever, nausea and vomiting, and urinary urgency.

When considering the fluid obtained from food and the patient weighs 120 pounds (54.54 kg), how many ounces of fluid would the nurse recommend this patient needs to drink each day if the patient were at risk for developing a urinary tract infection?Record the answer using a whole number. ____________ oz

48 oz --- To estimate the amount of fluid intake that a patient should have in 24 hours, divide the person's weight in pounds by 2, then multiply this number by 80% because 20% of a person's fluid is obtained from food. So 120/2 = 60, 60 x.80 = 48 ounces to be drunk each day, or six 8-ounce glasses of water.