PrepU ch. 37 urinary elimination

Three days post-surgery for breast reconstruction, the nurse assesses that 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? Select all that apply. -Contact the health care provider to ask for an order for catheter discontinuation. -Delegate catheter discontinuation to the Unlicensed Assistive Personnel (UAP). -Perform, or allow client to perform, perineal hygiene at least once daily. -Ensure that the drainage bag is above the level of the bladder at all times. -Discontinue to catheter and report this to the healthcare provider.

-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. The nurse should advocate for catheter discontinuation to prevent catheter-associated urinary tract infections (CAUTI), and still perform or encourage the client to perform daily perineal care. Discontinuation of the catheter should not take place until the nurse has received and order, and delegation should take place only if appropriate based on the UAP's qualification and the nurse's ongoing appropriate supervision. The drainage bag should never remain above the level of the bladder.

Use of an indwelling urinary catheter leads to the loss of bladder tone. -True -False

-True People with indwelling urinary catheters lose bladder tone because the bladder muscle is not being stretched by the bladder filling with urine. During prolonged periods of immobility, decreased bladder and sphincter tone can result in poor urinary control and urinary stasis. Other causes of decreased muscle tone include childbearing, muscle atrophy due to decreased estrogen levels as seen with menopause, and damage to muscles from trauma.

The client is preparing to obtain a clean-catch midstream urine specimen. List in order the steps needed to complete the diagnostic test. 1-Provide instruction to the client. 2-Secure the lid on the specimen container. 3-Void a small amount into stool. 4-Clean the area surrounding the urinary meatus with the provided cloth. 5-Submit collected specimen to the health care professional. 6-Void into the provided collection device.

1-Provide instruction to the client. 2-Clean the area surrounding the urinary meatus with the provided cloth. 3-Void a small amount into stool. 4-Void into the provided collection device. 5-Secure the lid on the specimen container. 6-Submit collected specimen to the health care professional. A clean-catch urine specimen is used to obtain a specimen that is clean in nature. The procedure is not sterile. The process requires the nurse to provide the needed education to the client. The client will begin by cleaning the area surrounding the meatus with a provided wipe. The client will void into the stool and discard. The client will next void into the provided specimen container. Once the specimen container is filled the client may finish voiding in the stool and discard. The specimen will need to be secured and submitted to the health care professional.

A woman informs the nurse that when she is experiencing stress it is difficult to void, and wonders why this happens. What is the nurse's best explanation? a."Stress causes the muscles to become tense." b."You require greater privacy to void." c."You might have a neurologic condition." d."What medications are you taking?"

a. "Stress causes the muscles to become tense." A person's muscles may become so tense that relaxation of the perineal muscles does not occur, and voiding is inhibited.

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? a.24-hour specimen b.clean-catch specimen c.random specimen d.intermittent specimen

a. 24-hour specimen A 24-hour urine specimen is required for accurate measurement of the kidney's excretion of substances that the kidney does not excrete at the same rate throughout the day. A clean-catch or midstream-voided specimen is used when a specimen relatively free from microorganisms is required. Random urine specimen collection is used when sterile urine is not required.

A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take? a.Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. b.Administer an IV on the arm high above the access site. c.Perform venipuncture below the access site to obtain a blood sample for laboratory testing. d.Measure the client's blood pressure on the arm above the access site.

a. Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. The nurse should auscultate over the hemodialysis access site with the bell of a stethoscope, listening for a bruit or vibration, to assess the patency of the access. The nurse should not measure the client's blood pressure, perform a venipuncture, or start an IV on the access arm, as doing so could lead to infection or clotting of the graft or fistula.

The nurse is teaching an older adult female client who must provide a urine specimen. Which is the proper method to instruct the client to use to obtain a clean-catch urine specimen? a.Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet. b.Catch the urine while holding the labia apart, then cleanse each side of the labia with prepared aseptic swabs. c.Catch the urine while holding the labia apart, after cleansing. Fill the specimen cup. d.Catch the urine in the cup after cleansing the perineum.

a. Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet. The client should first perform hand hygiene, then separate the labia minora and cleanse the perineum with commercially prepared aseptic swabs, starting in front of the urethral meatus and moving the swab toward the rectum. The client should repeat this cleansing process three times with different cotton balls or swabs, then begin to urinate while continuing to hold the labia apart. Next, the client should allow the first urine to flow into the toilet, followed by holding the specimen container under the urine stream. Then, the client should remove the specimen container, release the hand from the labia, seal the container tightly, and finish voiding. The client then performs hand hygiene again.

A client could experience increased urination when using which classification of medication? a.Cholinergic agents b.Analgesic medications c.Central nervous system depressants d.Stool softeners

a. Cholinergic agents Cholinergic agents stimulate the detrusor muscle, which causes more frequent urination. Analgesics act to relieve pain. Central nervous system depressants are medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders. Stool softeners makes bowel movements softer and easier to pass. Reference: Chapter 37: Urinary Elimination - Page 1347

Upon assessment of the urine in a client's indwelling urinary catheter drain bag, the nurse notes the urine to be dark yellow. Which next step should the nurse implement? a.Encourage fluid intake. b.Restrict fluid intake. c.No action is required. d.Alert the health care provider of possible infection.

a. Encourage fluid intake. Conservation of fluid by the body during states of underhydration, fever, and diaphoresis results in the production of concentrated urine that is dark in color. A sign of overhydration would be very light or clear urine. Adequate fluid intake would correspond with pale yellow and clear urine. Signs of urinary tract infection include cloudy urine or urine containing blood or blood cells.

What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence? a.It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. b.The client can apply it himself with minimal supervision. c.It can be left in place for a long period of time. d.A sterile urine specimen can be obtained from the drainage bag tubing.

a. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters. The external condom catheter is not in the bladder. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters which are placed in the bladder. Because it is not sterile, a sterile urine specimen cannot be obtained. Often, the client does not place the external condom catheter by himself. The catheter is changed every day and the skin of the penis is assessed.

The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate? a.Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. b.Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics. c.Ask the client to bear down until the catheter is expelled. d.Remove the catheter from the vagina and attempt to insert it into the bladder.

a. Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. Leaving the catheter in place as a marker assists in the correct placement of the second catheter into the bladder. It is not necessary to contact the health care provider. The vagina is not sterile, so insertion of a sterile catheter poses little risk for infection. Asking the client to bear down is not necessary because the catheter is not typically completely inserted. Removing the catheter from the vagina and attempting to insert it into the bladder will cause cross-contamination.

A nurse will use a bladder scanner to assess a client with urinary frequency. How should the nurse best prepare the client for this procedure? a.Position the client in a supine position. b.Administer a diuretic, as ordered. c.Have the client rest for 15 minutes before the assessment. d.Assess the client's need for analgesia.

a. Position the client in a supine position. Portable bladder scanner results are most accurate when the client is in the supine position during the scanning. The procedure is painless, so there is no specific need to administer analgesia. Diuretics are not given in anticipation of the procedure and it is unnecessary to rest prior to scanning.

The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client? a.The birth can cause perineal swelling. b.A neurogenic bladder results from local anesthesia. c.A urinary tract infection results from the birth process. d.Catheterization is necessary for 1 week.

a. The birth can cause perineal swelling. Trauma from vaginal birth causes swelling in the perineal area, which can obstruct the flow of urine and cause urinary retention during the early postpartum period.

The nurse is teaching a client how to perform pelvic floor muscle exercises (Kegel exercises). Which teaching will the nurse include? a.Tighten the internal muscles used to prevent or interrupt urination. b.Keep muscles contracted for at least 30 seconds. c.Relax muscles for at least 1 minute between contractions. d.Perform these exercises 10 times daily for 1 month.

a. Tighten the internal muscles used to prevent or interrupt urination. Kegel exercises should be performed by tightening the internal muscles used to prevent or interrupt urination for 10 seconds, followed by a period of 10 seconds of relaxation. The client should be instructed to perform this regimen three to four times daily for 2 weeks to 1 month. The client should not be instructed to keep muscles contracted for at least 30 seconds, relax muscles for at least 1 minute between exercises, nor perform these exercises 10 times daily for 1 month. Reference: Chapter 37: Urinary Elimination - Page 1362

A sterile urine specimen for culture and sensitivity has been prescribed for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? a.Withdraw several milliliters of urine from the port on the collection tubing, using aseptic technique. b.Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag. c.Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen. d.Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic.

a. Withdraw several milliliters of urine from the port on the collection tubing, using aseptic technique. When it is necessary to collect a urine specimen from a client with an indwelling catheter, it should be obtained from the catheter itself using the special port for specimens and aseptic technique. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. A client's catheter would not be removed for the sole purpose of obtaining a urine specimen. Collection of a specimen does not need to happen in the morning or after a diuretic.

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? a.anuria b.oliguria c.nocturia d.urinary retention

a. anuria Absence of urine for a 24-hour period reflects anuria.

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: a.oliguria. b.anuria. c.nocturia. d.polyuria.

a. oliguria Oliguria is a significant decrease in urine production (24-hour urine output is <400ml). Anuria is an absence or near-absence of urine output (24 hour urine output is <50ml). Nocturia is nighttime awakening to void. Polyuria is greatly increased urine production (diuresis).

A client is preparing to give a clean-catch specimen. Which instruction will the nurse provide? a.Collect the first urine expelled. b.After the initial stream is initiated, collect the sample. c.Wait until the void is almost over to collect a specimen. d.Collect the entire urinary output.

b. After the initial stream is initiated, collect the sample. A clean-catch specimen is collected in mid-stream. It is not reasonable, nor necessary, to collect the entire urinary output. It is not correct to collect the first urine expelled or to wait until the void is almost over.

While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which sign/symptom would the nurse document as an abnormal finding? a.Moist perineal skin b.Reddened perineal skin c.Presence of smegma d.Absence of discharge

b. Reddened perineal skin The presence of reddened perineal skin is an abnormal finding. The healthy skin should be moist and noninflamed with no discharge present. Smegma (an accumulation of white, odorous secretions from sebaceous glands found under the labia minora in women and under the foreskin in men) is considered a normal finding.

A client's BUN test results are significantly elevated. When reviewing the client's history, which finding is consistent with BUN elevation other than renal compromise? a.The client is on a low protein diet. b.The client is dehydrated. c.The client has a history of osteoarthritis. d.The client is lactose intolerant.

b. The client is dehydrated. The BUN test measures the amount of urea nitrogen in the blood. Urea, the major nitrogenous end-waste product of metabolism, is formed in the liver. The bloodstream carries urea from the liver to the kidneys for excretion. When the kidneys are diseased, they are unable to excrete urea adequately, and urea begins to accumulate in the blood, causing BUN to rise. Normal BUN is 8 to 25 mg/100 mL. Because other factors, such as high dietary intake of protein, fluid deficit, infection, gout, or excessive breakdown of protein stores, can also elevate BUN, it is not a highly sensitive indicator of impaired renal function.

The nurse is caring for a client with weakness who is ambulatory but tires easily. Which method for urinary elimination does the nurse recommend? a.fracture pan b.bedside commode c.bedpan d.regular bathroom

b. bedside commode The client with weakness who tires easily may benefit from a bedside commode. Because the client is ambulatory, a bedpan or fracture pan is not needed. Ambulating to the regular bathroom may increase the risk for falls.

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? a.indwelling urethral catheter b.intermittent urethral catheter c.Foley catheter d.retention catheter

b. 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). With an indwelling urethral catheter (retention or Foley catheters), a catheter (tube) is inserted through the urethra into the bladder for continuous drainage of urine; a balloon is then inflated to ensure that the catheter remains in the bladder once it is inserted.

A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing? a.reflex incontinence b.stress incontinence c.urge incontinence d.functional incontinence

b. stress incontinence The nurse should document the client's condition as stress incontinence following weakening of perineal and sphincter muscle tone secondary to giving birth. Reflex incontinence is caused by damage to motor and sensory tracts in the lower spinal cord secondary to trauma. Urge incontinence is caused by bladder irritation secondary to infection. Functional incontinence is caused by impaired mobility, impaired cognition, or an inability to communicate.

The nurse is caring for an older adult client suspected of having a urinary tract infection. The nurse should assess for what finding specifically associated with the development of this condition in the older adult? a.High fever b.Dysuria c.Acute confusion d.Nausea

c. Acute confusion Symptoms of UTI are different in the older adult, especially if the immune system is depressed. Rather than experiencing painful urination and a high fever, the older adult will become acutely confused.

The nurse is performing a portable bladder ultrasound on a client who has palpable bladder distention. The scanner reveals little urine in the bladder. What should the nurse do next? a.Have the client drink 8 ounces of water every 15 minutes for 1 hour. b.Wipe off some of the ultrasound gel and rescan. c.Ensure proper positioning of the scanner head and rescan. d.Place the client on either side and rescan.

c. Ensure proper positioning of the scanner head and rescan. The scanner head should be repositioned, and the bladder should be rescanned before assuming that the bladder is truly empty. Additional ultrasound gel may need to be added for the scanner to work properly. If the bladder is truly distended, the client may become more uncomfortable from drinking additional water. The best position for bladder scanning is supine.

A nurse is caring for a client with an external condom catheter. Which guideline should be implemented when applying and caring for this type of catheter? a.Remove the catheter every 8 hours, or more often in humid weather. b.Wipe the penis thoroughly with an alcohol swab and dry thoroughly before application. c.Fasten the condom securely enough to prevent leakage without constricting blood flow. d.Ensure the tip of the tubing is touching the tip of the client's penis.

c. Fasten the condom securely enough to prevent leakage without constricting blood flow. Nursing care of a client with a condom catheter includes vigilant skin care to prevent excoriation. This includes removing the condom catheter daily, washing the penis with soap and water and drying carefully, and inspecting the skin for irritation. In hot and humid weather, more frequent changing may be required. In all cases, care must be taken to fasten the condom securely enough to prevent leakage, yet not so tightly as to constrict the blood vessels in the area. In addition, the tip of the tubing should be kept 1 to 2 in. (2.5 to 5 cm) beyond the tip of the penis to prevent irritation to the sensitive glans area. Reference: Chapter 37: Urinary Elimination - Page 1389-1391

A woman is reporting bladder urgency. It is most important to assess: a.exercise. b.weight. c.caffeine intake. d.vitamin supplements.

c. caffeine intake. Fluids or food containing alcohol or caffeine, such as coffee, tea, cola, or chocolate, irritate the bladder and contain a diuretic that can increase urine output when ingested in large amounts.

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? a.reddish-brown, clear b.clear, light yellow c.dark brown, cloudy d.aromatic, green

c. dark brown, cloudy The client with advanced liver disease is expected to have dark brown or dark amber urine; infection may be represented by cloudy urine. Other answers are incorrect.

A client reports that he is often unable to retain urine until he locates a toilet because his mobility is decreased. The nurse should recognize the characteristics of what type of incontinence? a.stress b.urge c.functional d.total

c. functional The nurse should document the client's condition as functional incontinence when the client is unable to retain urine for some time after getting an urge to void. Stress incontinence can result in the loss of small amounts of urine when intra-abdominal pressure rises. Urge incontinence is the need to void, perceived frequently with a short-lived ability to sustain control of flow. Total incontinence is the loss of urine without any identifiable pattern.

A 75-year-old man was admitted to the hospital for altered mental status. He had been in his usual state of good health until this morning when a nurse at the long-term care facility where he lives noticed that he was confused. Shortly after being admitted to the hospital, he became combative and had to be restrained. His bed linens have to be changed frequently because of urinary incontinence. Which nursing diagnosis best describes this client's condition? a.stress incontinence b.urge urinary incontinence c.functional incontinence d.total urinary incontinence

c. functional incontinence Functional incontinence is the inability of a normally continent person to reach the bathroom in time to avoid the unintentional loss of urine. Stress incontinence is a state where the client loses small amounts of urine with increased pressure on the abdomen. Urge urinary incontinence is when a client experiences an involuntary loss of urine when a specific bladder volume is reached. Total urinary incontinence is when a client experiences continuous, unpredictable loss of urine.

The nurse is reviewing the urinalysis of a client suspected of having a urinary tract infection. The potential diagnosis will be supported by the presence of: a.protein. b.calculi. c.pus. d.casts.

c. pus. Pyuria is the presence of pus in the urine. Pyuria occurs in the presence of any UTI. Reference: Chapter 37: Urinary Elimination - Page 1350

A 70-year-old client who has four children and six grandchildren states that she "wets" herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate? a.urge b.reflect c.stress d.total

c. stress Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Other types of incontinence have different causative factors.

The health care provider notifies a client of a diagnosis of glycosuria. Which additional assessment information will the nurse obtain from the client next? a.Frequency of urine b.Intake and output c.Blood pressure d.Blood sugar

d. Blood sugar Glycosuria is a condition that describes the finding of glucose in the urine. The natural next step would be to obtain a fingerstick for blood glucose level. Vital signs are a baseline indicator of any illness or injury. Intake and output may be important going forward, but the diagnosis directs the next action.

The nurse is preparing to irrigate a Foley catheter. What is the nurse's initial action? a.Gather equipment and supplies. b.Assess urine characteristics. c.Explain the procedure to the client. d.Check electronic health record for medical order.

d. Check electronic health record for medical order. The nurse will first check for an order to irrigate the Foley catheter. The other steps can be taken after it has been confirmed that an order for irrigation exists.

A client who undergoes peritoneal dialysis is admitted to the hospital after an elective total-knee arthroplasty. Upon assessment the nurse visualizes redness, drainage, and odor to the area around the peritoneal dialysis catheter. Palpation of the abdomen causes the client pain. Which intervention is the priority? a.Placing the client as N.P.O. status. b.Obtaining laboratory studies. c.Sitting the client up in a greater than a 40-degree angle. d.Notifying the health care provider of the assessment findings.

d. Notifying the health care provider of the assessment findings. The assessment is indicative of peritonitis or infection associated with the peritoneal dialysis catheter. The health care provider may request laboratory studies, but these cannot be obtained until a prescription is received. There is no indication to withhold oral food or fluids from the client at this time. Sitting the client up may aggravate the pain. The nurse should attempt to keep the client in the most comfortable position possible until a prescription is received from the health care provider.

The nurse has received an order to catheterize a female client. What action should the nurse perform? a.Lubricate 3 to 4 in of the catheter tip before insertion. b.Using both hands, hold the catheter near the tip and insert slowly into the urethra. c.Advance the catheter until slight resistance is felt. d.Once urine drains, advance the catheter another 2 to 3 inches (5 to 7.5 cm).

d. Once urine drains, advance the catheter another 2 to 3 inches (5 to 7.5 cm). The nurse should lubricate 1 to 2 in (2.5 to 5 cm) of the catheter tip and, using the dominant hand, hold the catheter 2 to 3 in (5 to 7.5 cm) from the tip and insert slowly into the urethra. The nurse should then advance the catheter until there is a return of urine (approximately 2 to 3 in [5 to 7.5 cm]) and, once urine drains, advance catheter another 2 to 3 in (5 to 7.5 cm). The nurse may encounter slight resistance when advancing the catheter, but this does not necessarily indicate correct placement; further advancement of the catheter may be necessary to obtain urine flow.

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? a.Encouraging the client to stay close to home b.Fluid restriction c.Indwelling catheterization d.Regular toileting routine

d. Regular toileting routine The nurse should document the client's condition as urinary incontinence. A toileting routine and verbal reminders, external catheters for men, absorbent products, and excellent skin care and hygiene are appropriate interventions. Indwelling catheterization and fluid restriction can lead to urinary tract infection. Encouraging the client to stay home may be isolating.

The nurse caring for an older adult male client is determining whether the client can use a urinal to void. Which aspects of the client's medical history may contraindicate the use of a urinal? a.The client was treated for kidney stones a few months earlier. b.The client has a history of benign prostatic hyperplasia (BPH; prostate enlargement). c.The client has had urinary catheters in place repeatedly during previous admissions. d.The client is acutely confused and has been diagnosed with delirium.

d. The client is acutely confused and has been diagnosed with delirium. A client who is acutely confused is likely unable to manipulate a urinal effectively. Kidney stones, BPH, and previous catheterizations do not preclude the use of a urinal. Reference: Chapter 37: Urinary Elimination - Page 1386-1388

A nurse is preparing a discharge teaching plan for a client being sent home with a peritoneal dialysis catheter in place. Which guideline should be included in the instructions? a.The client may bathe rather than shower, provided the site is covered with gauze. b.A dressing should always be worn over the site to avoid leaking. c.Sterile technique must be observed by the client in the home setting. d.The client should avoid wearing tight clothes or belts near the site.

d. The client should avoid wearing tight clothes or belts near the site. Clients should avoid baths and public pools as well as wearing tight clothes and belts around the exit site. Once the site is healed, some health care providers do not require clients to wear a dressing unless the site is leaking. Clean technique is sometimes allowed in the home.

The novice nurse is assessing the urinary bladder of a client with transient urinary incontinence. The nurse mentor would intervene if which action by the novice nurse is noted? a.The novice nurse measures the height of the edge of the bladder above the symphysis pubis. b.The novice nurse asks the client when was the last time he voided before palpating the bladder. c.The novice nurse observes the lower abdominal wall for any swelling. d.The novice nurse asks the client to urinate before palpating the bladder.

d. The novice nurse asks the client to urinate before palpating the bladder. The urinary bladder cannot be palpated when empty, so the client should not urinate before the nurse palpates or percusses it. During data collection, the client should be asked—before the bladder is palpated—when the last voiding occurred. The height of the edge of the bladder should be measured above the symphysis pubis. The lower abdominal wall during an urinary bladder assessment is observed for any swelling.

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? a.dehydration b.infection c.stasis d.blood

d. blood A reddish-brown urine sample is indicative of the presence of blood. The urine appears dark amber in color due to dehydration. Infection and stasis would cause the urine to appear cloudy.

A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample? a.before bedtime b.afternoon c.evening d.first thing in the morning

d. first thing in the morning While the specimen can be collected at any time during the day, the first urine voided in the morning is preferred. 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 has a cerebrovascular accident and is incontinent of bowel and bladder. Incontinence of urine in this client is related to a: a.cystocele. b.enuresis. c.overactive bladder. d.neurogenic bladder.

d. neurogenic bladder. Neurologic injury after a stroke or spinal cord injury can disrupt normal patterns of urinary elimination. This condition is called neurogenic bladder. A cystocele is a herniation of the urinary bladder. Enuresis is the clinical term for bedwetting. An overactive bladder is the term used when a person has increased urinary urge, increased urinary frequency, or both.

A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion? a.inability to control either urinary or bowel elimination b.hygiene measures used to keep meatus and adjacent area of the catheter clean c.use of a catheter to collect urine in a sterile environment d.one or both of the ureters are surgically implanted elsewhere

d. one or both of the ureters are surgically implanted elsewhere The nurse should understand that in a urinary diversion, one or both of the ureters are surgically implanted elsewhere. This procedure is done for various life-threatening conditions. Incontinence is the inability to control either urinary or bowel elimination. Catheter care means the hygiene measures used to keep meatus and adjacent area of the catheter clean. In order to collect a catheter specimen, the nurse uses a catheter to collect a sample of urine in a sterile environment.

A client reports to the nurse that after delivering a baby, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate? a.urge b.total c.reflex d.stress

d. stress Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Urge incontinence takes place when there is a delay in accessing a toilet. Reflex incontinence takes place when a client automatically releases urine and cannot control it. Total incontinence takes place without a pattern or warning, and without client control.