Prepu chapter 27
The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which of the following statements?
"Alterations in bladder function can only occur when there is incontinence."
A young mother asks,"Why can my 3-year-old daughter have a bowel movement on the toilet but she wets her pants?" Which of the following is the nurse's best response?
"Bowel control occurs earlier than bladder control."
The nurse is conducting pre-operative teaching for a patient with bladder cancer who is scheduled to undergo surgical creation of an alternative bladder reservoir. The nurse determines that the patient is understanding the pre-operative teaching when the patient identifies the surgical treatment as which of the following?
Cystectomy
24s A 71-year-old client reports to the nurse that he often notices a pink tinge to his urine. Upon further questioning, he states that he experiences no pain when voiding and has not noticed any change in the frequency of his voiding. Which response by the nurse is best?
Promptly report this finding to the client's primary care provider.
An older adult states that he awakens at least three times each night to void. When assessing the client, what potential causative factor should the nurse prioritize?
The client takes his prescribed beta blocker and diuretic each evening at bedtime.
A young adult client is currently in a rehabilitation facility following a spinal cord injury at level T2. They are discussing long term options for continence management. Which statement demonstrates the client has a clear understanding of the issue?
"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."
A diabetes education nurse is teaching a group about the potential genitourinary complications of diabetes. Which teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus?
"It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying."
Which methods are most commonly used to treat detrusor-sphincter dyssynergia?
Anticholinergic medications and urinary catheterization
The nursing instructor who is teaching about incontinence in the elderly recognizes a need for further instruction when one of the students makes which of the following statements?
"Frequency is not a major problem for the elderly."
The client has just been diagnosed with bladder cancer and asks the nurse what causes it. Which of the following would be the nurse's best response to the client?
"The cause is unknown."
A mother asks, "why can't my 1 year old go to the bathroom by himself?" Which of the following is the nurse's best response?
"Your child is too young to begin toilet training."
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?
Administration of a-adrenergic agonistic drugs as ordered
Which of the following accurately describes the etiology of stress incontinence?
An increase in intra-abdominal pressure which results in involuntary urination
A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which of the following medications should the nurse plan on the physician ordering to also treat this problem?
Anticholinergic medication
When explaining about the passage of urine to a group of nursing students, the clinic nurse asks them which muscle is primarily responsible for micturition? Which student response is correct?
Detrusor
6s While studying about the process of urination, the nursing student learns that which of the following is known as the "muscle of micturition"?
Detrusor muscle
Which reserve urinary structure helps to stop micturition when it is occurring and maintains continence under high bladder pressure?
External sphincter
A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?
Gross hematuria
Which of the following assessments indicates to the nurse that a patient may have a spastic bladder dysfunction?
Incontinence
A nurse is caring for a patient admitted for chemotherapy due to bladder cancer. Which route would the nurse anticipate that the chemotherapy will be administered when the goal is to minimize systemic side effects?
Intravesical
A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 14 kg overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer?
It is caused by carcinogens that are excreted in the urine and stored in the bladder.
A female client asks the nurse if there is any noninvasive treatment to help with the involuntary loss of urine that occurs when she coughs or sneezes. Which is the best response by the nurse?
Kegel exercises
Which layer is produced by the bladder epithelia that binds water and forms a protective barrier between the bladder wall and the components of urine, thus protecting the bladder from carcinogens and infective organisms?
Mucin
A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. Which is the most likely diagnosis and possible underlying pathophysiologic problem?
Overactive bladder that may result from both neurogenic and myogenic sources.
A male client reports awakening three to four times nightly to void, and often has a sudden need to void with little warning during the day. What is this clients most likely diagnosis and possible underlying pathophysiological problem?
Overactive bladder that may result from both neurogenic and myogenic sources.
When teaching a community education class about the 7 warning signs of cancer, the nurse will note which is most common sign of bladder cancer?
Painless bloody urine.
A client who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. Their BP is 186/101; heart rate 45; profusely sweating and complaining of "not feeling right." Which intervention should the nurse perform at this time?
Palpate their bladder for overdistention.
An elderly resident of an assisted living facility has been inconsistently continent of urine until the last several weeks. Which intervention by the care providers at the facility is the most likely priority?
Performing a physical examination and history to determine the exact cause and character of the incontinence.
The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply.
Radiation therapy Surgical removal Chemotherapy
A elderly client with an upper respiratory infection for several weeks has presented with urinary retention. The client reports taking non-prescription cold medications over and above the suggested dose. Which medication most likely is contributing to this urinary retention?
The anticholinergic effects of the medication are impairing normal bladder function.
Which clients would the nurse assess for possible urinary retention? Select all that apply.
The client receiving an antihistamine The client taking over-the-counter medication for a cold or flu The client with depression taking an antidepressant The client with psychosis taking antipsychotic medicine daily
Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?
The stretch receptors in the bladder wall become hypersensitive.
A parent asks the nurse what signs and symptoms a child would display if the child had a urinary tract infection. Which is the best response by the nurse?
They do not present with typical symptoms.
A patient has a postvoid residual (PVR) volume of 40 mL. Which of the following information would the nurse teach the patient?
This is a normal value."
Which of the following clinical manifestations would tell a nurse that a patient is having progressive decompensation related to obstruction of urinary outflow?
When tested for residual urine volume, 1400 mL of urine is obtained when patient is catheterized.
An instructor is assisting a nursing student with inserting an indwelling catheter for a patient with urinary retention and acute overdistention of the bladder. The student inserts the catheter and gets an immediate return of clear yellow urine. When should the student clamp the catheter?
When the patient returns 1000 mL of urine from the bladder at once