Renal and Urologic Disorders
The nurse is caring for a patient with prostate cancer and symptomatic bone metastases. Which treatment would the nurse prepare the patient for? Avanafil Carbachol Alprostadil Radium-223 dichloride
Radium-223 dichloride Leakage of cancerous cells from a primary tumor that deposit on a bone results in symptomatic bone metastases. Radium-223 dichloride is an alpha particle-emitting radiotherapy drug that mimics calcium and forms complexes with hydroxyapatite at areas of increased bone turnover. Thus this drug is recommended for patients with symptomatic bone metastases. Avanafil is used to treat erectile dysfunction. Carbachol is used to treat prostatitis. Alprostadil is a vasoactive drug.
Which instruction to prevent recurrent urinary tract infections (UTIs) would the nurse provide female patients? "Restrict purines in your diet." "Wipe back to front after urinating." "Schedule a follow-up urine culture." "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.
An older adult patient has a new diagnosis of benign prostatic hyperplasia (BPH). The patient asks the nurse, "How did I even get BPH? I thought I was healthy." Which response by the nurse is correct? "BPH can be caused by a lack of estrogen and too much testosterone in the blood." "BPH can be caused by exercising too much, which increases the amount of estrogen." "As you age, you produce a large amount of testosterone, which contributes to the enlarged prostate." "BPH can be caused by too much dihydrotestosterone as you age, which causes the prostate to increase in size."
"BPH can be caused by too much dihydrotestosterone as you age, which causes the prostate to increase in size." Hormonal changes associated with aging are a contributing factor to BPH. A sex hormone, dihydrotestosterone (DHT), stimulates prostate cell growth, and excess amounts can cause overgrowth of the tissue. As men age, they have a decrease in testosterone but continue to produce high levels of DHT, resulting in prostate enlargement. BPH is not caused by a lack of estrogen, but by an increased proportion of estrogen compared with testosterone. Excessive exercise is not a risk factor for BPH, but a lack of physical activity is a risk factor. As men age, they do not produce large amounts of testosterone; rather, the amount of active testosterone in the blood decreases.
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. "Are you experiencing hesitancy?" "Do you follow urinary hygiene practices?" "Have you experienced any vomiting and/or chills?" "Have you felt a burning discomfort when you urinate?" "Do you have any pain over your suprapubic area or low back?"
"Have you felt a burning discomfort when you urinate?" "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
The nurse provides preoperative teaching for a patient scheduled for transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia (BPH). Which statements by the patient indicate understanding of the teaching? Select all that apply. "I will be able to go home after my treatment." "Erectile dysfunction is rare with this treatment." "I may experience urinary incontinence as a result of this treatment." "This procedure has similar results to that of a transurethral resection of the prostate." "My doctor can see my prostate and the surrounding tissue with this treatment option."
"I will be able to go home after my treatment." "Erectile dysfunction is rare with this treatment." When prescribed the TUMT treatment for BPH, the patient will be able to go home after the treatment (because it is an outpatient procedure), and erectile dysfunction is rare; therefore, these patient statements indicate correct understanding of the teaching presented by the nurse. Urinary incontinence is rare with this procedure, the TUMT does not have similar results as the transurethral resection of the prostate, and the health care provider cannot see the prostate and surrounding tissue. These patient statements indicate a need for further education from the nurse.
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? Pseudomonas Streptococcus Escherichia coli Methicillin-resistant Staphylococcus aureus (MRSA)
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 type of lithotripsy is noninvasive but requires the patient to be anesthetized to ensure the same position is maintained throughout the procedure? Laser lithotripsy Electrohydraulic lithotripsy (EHL) Percutaneous ultrasonic lithotripsy (PUL) Extracorporeal shock-wave lithotripsy (ESWL)
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
Which clinical manifestation would the nurse associate with a urethral stricture? Foamy urine Hyperlipidemia Frequent urge to urinate Sharp pain in flank area
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 side effect would the nurse discuss with a patient being treated for prostate cancer with leuprolide? Diarrhea Priapism Gynecomastia Elevated liver enzymes
Gynecomastia Leuprolide is an androgen synthesis inhibitor drug used to treat prostate cancer. This drug causes hormone imbalances that can lead to gynecomastia. Abiraterone causes diarrhea as a side effect. Trazodone can cause priapism. Degarelix causes elevated liver enzymes.
A patient is diagnosed with benign prostatic hyperplasia and is scheduled for low-wave radiofrequency to heat the prostate. Which complication would the nurse monitor the patient for after the procedure? Infection Hematuria Hydrocele Retrograde ejaculation
Hematuria Transurethral needle ablation is involved in using low-wave radiofrequency to heat the prostate, which can cause necrosis in the patient and lead to hematuria (blood in the urine). Open prostatectomy can cause infection as a side effect. Hydrocele occurs due to swelling of the tunica vaginalis, which surrounds the testis and interference with lymphatic drainage of the scrotum. A possible side effect of laser prostatectomy is retrograde ejaculation.
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? Lithotripsy Marsupialization Transurethral incision Ileal conduit diversion
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 term would the nurse use to document a patient's involuntary or accidental urine loss? Dysuria Intermittency Incontinence Postvoid dribbling
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 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? Interstitial cystitis Glomerulonephritis Acute pyelonephritis Goodpasture syndrome
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
A nurse is caring for a patient diagnosed with benign prostatic hyperplasia (BPH) following a transurethral resection of the prostate (TURP). Which nursing intervention would the nurse include in the plan of care? Restoring urinary drainage Administering prescribed prophylactic antibiotics Discussing concerns related to erectile dysfunction Irrigating the catheter manually if bladder spasms occur
Irrigating the catheter manually if bladder spasms occur For a postoperative TURP patient, the nurse should plan to irrigate the urinary catheter if bladder spasms occur or decreased urine flow is noted. Restoring urinary drainage, administering prophylactic antibiotics, and discussing concerns related to erectile dysfunction are typically nursing interventions that are included in the preoperative plan of care.
The nurse is providing care for a patient diagnosed with benign prostatic hyperplasia (BPH) who prefers minimally invasive therapy. Which therapy would the nurse prepare to teach this patient? Open prostatectomy Laser enucleation of the prostate Transurethral resection of the prostate (TURP) Transurethral incision of the prostate (TUIP)
Laser enucleation of the prostate A laser enucleation of the prostate is an example of a minimally invasive therapy; since this patient prefers this type of therapy, the nurse should prepare to teach this patient about this plan of care. An open prostatectomy, TURP, and TUIP are all more invasive surgical therapies for BPH.
A patient is discharged with an indwelling catheter in place after prostate cancer surgery. Which instructions would the nurse include when teaching the patient about catheter care? Select all that apply. Maintain a high fluid intake. Report bladder hematuria. Attach the catheter to the waistband or pant leg. Clean the urethral meatus with soap and water once a day. Keep the collection bag higher than the bladder at all times
Maintain a high fluid intake. Report bladder hematuria. Clean the urethral meatus with soap and water once a day. The nurse should advise the patient to maintain a high fluid intake; to report bladder spasms, fever, and hematuria; to keep the catheter securely attached to the inner thigh or abdomen rather than to clothing; to clean the urethral meatus with soap and water once a day; and to keep the collecting bag lower, not higher, than the bladder at all times.
A nurse assesses a male patient who reports numerous urinary symptoms. Which early signs of benign prostatic hypertrophy would the nurse recognize? Select all that apply Nocturia Urinary frequency Erectile dysfunction Overflow incontinence Reduced force of urinary stream Difficulty in starting the flow of urine
Nocturia Urinary frequency Reduced force of urinary stream Difficulty in starting the flow of urine Because the prostate surrounds the urethra, enlargement interferes with voiding. Early symptomsinclude the urge to urinate often, some delay in starting urination, nocturia, and decreased force of the urinary stream. Later signs include increased difficulty in initiating a urinary stream and significantly reduced force of stream. Overflow incontinence and erectile dysfunction are not signs associated with benign prostatic hypertrophy
Which medication is the only oral agent approved for the treatment of interstitial cystitis? Penicillin (Amoxicillin) Pentosan (Elmiron) Nortriptyline (Allegron) Amitriptyline (Elavil
Pentosan 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 instructions would the nurse give a patient regarding the management of urinary incontinence after prostate surgery for benign prostatic hyperplasia (BPH)? Select all that apply. Limit fluid intake. Drink citrus juices. Perform Kegel exercise. Avoid caffeine products. Avoid alcohol consumption.
Perform Kegel exercise. Avoid caffeine products. Avoid alcohol consumption. Kegel exercises help strengthen the pelvic muscles and manage urinary incontinence. Avoiding caffeinated and alcoholic products prevents bladder irritation and reduces urinary incontinence. The patient should drink at least two to three liters of fluid per day to flush out the urinary tract. Citrus juices cause bladder irritation and lead to urinary incontinence; these drinks should be avoided.
Which prescribed medication would the nurse expect to administer to a patient reporting painful urination secondary to bladder tumors? Ciprofloxacin (Cipro) Fluconazole (Diflucan) Phenazopyridine (Pyridium) Nitrofurantoin (Macrodantin)
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
A patient will undergo laser prostatectomy for the treatment of benign prostatic hyperplasia (BPH). Which technique would the nurse discuss when educating the patient? Open prostatectomy Transurethral incision of the prostate (TUIP) Photoselective vaporization of the prostate (PVP) Transurethral electrovaporization of the prostate (TUVP)
Photoselective vaporization of the prostate (PVP) The PVP procedure is one technique that is an example of a laser prostatectomy; therefore the nurse should include this procedure in the teaching session. An open prostatectomy, TUIP, and TUVP are not examples of laser prostatectomies.
Which actions would the nurse implement when managing a female patient's active urethritis symptoms? Select all that apply. Provide the patient with a warm sitz bath. Suggest that the patient use a vaginal deodorant spray daily. Teach the patient how to correctly cleanse the perineal area. Inform the patient that she may resume sexual intercourse activities. Obtain a culture and sensitivity analysis of a current urine sample.
Provide the patient with a warm sitz bath. Teach the patient how to correctly cleanse the perineal area. 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? Pyelonephritis Interstitial cystitis Urethral diverticula Glomerulonephritis
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.
An older adult patient with a diagnosis of benign prostatic hyperplasia (BPH) has been scheduled for a contact laser technique. Which occurrence would the nurse determine to be the primary goal of this intervention? Resumption of normal urinary drainage Maintenance of normal sexual functioning Prevention of acute or chronic renal failure Prevention of fluid and electrolyte imbalances
Resumption of normal urinary drainage The most significant signs and symptoms of BPH relate to the disruption of normal urinary drainage and consequent urine retention, incontinence, and pain. A laser technique vaporizes prostate tissue, cauterizes blood vessels, and is used as an effective alternative to a transurethral resection of the prostate (TURP) to resolve these problems. Fluid imbalances, sexual functioning, and kidney disease may result from uncontrolled BPH, but the central focus remains urinary drainage.
The patient has a low-grade carcinoma on the left lateral aspect of the prostate gland and has been monitored for five years. Six months ago, his last prostate-specific antigen (PSA) level was 5 ng/mL. Which manifestations indicate that the prostate cancer may be growing and that he needs a change in his care? Select all that apply. Casts in his urine Presence of α-fetoprotein Serum PSA level 10 ng/mL Onset of erectile dysfunction Nodularity of the prostate gland
Serum PSA level 10 ng/mL Nodularity of the prostate gland The manifestations of increased PSA level along with the new nodularity of the prostate gland potentially indicate that the tumor may be growing. Casts in the urine, presence of α-fetoprotein, and new onset of erectile dysfunction do not indicate prostate cancer growth.
When assessing a patient with benign prostatic hyperplasia (BPH), which diagnostic tests would the nurse anticipate preparing the patient for to rule out related conditions? Select all that apply. Hemoglobin levels Serum uric acid levels Serum creatinine levels Urine analysis with culture Prostate-specific antigen (PSA
Serum creatinine levels Urine analysis with culture Prostate-specific antigen (PSA) Urinalysis with culture is done to identify any infection, bacteria, white blood cells, or microscopic hematuria that may indicate infection or inflammation. Serum creatinine levels should be obtained to rule out renal insufficiency, and a PSA blood test should also be completed to rule out prostate cancer. Hemoglobin levels and serum uric acid levels are not specific to prostate hyperplasia
Which information would the nurse include when preparing education for a patient scheduled to begin radiation therapy and hormone manipulation for prostate cancer? Constipation is usually a problem; a high-fiber diet is recommended. Sexual ability may be affected; discussion with the partner is recommended. An intense daily exercise program will help prevent urinary dysfunction and fatigue. Facial hair loss and a change in voice tone are expected side effects of hormone therapy.
Sexual ability may be affected; discussion with the partner is recommended Sexual function is usually affected by radiation therapy and hormone manipulation for the treatment of prostate cancer. Therefore, it is important for the nurse to suggest options to assist the patient and his partner in adapting and coping with the changes in sexual function that may become permanent. Constipation is usually not a problem with a patient undergoing radiation therapy for prostate cancer. Instead, these patients usually experience diarrhea. Radiation therapy will cause urinary dysfunction and fatigue. Intense exercise in these patients will likely worsen these symptoms. Facial hair loss and change in voice tone are not expected side effects of hormone therapy.
The nurse provides immediate postoperative care for a patient who has undergone perineal prostatectomy. Which manifestations would the nurse monitor the patient for? Signs of infection Impaired physical mobility Problems with urinary control Reports of sexual dysfunction
Signs of infection A patient who has undergone perineal prostatectomy is at high risk for infection in the early postoperative period because of the location of the incision related to the anus. Sexual dysfunction, urinary control, and impaired mobility are of more concern later in the postoperative period.
Which surgical procedure would the nurse associate as treatment for a patient who has frequent urination, accidental loss of urine, and dyspareunia? Cystoscopy Cystolitholapaxy Spence procedure Electrohydraulic lithotripsy
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
A nurse is caring for a patient who has benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). Which drug would the nurse expect to incorporate into the plan of care? Prazosin Tadalafil Silodosin Finasteride
Tadalafil Tadalafil is an erectogenic drug that is used to treat ED for the patient diagnosed with BPH. Prazosin and silodosin are α-adrenergic receptor blockers used to treat BPH; however, these drugs do not treat ED. Finasteride is a 5α-reductase inhibitor used to treat BPH; however, this drug does not treat ED.
When explaining to a patient about the advantages of contact laser techniques over transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), which information would the nurse include? Select all that apply. There is no need for a catheter after the surgery. The laser cauterizes blood vessels, so bleeding is minimal. The contact laser techniques lead to shorter recovery times. The contact laser technique can be performed on patients taking anticoagulants. The laser does not directly touch the prostate, so there is less tissue damage
The laser cauterizes blood vessels, so bleeding is minimal. The contact laser techniques lead to shorter recovery times. The contact laser technique can be performed on patients taking anticoagulants. During the laser-assisted procedure, the blood vessels near the laser tip are immediately cauterized, so there is minimal bleeding. The procedure is advantageous over TURP because it means faster recovery time, and it can be performed on patients taking anticoagulants. A three-way indwelling catheter must be used but can be removed within six to eight hours after the procedure. With contact laser techniques, the laser makes direct contact with the prostate tissue, immediately vaporizing the tissue.
A patient is one day postoperative following a transurethral resection of the prostate (TURP). Which events are expected findings in the care of this patient? Select all that apply. The patient reports fatigue and claims to have minimal appetite. The patient requires two tablets of acetaminophen #3 during the night. The patient has continuous bladder irrigation (CBI) infusing, but output has decreased. The patient has expressed anxiety about his planned discharge home the following day. The patient should be given written discharge instructions regarding ways to decrease anxiety once discharged home
The patient reports fatigue and claims to have minimal appetite. The patient requires two tablets of acetaminophen #3 during the night The patient has continuous bladder irrigation (CBI) infusing, but output has decreased. A decrease or cessation of output in a patient with CBI requires immediate intervention. The nurse temporarily should stop the CBI and attempt to resume output by repositioning the patient or irrigating the catheter. Complaints of pain, fatigue, and low appetite at this early postoperative stage are not unexpected. Discharge planning should be addressed, but this should not precede management of the patient's CBI.
The nurse is performing an assessment of a patient with benign prostatic hyperplasia (BPH). Which finding is likely to be noted on palpation by digital rectal examination (DRE)? The prostate is symmetric, movable, and hard. The prostate is asymmetrically enlarged and uneven. The prostate is symmetrically enlarged, firm, and smooth. The prostate is asymmetrically enlarged, movable, and hard
The prostate is symmetrically enlarged, firm, and smooth. The prostate can be palpated by DRE to estimate its size, symmetry, and consistency. In BPH, the prostate is symmetrically enlarged, firm, and smooth. If the prostate is symmetric, movable, or hard, this does not indicate BPH. An asymmetric, enlarged, movable, hard, and uneven prostate is not indicative of BPH.
A patient is discussing a potential surgery for prostate cancer and asks the nurse the benefit of the robot-assisted radical prostatectomy versus the traditional approach. Which responses by the nurse are correct? Select all that apply. The robot improves recovery time after the procedure. The robot has increased precision during the procedure. The robot has fewer positive outcomes after the procedure. The robot allows better visualization during the procedure. The robot causes an increased length of bed rest after the procedure
The robot improves recovery time after the procedure. The robot has increased precision during the procedure. The robot allows better visualization during the procedure. Robotic-assisted radical prostatectomy allows for better visualization and increased precision and dexterity by the surgeon when removing the prostate gland. Compared with traditional approaches, a robotic-assisted radical prostatectomy has resulted in similar surgical outcomes with improved recovery time.
A patient will undergo a transurethral resection of the prostate (TURP). Which preoperative care would the nurse perform? Select all that apply. Treat any urinary infection with antibiotics. Restore urinary drainage and maintain fluid intake. Inform the patient that surgery may affect sexual function. Ensure that bladder irrigation is done before the surgery. Inform the patient that there will be no complications after surgery
Treat any urinary infection with antibiotics. Restore urinary drainage and maintain fluid intake. Inform the patient that surgery may affect sexual function. Treating any urinary infection with antibiotics, restoring urinary drainage and maintaining fluid intake, and informing the patient that surgery may affect sexual function are actions that should be performed during the preoperative period. Bladder irrigation is done postoperatively and is not included in preoperative care. Informing the patient that there will be no complications after surgery is not appropriate because the main complications that may occur after surgery are hemorrhage, bladder spasms, urinary incontinence, and infection.
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? "The development of mucus is a normal occurrence." "You will need to catheterize your stoma to remove the mucus." "I will call the health care provider to verify the desired stoma outflow." "Your lack of fluid intake thickened the drainage; increase your intake of fluids."
"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.
A patient is scheduled for transurethral resection of the prostate. Which question would the nurse ask to address the patient's concerns about sexual function after the surgery? "Are you worried about how this surgery will affect your sex life?" "This surgery may affect your sex life. Would you like to talk about this?" "What are your concerns about how this surgery will affect your sex life?" "Have you talked to your surgeon about how the surgery will affect your sex life?"
"What are your concerns about how this surgery will affect your sex life?" Giving the patient permission to express his feelings and health-related concerns engages him and his partner and encourages open discussion about concerns regarding the surgery and sexual function. Asking the patient whether he is worried, whether he would like to talk, or whether he has talked with the surgeon does not encourage him to verbalize his concerns. They are not therapeutic and are closed-ended (yes/no) questions.
The nurse is caring for a patient after transurethral resection of the prostate (TURP). Which actions would the nurse perform to maintain patient safety during the initial postoperative period? Select all that apply. Apply traction on the catheter. Remove the catheter and observe. Ask the patient to walk for prolonged periods. Relieve the pressure of the traction on a scheduled basis. Advise the patient to avoid straining during bowel movements
Apply traction on the catheter. Relieve the pressure of the traction on a scheduled basis. Advise the patient to avoid straining during bowel movements Applying traction on the catheter to provide counter pressure (tamponade) on the bleeding site helps to reduce bleeding. The pressure of the traction should be relieved on a scheduled basis to avoid local necrosis. The patient should be advised to avoid straining during bowel movements because this can increase the intraabdominal pressure and can cause more bleeding. Removing the catheter and observing are not advisable, and the patient should not be encouraged to walk for prolonged periods because this too increases the intraabdominal pressure.
Which interventions would the nurse provide when caring for a patient receiving continuous bladder irrigation (CBI) after invasive prostate surgery? Select all that apply. Record intake and output. Clean around the catheter daily. Assess for bleeding and clots. Discontinue CBI and notify the health care provider if obstruction occurs. Provide care instructions for patients being discharged with an indwelling catheter
Assess for bleeding and clots. Discontinue CBI and notify the health care provider if obstruction occurs. Provide care instructions for patients being discharged with an indwelling catheter. The role of a registered nurse during continuous bladder irrigation is to assess for bleeding and clots, to discontinue CBI and notify the health care provider if obstruction occurs, and to provide care instructions for a patient discharged with an indwelling catheter. Recording intake and output and cleaning around the catheter daily are the primary roles of unlicensed assistive personnel (UAP)
Which diagnostic test would the nurse anticipate scheduling for the patient experiencing recurrent infections from a suspected urinary tract obstruction? Sensitivity testing Dipstick urinalysis Clean-catch urine sample CT scan
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.
Which clinical manifestations would the nurse associate with acute pyelonephritis? Chills and flank pain Hemoptysis and rhonchi Hematuria and proteinuria Pain and lower urinary tract symptoms (LUTS)
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
A patient who underwent bladder surgery three hours ago is receiving a continuous bladder irrigation (CBI). The nurse would increase the rate of the CBI for which type of return? Slow Absent Dark red Yellow and cloudy
Dark red If the return becomes dark red, then the solution rate should be increased to flush and irrigate the tube of clots and prevent further formation of clots. If there is no return or the return is slow, then the irrigation should not be increased and the health care provider should be notified. A cloudy return could indicate an infection.
Which prescribed medication would the nurse expect to administer to a patient with a urinary tract infection (UTI) secondary to a fungal infection? Ampicillin (Omnipen) Norfloxacin (Noroxin) Fluconazole (Diflucan) Phenazopyridine (Pyridium)
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.
While caring for a patient after a transurethral procedure, the nurse observes that the patient is showing signs of bladder spasms. Which medication would the nurse expect to be prescribed to the patient? Buserelin Triptorelin Oxybutynin Zoledronic acid
Oxybutynin A transurethral procedure involves the insertion of a resectoscope; this tool can irritate the bladder mucosa and result in urinary bladder spasms. Oxybutynin reduces bladder spasms. Buserelin is used to treat prostate cancer. Triptorelin is recommended for prostate cancer treatment. Zoledronic acid reduces bone mineral loss.
In women, which disorder of the urinary system is caused by Trichomonas? Urethritis Interstitial cystitis Urethral diverticula Chronic pyelonephritis
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 urinary disorder commonly occurs in Jewish men? Bladder cancer Uric acid stones Urinary tract calculi Urinary incontinence
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.
When teaching a female patient measures to prevent recurrent urinary tract infection (UTI), which instructions would the nurse include? Select all that apply. Urinate every six hours. Wipe the perineal area from front to back after urinating. Empty the bladder before and after sexual intercourse. Use vaginal douches or sprays to clean the perineal area. Cleanse with warm soapy water after each bowel movement
Wipe the perineal area from front to back after urinating. Empty the bladder before and after sexual intercourse. 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. "Is your work putting too much stress on you?" "Have you ever received a blood transfusion?" "Do you hold your urine for long periods of time?" "Do you have a recent history of urinary calculi or stones?" "Have you had any condition that required urinary catheterization?"
"Do you hold your urine for long periods of time?" "Do you have a recent history of urinary calculi or stones?" "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 information would the nurse identify as increasing the patient's risk for benign prostatic hyperplasia (BPH)? A history of hyperthyroidism A father with a history of BPH A body mass index (BMI) of 28 Physical activity for 30 minutes at least five days a week
A father with a history of BPH A first-degree relative, such as the patient's father, with a history of BPH is a risk factor for developing this condition. A history of diabetes, not hyperthyroidism, is a risk factor. Obesity, not being overweight as indicated by the current BMI, is a risk factor for BPH. A lack of physical activity is a risk for BPH.
Per evidence-based practice guidelines, which guideline effectively reduces catheter-associated urinary tract infections (CAUTI)? Empty the catheter's collection reservoir every hour. Administer topical and oral antibiotics prophylactically. Clean the sample port of the urinary catheter with alcohol prior to accessing. Avoid unnecessary catheterization and aim for early removal of urinary catheters
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.
When teaching patients with prostate cancer about brachytherapy, which information would the nurse include? Select all that apply. Brachytherapy is a one-time outpatient procedure. Brachytherapy can cause damage to the bladder and rectum. Brachytherapy is best suited for patients with early stage disease. Brachytherapy is advantageous because it preserves erectile function. Brachytherapy has side effects that include urinary irritative or obstructive problems
Brachytherapy is a one-time outpatient procedure. Brachytherapy is best suited for patients with early stage disease. Brachytherapy has side effects that include urinary irritative or obstructive problems Brachytherapy is a one-time outpatient procedure, and the side effects include urinary irritative or obstructive problems. Brachytherapy is best suited for patients with early stage disease because the procedure involves placing radioactive seed implants into the prostate gland, allowing higher radiation doses directly in the tissue while sparing the surrounding tissue. Brachytherapy is specifically designed to protect surrounding tissues such as the bladder and rectum. The procedure can, however, cause erectile dysfunction.
Which aspects would the nurse consider when planning care for a patient who will be undergoing an open prostatectomy for the treatment of benign prostatic hyperplasia (BPH)? Select all that apply. Comfort Infection Sexuality Perfusion Metabolism
Comfort Infection Sexuality Perfusion Disadvantages for an open prostatectomy include acute pain, risk for infection, erectile dysfunction, and bleeding; therefore, the nurse should consider the patient's comfort, risk for infection, sexuality, and perfusion. This procedure does not affect metabolism.
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? After drinking 1 liter of water, wash your hands and collect the urine sample. When you complete your breakfast, immediately collect the next voided urine. Clean your periurethral area, begin voiding, and then catch a sample of your urine. Use the antiseptic cloth to clean your periurethral area before collecting the sample
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.
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? Ultrasound Sensitivity testing Dipstick urinalysis Clean-catch urine sample
Dipstick urinalysis Dipstick analysis is the diagnostic study that is used to detect the presence of white blood cells (pyuria) and bacteria in the urine (bacteriuria). An ultrasound or CT urogram is obtained when urinary system obstruction or urinary tract infections are detected. Sensitivity testing is used to determine the bacteria's susceptibility to a variety of antibiotic drugs. Clean-catch urine sample is a voided midstream technique used for obtaining a urine culture
The nurse is caring for a patient with acute prostatitis. Which interventions would the nurse incorporate into the plan of care for this patient? Select all that apply. Restrict fluid intake. Encourage the patient to walk. Encourage warm sitz baths. Medicate for fever PRN. Administer prescribed antibiotics.
Encourage warm sitz baths. Medicate for fever PRN. Administer prescribed antibiotics. The nurse should manage the fever, administer prescribed antibiotics, and offer warm sitz baths in order relieve the patient's pain. Restricting fluid intake and encouraging the patient to walk will not help to relieve symptoms.
A patient with prostate cancer is receiving drug therapy with androgen receptor blockers. Which side effects would the nurse inform the patient to expect? Select all that apply. Hot flashes Loss of libido Joint swelling Muscle discomfort Erectile dysfunction
Hot flashes Loss of libido Erectile dysfunction Hot flashes, loss of libido, and erectile dysfunction are side effects of androgen receptor blockers because they block the action of testosterone by competing with receptor sites. Joint swelling and muscle discomfort are not side effects of androgen receptor blockers.
Which clinical manifestation associated with benign prostatic hyperplasia (BPH) would cause the nurse to assess the patient's sleep patterns? Dysuria Anxiety Nocturia Hesitancy
Nocturia Nocturia, or the need to urinate while sleeping, is a clinical manifestation associated with BPH that should cause the nurse to assess the patient's sleep pattern. Sleep is often interrupted as a result of nocturia. Dysuria should cause the nurse to assess the patient's cognition or perception. Anxiety should cause the nurse to assess the patient's sexuality or reproductive status. Hesitancy should cause the nurse to assess the patient's elimination patterns.
Which findings would the nurse expect when assessing a patient with stage II prostate cancer? Select all that apply. Prostate-specific antigen (PSA) level is 10 to 20. Gleason score is 2. Tumor is seen by imaging. Tumor is confined to prostate. Cancer has spread to seminal vesicles
Prostate-specific antigen (PSA) level is 10 to 20. Tumor is seen by imaging. Tumor is confined to prostate. The possible findings that indicate stage II prostate cancer include a PSA level of 10 to 20, a tumor that is seen by imaging, and a tumor that is confined to the prostate. A Gleason score of 6 or less indicates stage I, not stage II, prostate cancer. Cancer spreading to the seminal vesicles indicates stage III cancer.
