Urinary

Ms. Simpson, age 72 years, is being seen in the clinic with a suspected bladder tumor. These tumors occur more frequently in men than women and usually affect clients 50 years of age and older. Use of tobacco products is the leading cause of bladder cancer. You are asking Ms. Simpson about symptoms that she has had that brought her to the clinic. What is the most common first symptom of a malignant tumor of the bladder?

Painless hematuria

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the student have understood the material when they identify which of the following as a cause of stress incontinence?

Decreased pelvic muscle tone due to multiple pregnancies

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

Hematuria

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

Kidney

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:

Loss of motor control of the detrusor muscle.

A patient undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which of the following?

Low purine

A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?

Monitor urine output hourly and report output less than 30 mL/hr.

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

Risk for infection

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections?

The urethra

A 32-year-old client has a history of neurogenic bladder and presents with fever, burning, and suprapubic pain. What would you suspect is the problem?

Urinary tract infection

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?

Urinary urgency

The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which of the following as a contributing factor for UTIs in older adults?

Immunocompromise

The nurse advises the patient with chronic pyelonephritis that he should:

Increase fluids to 3 to 4 L/24 hours to dilute the urine.

Patients with urolithiasis need to be encouraged to:

Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?

"Increase your fluid intake to 2 to 3 L per day."

The nurse is employed in an urologist office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

Anticholinergic

Which type of medication may be used in the treatment of a patient with incontinence to inhibit contraction of the bladder?

Anticholinergic agent

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

Assessing present voiding patterns

Which finding is an early indicator of bladder cancer?

Painless hematuria

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

Low purine

A patient who has been treated with uric acid for stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?

Low-purine diet

The most common presenting objective symptoms of a urinary tract infection in older adults, especially in those with dementia, include?

Change in cognitive functioning

The nurse is educating a patient who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection?

Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.

The nurse is conducting a history and assessment related to a patient's incontinence. Which of the following should the nurse include in the assessment before beginning a bladder training program?

Medication usage

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?

Urinary retention

The nurse is conducting a community education program on urinary incontinence. The nurse determines that the participants understand the teaching when they identify which of the following as risk factors for urinary incontinence?

sedative

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?

take the antibiotic for 3 days as prescribed

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?

urge

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.

• Deficient knowledge: management of urinary diversion • Disturbed body image • Risk for impaired skin integrity

The nurse caring for a patient with a urinary diversion notices mucus around the stents and in the patient's urine. The appropriate nursing intervention is to do which of the following?

Document presence of mucus in the urine.

Which of the following would be included in a teaching plan for a patient diagnosed with a UTI?

Drink liberal amount of fluids.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

cipro

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?

Coffee in the morning

One of the potential problems for the client with a urinary diversion is disturbed body image related to change in appearance and function. The expected outcome is that the client will accept the altered appearance and perform self-care. Which of the following are activities that would help in achieving that expected outcome? Select all that apply.

• Reassure the client that nursing staff will provide care until he or she is ready. • Discuss change in function and let the client know what to expect when recovery from surgery is complete. • Help the client gain independence by reinforcing that self-care is quite manageable and providing time for practice.

A patient has a suprapubic catheter inserted postoperatively. What would be the advantages of the suprapubic catheter versus a urethral catheter? (Select all that apply.)

• The patient can void sooner than with a urethral catheter. • The suprapubic catheter allows for more mobility. • The suprapubic catheter permits measurement of residual urine without urethral instrumentation.

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?

Need to urinate after engaging in sexual intercourse

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?

Painless, gross hematuria

Which of the following medications may be ordered to relieve discomfort associated with a UTI?

Phenazopyridine (Pyridium)

A female patient visits her primary health care provider with a complaint of frequency of urination and incontinence when she sneezes. The health care provider suspects the patient is experiencing cystitis. The nurse knows that this is most likely due to which of the following?

Reflux of urine from the urethra into the bladder

Sympathomimetics have which of the following effects on the body?

Relaxation of bladder wall

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?

Relieve the pain.

Which of the following is the most common site of a nosocomial infection?

Urinary tract

The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements?

Void immediately after sexual intercourse

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:

WBC 50

A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply.

• Empty the collection bag at least every 8 hours to reduce bacterial growth. • Suspend the drainage bag off the floor. • Wash the perineal area with soap and water at least twice daily.