232 Urinary elimination
A nurse is inserting a urinary catheter into a client who is extremely anxious about the procedure. The nurse can facilitate the insertion by asking the client to:
breathe deeply
A client who had transurethral resection of the prostate has dribbling urine after his Foley catheter is removed on the second postoperative day. The nurse notes that the client had 200 mL of urine output in the last 8 hours with a 1,000-mL intake. What should the nurse do first?
Assess for bladder distention.
Which question should the nurse ask first when obtaining a history from the parent of a school-age child with a fever, malaise, and swelling around the eyes?
"Does the child urinate as much as usual?"
A registered nurse and a nursing assistant are caring for a group of clients. Which client's care may safely be delegated to the nursing assistant?
A client diagnosed with renal calculi who must ambulate four times daily and drink plenty of fluids.
When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches the client how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?
The client keeps the drainage bag below the bladder at all times
The nurse is assessing a client who has benign prostatic hypertrophy (BPH). The nurse should determine if the client has which symptom?
difficulty starting the urinary stream
The primary reason for lubricating the urinary catheter generously before inserting the catheter into a male client is to prevent which problem?
friction along the urethra when the catheter is being inserted..
A nurse is caring for an elderly adult client admitted to the hospital from a nursing home because of a change in behavior. The client has a diagnosis of Alzheimer's disease and has started to experience episodes of incontinence. The hospital staff is having difficulty with toileting because the client wanders around the unit all day. To assist with elimination, a nurse should:
incorporate the client's toileting schedule into the pattern of his wandering.
A client with fever and urinary urgency must provide a urine specimen for culture and sensitivity. The nurse should instruct the client to collect the specimen from the
middle stream of urine from the bladder.
Which aspects of client care would be most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
obtaining a urine specimen for a culture and sensitivity analysis from a client who has an indwelling urinary catheter inserted
When assessing an 18-year-old primipara who gave birth under epidural anesthesia 24 hours ago, the nurse determines that the fundus is firm but to the right of midline. Based on this finding, the nurse should further assess for which complication?
urinary retention
Which client is at highest risk for developing a urinary tract infection?
a man with an indwelling urinary catheter
A client is diagnosed with acute pyelonephritis. What should the nurse instruct the client to do?
Empty the bladder every 2 to 3 hours
A client developed cardiogenic shock after a severe myocardial infarction and has now developed acute renal failure. The client's family asks the nurse why the client has developed acute renal failure. What should the nurse tell the family? "Because of the cardiogenic shock, there is:
a decrease in the blood flow through the kidneys.
Using Abraham Maslow's hierarchy of human needs, the nurse assigns highest priority to which client need?
inserting a Foley catheter
After teaching the parents about the urethral catheter placed after surgical repair of their son's hypospadias, the nurse determines that the teaching was successful when the mother states that the catheter in her child's penis accomplishes which goal?
keeps the new urethra from closing
The nurse is instructing an unlicensed assistive personnel (UAP) to collect a urine specimen from an indwelling catheter. Which statement indicates that the UAP understands the instructions?
"I'll get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container."
A physician orders hourly urine output measurement for a postoperative client with an indwelling catheter. The nurse records these amounts of output for 2 consecutive hours: 8 a.m. (0800): 50 ml; 9 a.m. (0900): 60 ml. Based on these amounts, which action should the nurse take?
Continue to monitor and record hourly urine output.
A client is to be discharged from same-day surgery 7 hours after his inguinal hernia repair. Which nursing observation indicates this client is ready to be discharged?
The client voids 500 mL of urine.
A confused client with carbon monoxide poisoning experiences dizziness when ambulating to the bathroom. What should the nurse do?
Check on the client at regular intervals to ascertain the need to use the bathroom.
The nurse teaches a primigravid client how to do Kegel exercises. What does the nurse explain is the expected outcome of these exercises?
strengthening the perineal muscles
