AH Chapter 55 -Urinary Disorders

If an indwelling catheter is necessary, the nursing interventions that should be implemented to prevent infection include

performing meticulous perneal care daily with soap and water

A client comes to the emergency department complaining of severe pain in the right flank, nausea and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning the clients care the nurse should assign the highest priority to which nursing diagnosis?

Acute pain

A client presents at the clinic with complaints of urinary retention. What question should the nurse ask to obtain additional information about the client's complaint?

"When did you last urinate?"

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

A low-purine diet

The nurse is participating in a bladder retraining program for a pt who had an indwelling catheter for 2 weeks. The nurse knows that, during this process, straight catheterization, after catheter-free intervals, can be discontinued when residual urine is:

<100 mL

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

Assessing present voiding patterns

The nurse is conducting discharge teaching for a pt who was admitted with a kidney stone. The nurse includes which of the following as a measure to prevent additional kidney stones?

Avoid drinking tea

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

Change in cognitive function

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?

Ciprofloxacin (Cipro)

As the nurse comes from morning report, the nurse is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention?

Client voided 300 mL with 250 mL residual volume

The nurse is caring for an older pt whose chart reveals that the pt has a reversible cause of urinary incontinence. The nurse creates a plan of care for which of the following conditions?

Constipation

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

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

A major goal when caring for a catheterized pt 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

Which of the following is a cause of a calcium renal stone?

Excessive intake of vitamin D

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing malignant bladder tumor?

History of cigarette smoking

Which type of incontinency refers to the involuntary loss of urine due to medications?

Iatrogenic

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 is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which of the following should the nurse include?

Implementing a 2 to 3 hour voiding schedule

The client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands that this drug is an effective treatment because it

Increases bladder neck resistance

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing by mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter thats draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output?

Its an abnormal finding that requires further assessment

The nurse caring for a pt after urinary diversion surgery monitors the pt closely for peritonitis by assessing which of the following? Select all.

Leukocytosis Abdominal distention

A nurse who is taking care of a pt 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

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

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action, made by the nursing assistant, would require instruction?

The nursing assistant places the drainage bag on the clients abdomen for transport

The nurse is assessing the client's ileal conduit stoma in the clinic. Which assessment finding would be of greatest concern to the nurse?

The stoma is dusky red

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 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

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

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

Urinary tract

Which of the following terms is used to refer to inflammation of the renal pelvis?

Pyelonephritis

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?

Sedatives

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

Permanent drainage with a urethral catheter

Which of the following is a characteristic of a normal stoma?

Pink color

Which of the following is a potential cause of transient incontinence? Select all.

Delirium Restricted activity Infection of urinary tract Atrophic vaginitis Stool impaction

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 with the nurse document?

Urinary urgency

A pt 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?

Maintain skin and stomal integrity

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

Medication usage

Which finding is an early indicator of bladder cancer?

Painless hematuria

Sympathomimetics have which of the following effects on the body?

Relaxation of bladder wall

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?

Pyridium

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

Risk for infection