Ch 35

An older adult with urge incontinence and overactive bladder begins medication treatment with oxybutynin. Which side effects would the nurse include in the education?

Dry mouth and constipation are common.

A young mother asks, "Why can my 3-year-old daughter have a bowel movement on the toilet but she wets her pants?" What is the nurse's best response?

"Bowel control occurs earlier than bladder control."

The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement?

"Frequency is not a major problem for the elderly."

A client has a spastic bladder. Which comment is of most concern to the nurse?

"I feel like I have a fever."

A neighbor is complaining to a friend (who happens to be a nurse) about several changes in her body. Which of the following complaints raises a "red flag" because it could be a sign of epithelial cell bladder cancer?

"I noticed my urine is pinkish red, but I'm not having any pain when I pee."

Following a health promotion class, which statement by a participant demonstrates an accurate understanding of the risk factors for bladder cancer?

"More than ever, I guess it would be worthwhile for me to quit smoking."

A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client?

"This value indicates you are having difficulty emptying your bladder."

A client who is experiencing bladder overfilling will more than likely have which disease process? Select all that apply.

-Diabetic neuropathies -Multiple sclerosis

The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply.

-Surgical removal -Radiation therapy -Chemotherapy

One of the many tests done during urodynamic studies is the sphincter electromyelogram. What does this test study?

Activity of the voluntary muscles of the perineal area

Which type of pharmacologic therapy does the nurse anticipate administering to a client for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is:

Bladder

Disruption of which muscle's contraction can lead to the inability to expel urine from the bladder?

Detrusor

While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"?

Detrusor muscle

An older male comes to the clinic with the chief report of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. What should the nurse suspect to be the most frequent cause of this client's problem?

Enlargement of prostate gland

Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction?

Incontinence

A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis?

Incontinence related to neuropathy causing overactive bladder

A client reports that she frequently suffers from UTIs after engaging in sexual intercourse. Which would be the best information for the nurse to provide?

Increase fluid intake before intercourse

A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (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.

An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence?

Loss of small amounts of urine when laughing or sneezing

A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status?

Perform intermittent catheterization

A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as:

Stress

The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence?

Transient

A client is admitted with lower urinary tract obstruction and stasis. Which action is the primary intervention?

Urinary catheterization

The nurse is evaluating client risk for the development of overactive bladder/urge incontinence and determines that which client is at highest risk for this condition?

A client with diabetes mellitus

A 65-year-old female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include:

cystoscopy.

The body compensates for obstructed urine outflow up to a certain point. Which signs/symptoms lead the nurse to suspect decompensatory changes are occurring? Select all that apply.

-Urinary frequency noted -High residual volume up to 1000 mL -Must strain to initiate the stream of urine