Ch. 55: Management of Patients With Urinary Disorders

Which nursing diagnosis is appropriate for a client with renal calculi?

Risk for infection

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

If an indwelling catheter is necessary, which of the following nursing interventions should be implemented to prevent infection?

Performing meticulous perineal care daily with soap and water

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

Anticholinergic agent

The nurse working with a patient after an ileal conduit notices that the pouching system is leaking small amounts of urine. The appropriate nursing intervention is which of the following?

Change wafer and pouch.

A female client who is diagnosed with a malignant tumor in her bladder is advised to undergo cystectomy followed by a urinary diversion procedure. Which of the following would be most important for the nurse to assess preoperatively?

Client's manual dexterity and vision

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?

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

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

Drink liberal amount of fluids.

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

Encouraging intake of at least 2 L of fluid daily

Urinary tract infections increase with age and disability. The nurse is aware that the elderly often fail to exhibit the typical symptoms of a UTI. Therefore, a urine culture and sensitivity should be obtained. What bacteria would the nurse expect to find to help confirm the diagnosis of a UTI?

Escherichia coli

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

Excessive intake of vitamin D

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

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 nurse is caring for a client with acute pyelonephritis. Which nursing intervention is the most important?

Increasing fluid intake to 3 L/day

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

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

Which finding is an early indicator of bladder cancer?

Painless hematuria

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)

The nurse is preparing to assess a patient's newly created stoma. Which of the following findings would the nurse include in the documentation of a healthy stoma?

Pink color

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

Pyelonephritis

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

When describing the types of bladder tumors that may occur, which type would the nurse identify as most common?

Transitional cell carcinoma

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances?

Uric acid

Which of the following is a strategy to promote urinary continence?

Void regularly, 5 to 8 times a day

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.

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 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 caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?

"My urine will be eliminated through a stoma."

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?"

A female client who suffers from urethral strictures undergoes a dilation procedure. Following the procedure, she experiences a burning sensation while voiding. Which of the following instructions would be most helpful?

Instruct her to take warm sitz baths.

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

WBC 50

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

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.

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following?

By ascending infection (transurethral)

Which of the following is the most common symptom of bladder cancer?

Painless gross hematuria

Sympathomimetics have which of the following effects on the body?

Relaxation of bladder wall

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

Which of the following is classified as a upper urinary tract infection (UTI)? Select all that apply.

-Acute pyelonephritis -Renal abscess

The nurse is participating in a bladder retraining program for a patient 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 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 this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Acute pain

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

Anticholinergic

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

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

Assessing present voiding patterns

A client is suspected of having interstitial cystitis. Which diagnostic test would the nurse anticipate as being used to confirm the diagnosis?

Bladder biopsy

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as:

Bladder retaining

The nurse is to check residual urine amounts for a client experiencing urinary retention. Which of the following would be most important?

Catheterize the client immediately after the client voids.

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 caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?

Peritonitis

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

Risk for infection

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 client's abdomen for transport

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 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 urinary diversion procedure follows a cystectomy and is performed to divert urine to another collecting system. In addition to the use with bladder tumors, it is also used for extensive pelvic malignancies and severe traumatic injury to the bladder. The type of urinary diversion that requires an external ostomy bag to collect the urine is called a:

cutaneous urinary diversion.

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

performing meticulous perineal care daily with soap and water.