EAQ #5 Urinary/ Specimen collection

A client comes to the emergency department because of minimal urinary output despite drinking adequate fluid. The client's blood pressure is 190/94 mm Hg. For what additional clinical manifestation associated with this data should the nurse assess the client? - Thirst - Weight gain - Urinary retention - Urinary hesitancy

weight gain

The older adult client with a weakened urinary sphincter is at risk for which condition? - Bladder distention - Skin irritation - Tendency to fall or trip over objects - Urinary retention

skin irritation

A client with limited mobility is being discharged. To prevent urinary stasis and formation of renal calculi, what should the nurse instruct the client to do? - Increase oral fluid intake to 2 to 3 L/day. - Maintain bed rest after discharge. - Limit fluid intake to 1 L/day. - Void at least every hour.

Increase oral fluid intake to 2 to 3 L/day.

A client is admitted to the hospital with urinary retention, and an indwelling urinary catheter is prescribed by the primary healthcare provider. What should the nurse do to help prevent the client from developing a urinary tract infection? - Assess urine specific gravity. - Collect a weekly urine specimen. - Maintain the prescribed hydration. - Empty the drainage bag once a day.

Maintain the prescribed hydration.

A client has been admitted with a urinary tract infection. The nurse receives a urine culture and sensitivity report that reveals the client has vancomycin-resistant enterococci (VRE). After notifying the healthcare provider, which action should the nurse take to decrease the risk of transmission to others? - Insert a urinary catheter. - Initiate droplet precautions. - Move the client to a private room. - Use a high-efficiency particulate air (HEPA) respirator during care.

Move the client to a private room.

A nurse is caring for an older bedridden male client who is incontinent of urine. Which action should the nurse take first? - Restrict fluid intake. - Offer the urinal regularly. - Apply incontinence pants. - Insert an indwelling urinary catheter.

Offer the urinal regularly.

A residual urine test is prescribed for a client with benign prostatic hyperplasia. What should the nurse instruct the client to do? - Void after a urinary catheter is removed. - Collect a specimen of urine during midstream. - Attempt to void when a urinary catheter is in place. - Empty the bladder before a urinary catheter is inserted.

Empty the bladder before a urinary catheter is inserted.

The nurse is caring for a client in the postanesthesia care unit. The client had a suprapubic prostatectomy for cancer of the prostate and has a continuous bladder irrigation (CBI) in place. Which primary goal is the nurse trying to achieve with the CBI? - Stimulate continuous formation of urine. - Facilitate the measurement of urinary output. - Prevent the development of clots in the bladder. - Provide continuous pressure on the prostatic fossa.

Prevent the development of clots in the bladder.

The nurse is caring for an older adult client. Which genitourinary factor that contributes to urinary incontinence in older adults should the nurse consider when planning care? - Sensory deprivation - Urinary tract infection - Frequent use of diuretics - Inaccessibility of a bathroom

Urinary tract infection

To help prevent a cycle of recurring urinary tract infections in a female client, which instruction should the nurse share? - "Urinate as soon as possible after intercourse." - "Increase your daily intake of citrus juice." - "Douche regularly with alkaline agents." - "Take bubble baths regularly."

"Urinate as soon as possible after intercourse."

A nurse provides discharge teaching related to intermittent urinary self-catheterization to a client with a new spinal cord injury. Which instruction is most important for the nurse to include? - "Wear sterile gloves when doing the procedure." - "Wash your hands before performing the procedure." - "Perform the self-catheterization every 12 hours." - "Dispose of the catheter after you have catheterized yourself."

"Wash your hands before performing the procedure."

An older adult male is discharged after treatment for urinary tract infection. The family members are instructed regarding age-related changes and care to be taken. In the follow-up visit, which statement made by the client's family indicates decreased risk of urinary retention in the client? - "I ensure he sips water just before bed." - "I respond immediately when he indicates a need to void." - "I provide privacy and assistance to him to void." - "I encourage him to use the urinal at least every 2 hours."

"I provide privacy and assistance to him to void."

A registered nurse is teaching a nursing student about how to safely use a urinary catheter. Which statement made by the nursing student indicates ineffective learning? - "I will avoid the pooling of urine in the tubing." - "I will avoid prolonged clamping of the tubing." - "I will avoid draining urine from the tubing before ambulation." - "I will avoid raising the drainage tube above the level of the bladder."

"I will avoid draining urine from the tubing before ambulation."

Which actions should the nurse perform while collecting subjective data from a client during a focused urinary assessment? - Inquire about painful urination - Ask the client about changes in characteristics of urination - Assess the levels of blood urea nitrogen and creatinine - Palpate the abdomen for bladder distention or masses - Inspect the urinary meatus for inflammation or discharge

A,B

Despite receiving 2900 mL intake for 2 days, the client's urine output has progressively diminished. The nurse identifies that the urinary output is less than 40 mL/hr over the past 3 hours. What action will the nurse take? - Assess breath sounds and obtain vital signs. - Decrease the intravenous flow rate and increase oral fluids. - Insert an indwelling catheter to facilitate emptying of the bladder. - Check for dependent edema by assessing the lower extremities.

Assess breath sounds and obtain vital signs.

An older adult in an acute care setting is having urinary incontinence. Which interventions would help the client? - Provide nutritional support - Provide voiding opportunities - Avoid indwelling catheterization - Provide beverages and snacks frequently - Promote measures to prevent skin breakdown

B,C,E

Which findings in the older client are associated with a urinary tract infection (UTI)? - Fever - Urgency - Confusion - Incontinence - Slight rise in temperature

C,D,E

While reviewing the result of an intravenous pyelogram, the nurse discovers that the client has a shortened urethra. The client also complains of urinary incontinence. Which nursing intervention is beneficial for the client? - Providing thorough perineal care after each voiding - Encouraging the client to use the toilet or bedpan every 2 hours - Responding quickly to the client's indication of the need to void - Providing privacy, assistance, and voiding stimulants over the perineum

Providing thorough perineal care after each voiding

What is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs)? - Removing the catheter - Keeping the drainage bag off of the floor - Washing hands before and after assessing the catheter - Cleansing the urinary meatus with soap and water daily

Removing the catheter

A nurse is caring for a client diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) in the urine. The healthcare provider orders an indwelling urinary catheter to be inserted. Which precaution should the nurse take during this procedure? - Droplet precautions - Reverse isolation - Surgical asepsis - Medical asepsis

Surgical asepsis

The nurse provides discharge instructions to a male client who had an ureterolithotomy. The client has a history of recurrent urinary tract infections (UTIs). For which indicators of a UTI should the nurse instruct the client to be on the alert? - Urgency or frequency of urination - An increase of ketones in the urine - The inability to maintain an erection - Pain radiating to the external genitalia

Urgency or frequency of urination

A nurse is providing care to a client 8 hours after the client had surgery to correct an upper urinary tract obstruction. Which assessment finding should the nurse report to the surgeon? - Incisional pain - Absent bowel sounds - Urine output of 20 mL/hr - Serosanguineous drainage on the dressing

Urine output of 20 mL/hr

A primary healthcare provider prescribes a urinalysis for a client with an indwelling catheter. To ensure that an appropriate specimen is obtained, the nurse would obtain the specimen from which site? Tubing injection port Distal end of the tubing Urinary drainage bag Catheter insertion site

tubing injection port

A urine specimen is needed to test for the presence of ketones in a diabetic client. What should the nurse do when collecting this specimen from a urinary catheter? - Disconnect the catheter, and drain the urine into a clean container. - Clean the drainage valve, and remove the urine from the catheter bag. - Wipe the catheter with alcohol, and drain the urine into a sterile test tube. - Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.

Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.