EAQS Urinary

A nurse is assessing the severity of a patient's urinary elimination problem. Which question is most appropriate? "Does your urinary problem restrict you from doing your usual activities?" "Do you dribble urine before voiding, after voiding, or at other times?" "Have you been hospitalized or have you received a diagnosis of a new medical problem recently?" "How often are you awakened with the urge to void while you are sleeping?"

"How often are you awakened with the urge to void while you are sleeping?" To assess the severity of a patient's urinary elimination problem, the nurse may ask the patient about the frequency of being awakened at night with the urge to void. To assess the effects of the patient's urinary elimination problem, the nurse may ask whether the urinary problem interferes with the patient's usual activities. To assess signs and symptoms, the nurse may ask whether the patient dribbles urine before voiding, after voiding, or at other times. To determine any predisposing factors, the nurse may ask whether the patient recently has been hospitalized or received a diagnosis of a new medical problem.

A nurse is educating a patient who has altered urinary elimination on how to maintain a healthy bladder. Which of the patient's statements indicate a need for further education? Select all that apply. "I'll drink six to eight glasses of water a day." "I'll avoid drinking beverages that contain caffeine." "I'll avoid drinking fluids 4 hours before bedtime to decrease nocturia." "I'll immediately tell my doctor if I experience pain when voiding." "After each voiding and bowel movement, I'll cleanse my perineum from back to front."

"I'll avoid drinking fluids 4 hours before bedtime to decrease nocturia." "After each voiding and bowel movement, I'll cleanse my perineum from back to front." The nurse should provide proper education to patients with altered urinary elimination about maintaining a healthy bladder. To decrease nocturia, the patient should be instructed to avoid drinking fluids 2, not 4, hours before bedtime. The nurse should advise the patient to cleanse the perineum from front to back, not back to front, after each voiding and bowel movement to help prevent urinary tract infections. The other statements indicate understanding. The patient should drink six to eight glasses of water a day to help maintain adequate hydration. The patient should avoid caffeine, and the patient should immediately report pain when voiding.

A patient tells a nurse, "I lose small amounts of urine while coughing, laughing, exercising, and walking but not at night while sleeping." Which of the nurse's responses is most appropriate? A patient tells a nurse, "I lose small amounts of urine while coughing, laughing, exercising, and walking but not at night while sleeping." Which of the nurse's responses is most appropriate? "You may require intermittent catheterization." "You should avoid caffeine, artificial sweeteners, and alcohol." "I'll teach you pelvic muscle exercises that you can perform regularly to address the problem." "You can perform urge-inhibition exercises to obtain relief from symptoms of urinary incontinence."

"I'll teach you pelvic muscle exercises that you can perform regularly to address the problem." Loss of a small volume of urine while coughing, laughing, exercising, and walking but not at night while sleeping, is characteristic of stress incontinence. This type of incontinence can be managed with pelvic muscle exercises. Overflow incontinence is associated with chronic retention of urine, and patients with this type of incontinence may require intermittent catheterization. Patients with urge incontinence may be instructed to avoid bladder irritants such as caffeine, artificial sweeteners, and alcohol. Urge-inhibition exercises may also help relieve symptoms associated with urge incontinence, not stress incontinence.

A registered nurse is educating nursing students about the factors that influence urination. Which of a student nurse's statements indicates a need for further education? "Patients with anxiety and stress may have increased frequency of voiding." "Patients who take atropine may have an increased risk of urinary retention." "Patients who undergo lower abdominal surgery may require the temporary use of an indwelling urinary catheter." "Patients with pathologic conditions such as arthritis and dementia may experience either bladder over activity or deficient bladder emptying."

"Patients with pathologic conditions such as arthritis and dementia may experience either bladder over activity or deficient bladder emptying." Patients with pathological conditions such as arthritis and dementia may experience interference with timely access to a toilet, not bladder over activity or deficient bladder emptying. The other statements are correct. Psychological factors such as anxiety and stress may affect a sense of urgency and increase the frequency of voiding. Anticholinergics, such as atropine, inhibit bladder contractility and thereby increase the risk of urinary retention. Local trauma during lower abdominal surgery may obstruct urine flow; therefore, patients who undergo lower abdominal surgery may require the temporary use of an indwelling urinary catheter. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking, and look for key words; (2) read each answer thoroughly, and see if it completely covers the material the question asks; and (3) narrow the choices by immediately eliminating answers you know are incorrect.

A nurse is assisting the primary health care provider in assessing a patient with altered urinary elimination. After assessing the patient, the primary health care provider suspects that the patient has an obstruction of the ureters. Which diagnostic test does the nurse expect the patient to undergo? A nurse is assisting the primary health care provider in assessing a patient with altered urinary elimination. After assessing the patient, the primary health care provider suspects that the patient has an obstruction of the ureters. Which diagnostic test does the nurse expect the patient to undergo? Cystoscopy Abdominal roentgenogram Ultrasound of the urinary bladder Axial computed tomographic scan

Axial computed tomographic scan An axial computed tomographic scan is commonly used to identify anatomic abnormalities, renal tumors and cysts, calculi, and obstruction of the ureters. Cystoscopy is an invasive procedure used to detect bladder tumors and obstruction of the bladder outlet and urethra. An abdominal roentgenogram is commonly ordered to detect and measure the size of urinary calculi. An ultrasound scan of the urinary bladder is helpful in the measurement of the post void residual volume.

The nurse takes an order to obtain a post-void residual for a patient via catheterization. Which is the best method to obtain this measurement? The nurse takes an order to obtain a post-void residual for a patient via catheterization. Which is the best method to obtain this measurement? Intermittent catheterization Long-term indwelling catheterization Short-term indwelling catheterization Medium-term indwelling catheterization

Intermittent catheterization Intermittent catheterization is used when evaluating the residual urine following urination. The investigation requires measurement of urine remaining in the bladder after voiding. Intermittent catheterization prevents the risk of infection. Long-term catheterization is done in patients with urinary retention. It may also be done for patients with recurrent episodes of urinary infections, skin breakdown, and terminal illness. Short-term catheterization is required for obstructive conditions, surgical repair of bladder and urethra, prevention of urethral obstruction, and bladder irrigation. There is no such thing as medium-term indwelling catheterization.

A nurse is caring for a patient with an indwelling catheter. Which nursing action may increase the risk for a catheter-associated urinary tract infection? Collecting specimens via a port in the tubing Keeping the drainage bag above the level of the bladder Allowing the patient to wear a leg bag while ambulating Monitoring the drainage system to prevent backflow of urine

Keeping the drainage bag above the level of the bladder An indwelling catheter is attached to a urinary drainage bag to collect the continuous flow of urine. The nurse should always keep the drainage bag below the level of the patient's bladder to allow urine to drain down out of the bladder, because pooling of urine in the tubing may increase the risk of a catheter-associated urinary tract infection. Urine specimens for laboratory examinations should be collected via a special port in the tubing. The nurse should ensure that the urinary drainage bag does not touch the ground; patients may be allowed to wear a leg bag while ambulating. Backflow of urine from the tubing and bag into the bladder increases the risk of catheter-associated urinary tract infection; therefore, the nurse should monitor the system to prevent such an occurrence.

A nurse is caring for a patient with a spinal cord injury who reports an absence of awareness of bladder filling and the urge to void. A family member adds that the patient also sometimes has leakage of urine without awareness. Which nursing intervention is most important for the patient? A nurse is caring for a patient with a spinal cord injury who reports an absence of awareness of bladder filling and the urge to void. A family member adds that the patient also sometimes has leakage of urine without awareness. Which nursing intervention is most important for the patient? Placing an indwelling catheter Encouraging the patient to perform pelvic muscle exercises Monitoring the postvoid residual volume according to the health care provider's direction

Monitoring for autonomic dysreflexia Reflex urinary incontinence occurs in patients who have spinal cord injuries and, it is characterized by diminished or absent awareness of bladder filling and the urge to void. The patient may also have leakage of urine without awareness. Patients with reflex urinary incontinence have an increased risk of autonomic dysreflexia, which is a life-threatening condition. This is a medical emergency that requires immediate intervention, so the nurse's most important intervention is to monitor the patient for autonomic dysreflexia and notify the health care provider immediately. Patients with overflow urinary incontinence may require the use of an indwelling catheter. Patients with stress urinary incontinence should be encouraged to perform pelvic muscle exercises. Monitoring the postvoid residual volume according to the health care provider's direction is important when caring for a patient with mild urinary retention associated with overflow urinary incontinence. p. 1105

A patient reports having the urge to void, but urine starts leaking before the patient reaches the bathroom. Which treatment strategies would be helpful for this patient? Select all that apply. Scheduled toileting Absorbent products Electrical stimulation Clothing modification Antimuscarinic agents

Scheduled toileting Absorbent products Clothing modification Functional incontinence is characterized by the inability to reach the bathroom in time. Scheduled toileting involves teaching the patient to void at specified times so that there is no urgency. Use of absorbent products helps prevent soiling of clothes. Clothing can be modified to make it easier to remove when there is an urgency to void. Electrical stimulation is helpful for patients with stress incontinence. Antimuscarinic agents are helpful for patients with urge incontinence.

A 70-year-old woman complains of involuntary passage of urine. The leakage of urine occurs in small amounts and is more frequent when she coughs. The nursing assessment reveals that the patient is obese, has had three pregnancies, and has already gone through menopause. Which nursing interventions would be helpful to this patient in reducing incontinence? Select all that apply. Advise the patient to suppress coughs. Teach the patient Kegel exercises. Advise the patient to avoid caffeinated drinks. Stress the importance of losing weight. Encourage lifting heavy weights to increase muscle strength.

teach the patient Kegel exercises. Advise the patient to avoid caffeinated drinks. Stress the importance of losing weight. Kegel exercises increase the strength of muscles around the urethra and help to reduce stress incontinence. Losing weight helps to reduce stress incontinence. Cough is a reflex activity and is difficult to control voluntarily. Caffeinated drinks have a diuretic effect and increase stress incontinence. Lifting heavy weights increases abdominal pressure and thus increases incontinence; therefore, this activity should be avoided.

What should the nurse teach a patient who has altered urinary elimination about maintaining a healthy bladder? "Drink ample fluids before bed time." "Drink three to four glasses of water daily." "Avoid drinking tea, coffee, or chocolate drinks." "Limit fluid intake if there is urinary incontinence."

The nurse should teach the patient to avoid beverages that contain tea, coffee, or chocolate. Drinking fluids before bed time should be avoided because of the risk of nocturia. A patient should be advised to drink six to eight glasses of water a day. Fluid intake should not be limited even if there is urinary incontinence.

Within what duration of voiding should the scan measurement be performed for measuring residual bladder volume? Record your answer using a whole number.

10 minutes The scan measurement should be done within 10 minutes of voiding.

What size (in French scale) urinary catheter should the nurse use for a 17-year-old girl? Write your answer using a whole number. Fr

12 Fr

A nursing instructor asks the nursing assistive person (NAP) to explain the skills of perineal care for a patient with an indwelling catheter. Which statement if made by the NAP indicates a need for further learning? "A female patient should be placed in dorsal recumbent position." "A catheter should be grasped with two fingers to stabilize it near the meatus." "A catheter should be cleaned using a vertical motion moving towards the meatus." "A waterproof pad should be placed under the patient while performing perineal care."

"A catheter should be cleaned using a vertical motion moving towards the meatus." The nursing assistive person (NAP) should clean the catheter using a circular motion directed upwards/away from the meatus. A female patient is placed in dorsal recumbent positioning. The catheter is grasped with two fingers to stabilize it near the meatus. A waterproof pad is placed under the patient to protect bed linens from soiling.

A nursing instructor asks a nursing student to elaborate on nursing interventions for a patient experiencing stress urinary incontinence related to a weakened pelvic musculature. Which statement if made by the student indicates a need for further learning? "I should instruct the patient to avoid tea and coffee." "I should teach the patient to take in adequate water and fluid." "I should advise the patient to perform pelvic muscle exercises." "I should encourage the patient to increase intraabdominal pressure."

"I should encourage the patient to increase intraabdominal pressure." A patient experiencing stress urinary incontinence related to a weakened pelvic musculature should be instructed to decrease (not increase) intraabdominal pressure. The patient should avoid tea, coffee and other bladder irritants. The patient should also have an adequate intake of fluid to stay hydrated and perform pelvic muscle exercises.

What is the minimum length of an intermittent catheter that should be inserted through the urethral meatus in a male patient? Record your answer using a whole number.

17 cm The minimum length of insertion of an intermittent catheter is 17 cm (7 inches).

An elderly patient has undergone a radical retropubic prostatectomy and will need an indwelling catheter. Which balloon size is most appropriate for this patient? An elderly patient has undergone a radical retropubic prostatectomy and will need an indwelling catheter. Which balloon size is most appropriate for this patient? 3 mL 5 mL 30 mL 75 mL

3 mL Patients who have undergone a surgical prostatectomy require a catheter of balloon size 30 mL to provide hemostasis of the prostatic bed. Catheters of balloon size 3 mL are used in pediatric patients. Catheters of balloon size 5 mL are appropriate for optimal drainage in adults. There are no urinary catheters with a balloon size of 75 mL.

What is the normal pH range of urine? 2.6 to 4 3.6 to 5 4.6 to 8 4.6 to 9

4.6 to 8 The normal pH of the urine ranges from 4.6 to 8.

After assessing a patient with urinary incontinence, the health care provider confirms that the patient is at risk for a life-threatening condition that causes severe elevation of blood pressure and pulse rate as well as diaphoresis. Which type of urinary incontinence does this patient have? Transient incontinence Stress urinary incontinence Reflex urinary incontinence Urgency urinary incontinence

Autonomic dysreflexia is a life-threatening condition that causes severe elevation of the blood pressure and pulse rate as well as diaphoresis. Patients with reflex urinary incontinence are at an increased risk for this condition. Transient incontinence, stress urinary incontinence, and urgency urinary incontinence are associated with other conditions.

Which conditions might the nurse identify as causes of polyuria? Select all that apply. Urethritis Diuretic therapy Kidney dysfunction Urinary tract infection Uncontrolled diabetes mellitus

Diuretic therapy Uncontrolled diabetes mellitus Diuretic therapy and uncontrolled diabetes mellitus may cause polyuria. Urethritis may cause dysuria, kidney dysfunction may cause oliguria, and urinary tract infections may cause dysuria, oliguria, and urgency.

How should the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems? How should the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems? Supine Fowler's Squatting Dorsal recumbent

Dorsal recumbent To best examine a female patient's genitalia, the nurse should position her in the dorsal recumbent position to obtain full exposure of the genitalia. The nurse may assist a male patient into the supine or Fowler's positions to insert or remove an indwelling catheter. The squatting position facilitates complete bladder emptying in female patients.

A 70-year-old woman complains of involuntary passage of urine. The leakage of urine occurs in small amounts and is more frequent when she coughs. The nursing assessment reveals that the patient is obese, has had three pregnancies, and has already gone through menopause. The nurse understands that the patient is at increased risk of developing urinary tract infection. Which nursing interventions are helpful to prevent a urinary tract infection in the patient? Select all that apply.

Emphasize wearing cotton underwear. Promote complete emptying of bladder by double voiding. Emphasize the importance of perineal hygiene. Cotton underwear absorbs moisture and helps to keep the skin on the perineal area dry. Residual urine in bladder promotes bacterial growth. Complete voiding reduces the risk of developing a urinary tract infection and may be achieved by double voiding. Perineal hygiene is important in preventing a urinary tract infection. The urethral meatus should be cleaned after each void or bowel movement. Adequate fluid intake helps to flush the microorganisms from the urinary tract and prevent infection. Catheterization increases the risk of bladder infections and should be avoided. p. 1118

The nurse is reviewing the lab report of a patient. The presence of which substance in the urine hints at the possibility of an abnormality? Protein, 6 Glucose, ++ Red blood cells, 2 White blood cells, 4

Glucose ++ A normal urinalysis should not be positive for glucose, because glucose undergoes complete reabsorption. The presence of protein in the urine is acceptable under 8 mg/100 mL. The presence of 2 red cells is acceptable, but there should not be any more than this. A white cell of count 4 is acceptable and does not indicate abnormality.

Which symptoms should the nurse anticipate in a patient with urge urinary incontinence? Select all that apply. Distended bladder on palpation Leaks on the way to the bathroom Leaks without awareness Strong urge or leaks upon hearing water running Loss of a small volume of urine while coughing or laughing

Leaks on the way to the bathroom Strong urge or leaks upon hearing water running Patients with urge incontinence may report leaks on the way to the bathroom and a strong urge or leaks when they hear water running. A distended bladder on palpation is a characteristic of overflow incontinence or urinary retention. Reflex incontinence is characterized by leakage of urine without awareness. Patients with stress incontinence may report the loss of a small volume of urine while coughing or laughing.

The nurse, along with an nursing assistive person Maintain the privacy of the patient. Provide perineal care. Assist in the positioning of the patient. Insert catheter into the urethral meatus. Inflate the balloon fully as per the manufacturer's direction.

Maintain the privacy of the patient. Provide perineal care. Assist in the positioning of the patient. Nursing assistive personnel (NAP) are responsible for maintaining the privacy of the patient. The NAP also provide perineal care before and after the procedure, and are responsible for assisting the nurse in positioning the patient for catheterization. Inserting the catheter into the urethral meatus and inflating the balloon of the catheter are skilled activities that should be performed by the nurse.

After assessing a patient, a nurse suspects that the patient has overflow urinary incontinence. Which findings support the nurse's conclusion? Select all that apply. Nocturia Frequency Distended bladder on palpation Leakage of urine on the way to the bathroom Diminished or absent awareness of bladder filling and the urge to void

Nocturia Frequency Distended bladder on palpation Overflow urinary incontinence may be characterized by nocturia, frequency, and a distended bladder on palpation. Leakage of urine on the way to the bathroom may occur in patients with urge urinary incontinence. Diminished or absent awareness of bladder filling and the urge to void is associated with reflex urinary incontinence.

A patient complains of diminished urinary output. The nurse finds that the patient also has diminished fluid intake. What is the medical term for this condition? Dysuria Oliguria Polyuria Nocturia

Oliguria Oliguria is the medical term used for low urinary output in relation to the fluid intake. Dysuria is pain or discomfort associated with voiding. Polyuria is a term for the voiding excessive amounts of urine. Nocturia is the condition of awakening from sleep because of the urge to void.

Which statement is true regarding the use of a bladder scanner to measure residual bladder volume? The patient is placed in the dorsal recumbent position. The scan measurement should be performed within 20 minutes of voiding. Women who have had a hysterectomy should be designated as male. Ultrasound gel is applied to the midline abdomen about 2.5 to 4 cm below the symphysis pubis

Women who have had a hysterectomy should be designated as male. Women who have had a hysterectomy should be designated as male when setting the gender designation according to the manufacturer's guidelines. The patient is placed in a supine position, not dorsal recumbent. The scan measurement is conducted within 10 minutes of voiding, not 20. Ultrasound gel is applied to the midline abdomen about 2.5 to 4 cm above, not below, the symphysis pubis.

Which of a student nurse's statements regarding urinary incontinence requires correction? Which of a student nurse's statements regarding urinary incontinence requires correction? "Urinary incontinence is common in older adults." "Urge incontinence and stress incontinence are common forms of urinary incontinence." "Urinary incontinence is characterized by any involuntary loss of urine." "Mixed incontinence is a combination of stress and functional incontinence."

"Mixed incontinence is a combination of stress and functional incontinence." Mixed incontinence is a combination of stress and urge, not functional, incontinence. Urinary incontinence is common in older adults. Urge incontinence and stress incontinence are common forms of urinary incontinence that are characterized by any involuntary loss of urine

A 55-year-old man is admitted to the hospital with urinary retention. The health care provider orders catheterization for the patient. When setting up the supplies for catheterization, which size catheter should the nurse select for this patient? 8 Fr 10 Fr 14 Fr 18 Fr

14 Fr Selecting a catheter depends on many factors. One of the factors is the size of the patient's urethral canal. Most adults with an indwelling catheter should use a size 14 to 16 Fr to minimize trauma and risk for infection. Smaller sizes are needed for children, such as a 5 to 6 Fr for infants, 8 to 10 Fr for children, and 12 Fr for young girls.

A diabetic patient's urine tests positive for glucose. What is the minimum level at which the nurse would expect the patient's blood glucose to be? 155 mg/100mL 165 mg/100mL 175 mg/100mL 185 mg/100mL

185 mg/100mL Urine will be positive for glucose when the glucose level is above the normal reabsorptive capacity of the kidneys, which corresponds to 180 mg/100 mL of blood. Therefore, the urine will be positive for blood glucose above a concentration of 180 mg/100 mL . Concentrations of 155 mg, 165 mg, and 175 mg are within the normal absorptive capacity of the kidney. Hence, the urine will be negative for glucose in these situations.

Which patients should the nurse anticipate to require the use of a short- or long-term urinary catheter? Select all that apply. A patient who has chronic urinary retention A patient who has reflex urinary incontinence A patient who has stress urinary incontinence A patient who needs accurate monitoring of urine output after a gynecologic procedure A patient who is unable to completely empty the bladder due to a neurological condition

A patient who needs accurate monitoring of urine output after a gynecologic procedure A patient who is unable to completely empty the bladder due to a neurological condition Indwelling catheterization may be short-term (two weeks or less) or long-term. A short- or long-term urinary catheter may be used in patients who require accurate monitoring of urine output after a gynecologic procedure and patients who are unable to completely empty the bladder due to a neurological condition. Patients with chronic urinary retention and reflex urinary incontinence may require intermittent catheterization (one-time catheterization for bladder emptying). Patients with stress urinary incontinence require pelvic floor strengthening exercises and no catheterization.

How should the nurse position a female patient for examining the genitalia for inflammation and infection related to urinary elimination problems? Supine Fowler's Squatting Dorsal recumbent

Dorsal recumbent To best examine a female patient's genitalia, the nurse should position her in the dorsal recumbent position to obtain full exposure of the genitalia. The nurse may assist a male patient into the supine or Fowler's positions to insert or remove an indwelling catheter. The squatting position facilitates complete bladder emptying in female patients.

The nurse is reviewing the lab report of a patient. The presence of which substance in the urine hints at the possibility of an abnormality? The nurse is reviewing the lab report of a patient. The presence of which substance in the urine hints at the possibility of an abnormality? Protein, 6 Glucose, ++ Red blood cells, 2 White blood cells, 4

Glucose ++ A normal urinalysis should not be positive for glucose, because glucose undergoes complete reabsorption. The presence of protein in the urine is acceptable under 8 mg/100 mL. The presence of 2 red cells is acceptable, but there should not be any more than this. A white cell of count 4 is acceptable and does not indicate abnormality.

A patient tells a nurse, "My urine output is lower even after increasing my fluid intake." What does the nurse suspect is the reason behind the patient's condition? Urinary tract infection Inflammation of the prostate gland Uncontrolled diabetes mellitus Increased production of antidiuretic hormone

Increased production of antidiuretic hormone Decreased urine output in relation to fluid intake is known as oliguria, which may be caused by increased production of antidiuretic hormone. Urinary tract infections may cause dysuria, urgency, frequency, and nocturia, but not oliguria. Inflammation of the prostate gland may cause dysuria, but not oliguria. Uncontrolled diabetes mellitus may cause polyuria, but not oliguria.

An older male patient states that he is having problems starting and stopping his stream of urine and feels the urgency to void. What is the best way to assist this patient? Help him stand to void. Place a condom catheter. Have him practice the Credé method. Initiate Kegel exercises.

Initiate Kegel exercises. Kegel exercises strengthen pelvic floor muscles and are effective in urine control in patients with urge incontinence and difficulty starting and stopping urination.

A primary health care provider instructs the nurse to insert an indwelling urinary catheter in a patient for 3 weeks. Which type of catheter is the best choice for this patient to prevent infection and promote comfort? Latex catheter Silicon catheter Teflon catheter Plastic catheter

Latex catheter Catheters made of latex are suitable for patients who require catheterization for 3 weeks. These catheters are used for the short term and may prevent infection if protected from contamination. Silicon and Teflon catheters are appropriate for patients who require catheterization for 2 to 3 months. Plastic catheters are appropriate for intermittent catheterization.

Which symptoms should the nurse anticipate in a patient with urge urinary incontinence? Select all that apply. Distended bladder on palpation Leaks on the way to the bathroom Leaks without awareness Strong urge or leaks upon hearing water running Loss of a small volume of urine while coughing or laughing

Leaks on the way to the bathroom Strong urge or leaks upon hearing water running Patients with urge incontinence may report leaks on the way to the bathroom and a strong urge or leaks when they hear water running. A distended bladder on palpation is a characteristic of overflow incontinence or urinary retention. Reflex incontinence is characterized by leakage of urine without awareness. Patients with stress incontinence may report the loss of a small volume of urine while coughing or laughing.

A patient is being assessed for a possible urinary tract infection (UTI). Before sending a urinalysis specimen to the laboratory, the nurse collects a small amount of urine to perform a dipstick test. If the patient has a UTI, which component should be detected in the urine? Protein Glucose Ketones Leukocytes

Leukocytes A dipstick test is performed in the healthcare provider's office to test for different components. In this case, the health care provider tests white blood cells, or leukocytes, which indicate an infection. Protein is detected in patients with nephropathy. Glucose is detected in patients with diabetes mellitus. Ketones are detected in patients with poorly controlled diabetes, starvation, and dehydration.

Which pretest and posttest procedures should the nurse follow while managing a patient who is scheduled for a cystoscopy? Select all that apply. Discourage fluid intake for 48 hours before the procedure. Monitor intake and output. Inform the patient that he or she may have voiding difficulty post procedure. Inform the patient that he or she may pass red-tinged urine post procedure. Inform the patient that it is a diagnostic procedure without any untoward effects.

Monitor intake and output. Inform the patient that he or she may have voiding difficulty post procedure. Inform the patient that he or she may pass red-tinged urine post procedure. Fluid intake and urine output should be monitored post cystoscopy to determine obstruction or trauma to the urinary system. After the procedure, the patient may have difficulty voiding or have red or pink urine because of trauma to the urethral or bladder mucosa. Fluids should be encouraged to promote urine formation and prevent infection. Cystoscopy can be used as a therapeutic procedure and may have untoward effects.

A nurse instructs an elderly patient to restrict fluid intake 2 hours before bedtime. Which complication is the nurse trying to reduce? A nurse instructs an elderly patient to restrict fluid intake 2 hours before bedtime. Which complication is the nurse trying to reduce? Nocturia Urinary retention Urinary tract infection Stress urinary incontinence

Nocturia To reduce nocturia, the patient should be advised to restrict fluid intake 2 hours before bedtime. Intermittent catheterization may be used to manage mild urinary retention. The nurse should instruct the patient to follow good perineal hygiene practices to prevent urinary tract infections. To manage stress urinary incontinence, the nurse should teach the patient pelvic muscle exercises.

After assessing a patient with urinary incontinence, the health care provider confirms that the patient is at risk for a life-threatening condition that causes severe elevation of blood pressure and pulse rate as well as diaphoresis. Which type of urinary incontinence does this patient have? Transient incontinence Stress urinary incontinence Reflex urinary incontinence Urgency urinary incontinence

Reflex urinary incontinence Autonomic dysreflexia is a life-threatening condition that causes severe elevation of the blood pressure and pulse rate as well as diaphoresis. Patients with reflex urinary incontinence are at an increased risk for this condition. Transient incontinence, stress urinary incontinence, and urgency urinary incontinence are associated with other conditions.

What nursing intervention is the nurse least likely to provide to a patient diagnosed with stress urinary incontinence related to a weakened pelvic musculature? Encouraging the patient to lose weight Reinforcing teaching related to type 2 diabetes Advising the patient to maintain adequate hydration Instructing the patient to avoid caffeine and other bladder irritants

Reinforcing teaching related to type 2 diabetes If a patient is diagnosed with stress urinary incontinence related to a weakened pelvic musculature, the nurse is least likely to reinforce teaching related to type 2 diabetes. This type of teaching is needed in cases where there is risk of infection due to diabetes. A patient who has stress urinary incontinence related to a weakened pelvic musculature should be encouraged to lose weight and maintain adequate hydration. The nurse should also instruct the patient to avoid caffeine and other bladder irritants.

The nurse notices pus in the catheter of a patient who had an indwelling catheter inserted 4 days ago. Which nursing measure is appropriate for this patient? The nurse notices pus in the catheter of a patient who had an indwelling catheter inserted 4 days ago. Which nursing measure is appropriate for this patient? Irrigating the catheter with 10 mL of water Irrigating the catheter with antiseptic solution Milking the catheter from proximal end to distal end

Replacing the catheter with a new one The nurse should replace an indwelling catheter when pus is noted in it. The contaminated catheter should be removed and replaced with a new catheter. Irrigation causes the pus to go back to the bladder, which worsens the infection. Irrigating with antiseptic solution is appropriate for patients with a bladder infection but without pus in the catheter. Milking the tube is helpful for relieving tubal obstructions within catheters. p. 1111

A patient reports having the urge to void, but urine starts leaking before the patient reaches the bathroom. Which treatment strategies would be helpful for this patient? Select all that apply. A patient reports having the urge to void, but urine starts leaking before the patient reaches the bathroom. Which treatment strategies would be helpful for this patient? Select all that apply. Scheduled toileting Absorbent products Electrical stimulation Clothing modification Antimuscarinic agents

Scheduled toileting Absorbent products Clothing modification Functional incontinence is characterized by the inability to reach the bathroom in time. Scheduled toileting involves teaching the patient to void at specified times so that there is no urgency. Use of absorbent products helps prevent soiling of clothes. Clothing can be modified to make it easier to remove when there is an urgency to void. Electrical stimulation is helpful for patients with stress incontinence. Antimuscarinic agents are helpful for patients with urge incontinence.

What can a nurse use to measure the post void residual volume in a patient with urinary retention? Select all that apply. Ultrasound Bladder scanner Cystoscopy Straight catheterization Axial computed tomographic scan

Ultrasound Bladder scanner Straight catheterization The post void residual (PVR) volume is the amount of urine left in the bladder after voiding; it can be measured by ultrasound, bladder scanner, or straight catheterization. Cystoscopy is an invasive procedure used to detect bladder tumors and obstruction of the bladder outlet and urethra. An axial computed tomographic scan is commonly used to identify anatomic abnormalities, renal tumors and cysts, calculi, and obstruction of the ureters.

The nurse assesses that the patient has a full bladder, and the patient states that he or she is having difficulty voiding. What should the nurse teach the patient to do? The nurse assesses that the patient has a full bladder, and the patient states that he or she is having difficulty voiding. What should the nurse teach the patient to do? Use the double-voiding technique. Perform Kegel exercises. Use the Credé method. Keep a voiding diary.

Use the Credé method. With the Credé method, pressure is put on the suprapubic area with each attempted void. The maneuver promotes bladder emptying by relaxing the urethral sphincter.

The nurse is reviewing laboratory results for a patient and notices the urine tested positive for ketones. Which underlying factors may lead to the presence of urinary ketone bodies? Select all that apply. The nurse is reviewing laboratory results for a patient and notices the urine tested positive for ketones. Which underlying factors may lead to the presence of urinary ketone bodies?Select all that apply. starvation Epilepsy Dehydration Hyperthyroidism Uncontrolled diabetes mellitus

starvation Dehydration Uncontrolled diabetes mellitus Ketones are produced as a by-product when the body uses fat for energy production. When a patient is not taking in adequate amounts of carbohydrate, such as in starvation, the body uses other sources for energy. Dehydration can also lead to ketonuria. A patient with uncontrolled diabetes mellitus breaks down fatty acids for energy. Epilepsy and hyperthyroidism are not associated with the presence of ketone bodies in urine. Epilepsy is a disease that affects the nervous system, and hyperthyroidism affects the endocrine system

The patient states that she "loses urine" every time she laughs or coughs. The nurse teaches the patient measures to regain urinary control. Which statement by the patient indicates the need for further teaching? The patient states that she "loses urine" every time she laughs or coughs. The nurse teaches the patient measures to regain urinary control. Which statement by the patient indicates the need for further teaching? "I will perform my Kegel exercises every day." "I joined Weight Watchers." "I drink two glasses of wine with dinner." "I have tried urinating every 3 hours."

"I drink two glasses of wine with dinner." Alcohol is a bladder irritant. It increases urine production and causes uncontrolled bladder contractions.

The nurse is caring for a patient with urinary incontinence. Which actions should the nurse perform to promote comfort for the patient?Select all that apply. Change dressings and linens when wet. Limit fluid intake. Use absorbent pads. Increase coffee intake. Catheterize the patient with orders from the health care provider.

-Change dressings and linens when wet. -Use absorbent pads. - Catheterize the patient with orders from the health care provider. Wet dressings and linens should be changed to prevent skin impairment and promote comfort. Absorbent pads can be used to keep the patient dry. The patient can be catheterized after obtaining orders from the health care provider. Limiting fluid intake increases the risk of dehydration and urinary tract infection. Coffee is an irritant to the bladder and its intake should be limited.

A nurse is teaching a 55-kg patient about the promotion of normal micturition by maintaining optimal fluid intake. The nurse is aware that the patient has normal renal function and no heart disease or alterations that require fluid restriction. What is the approximate amount of fluid that the nurse should instruct the patient to drink per day? Record your answer in mL using a whole number.

1650 mL A patient with normal renal function who does not have heart disease or alterations that require fluid restriction should have approximately 30 mL of fluids per kilogram of body weight. Therefore, the approximate amount of fluid that the nurse should instruct the patient to drink per day is 30 x 55 = 1650 mL.

What is the correct amount space allowed between the tip of the penis and the end of the catheter while placing a condom catheter on a patient? 1.5 to 3 cm 2.5 to 5 cm 3.5 to 5 cm 4.5 to 6 cm

2.5 to 5 cm While placing a condom catheter on the patient, the nurse should allow a space of 2.5 to 5 cm (1 to 2 inches) between the tip of the penis and the end of the catheter.

The nurse notes that the patient's indwelling catheter bag has been empty for 4 hours. What is the priority action? The nurse notes that the patient's indwelling catheter bag has been empty for 4 hours. What is the priority action? Irrigate the indwelling catheter. Check for kinks in the tubing. Notify the health care provider. Assess the patient's intake.

Check for kinks in the tubing. Kinks in tubing prevent flow of urine. To keep the drainage system patent, check for kinks or bends in the tubing.

What should the nurse include in the plan of care for a patient with urge urinary continence? What should the nurse include in the plan of care for a patient with urge urinary continence? Helping the patient learn efficient and safe toilet transfers Helping the patient with leg-strengthening exercises Helping the patient strengthen the pelvic floor muscles and learn fluid and food modifications Helping the patient obtain assistive devices for the home that are covered by insurance

Helping the patient strengthen the pelvic floor muscles and learn fluid and food modifications While caring for a patient with urge urinary continence, the nurse should help the patient strengthen the pelvic floor muscles, learn techniques to inhibit the urinary urge, and learn fluid and food modifications. The other actions are the responsibilities of other health care professionals. It is the responsibility of an occupational therapist to help the patient learn efficient and safe toilet transfers. It is the responsibility of a physical therapist to help the patient with leg-strengthening exercises. A social worker should help the patient obtain assistive devices for the home that are covered by insurance.

A patient's urinalysis shows the presence of casts. Based on this laboratory data, what should the nurse suspect? A patient's urinalysis shows the presence of casts. Based on this laboratory data, what should the nurse suspect? Protein-calorie malnutrition Renal disease Gout Renal stone formation

Renal Disease The increased presence of granular casts is always an abnormal finding and is usually indicative of renal disease or injury. Protein-calorie malnutrition is characterized by the presence of ketone bodies in the urine, not casts. The presence of excess crystals predisposes a patient to the development of renal stones, not casts. Patients with high uric acid levels (gout) may develop uric acid crystals.

A student nurse is learning about different types of urinary incontinence. Which of the student nurse's statements about urinary incontinence caused by weakness or injury to the urinary sphincter indicates effective understanding? Select all that apply. "It results in a high post void residual volume." "It can be managed by performing pelvic muscle exercises." "In severe cases, it may require intermittent or indwelling catheterization." "It is characterized by loss of a small volume of urine with coughing, laughing, exercise, and walking." "It is also related to altered mobility and manual dexterity, cognitive impairment, poor motivation, or environmental barriers."

"It can be managed by performing pelvic muscle exercises." "It is characterized by loss of a small volume of urine with coughing, laughing, exercise, and walking." Stress urinary incontinence is caused by weakness or injury to the urinary sphincter or pelvic floor muscles. It is characterized by loss of a small volume of urine with coughing, laughing, exercise, and walking and can be managed by performing pelvic muscle exercises. Overflow, not stress, urinary incontinence results in a high post void residual volume. In severe cases of overflow urinary incontinence, the patient may require intermittent or indwelling catheterization, but not in cases of stress urinary incontinence. Functional, not stress, incontinence is related to altered mobility and manual dexterity, cognitive impairment, poor motivation, or environmental barriers.

Which patient is most likely to exhibit symptoms such as dysuria, urgency, frequency, and nocturia? Which patient is most likely to exhibit symptoms such as dysuria, urgency, frequency, and nocturia? A patient with kidney failure A patient receiving diuretic therapy A patient with a urinary tract infection A patient with uncontrolled diabetes mellitus

A patient with a urinary tract infection Dysuria, urgency, frequency, and nocturia are symptoms that may be exhibited by patients with urinary tract infections. A patient with kidney failure may experience oliguria. Patients receiving diuretic therapy and those with uncontrolled diabetes mellitus may exhibit polyuria.

The nurse is caring for a patient who has an indwelling urinary catheter. Which action by the nurse increases the risk for patient complications? Allowing the drainage bag to get full before emptying Keeping the urinary drainage system closed Preventing urine backflow from the tubing and bag into the bladder Performing perineal hygiene after each bowel movement

Allowing the drainage bag to get full before emptying The nurse should not allow the drainage bag to get full before emptying. An overfull drainage bag creates tension and undue pressure on the catheter, which may induce trauma to the urethra or urinary meatus. The nurse should maintain a closed urinary drainage system that does not permit any channels for entry of pathogens. The nurse should make sure that there is no urine backflow from the tubing and bag into the bladder. The nurse should perform perineal hygiene after each bowel movement.

The patient is incontinent, and a condom catheter is placed. Which action should the nurse take? The patient is incontinent, and a condom catheter is placed. Which action should the nurse take? Shave the pubic area prior to application. Ensure foreskin is in retracted position. Assess the patient for skin irritation. Use sterile technique for placement.

Assess the patient for skin irritation. The nurse should assess the patient for skin irritation, which can occur when the condom is twisted at the drainage tube attachment and obstructs urine drainage. Skin should not be shaved prior to condom application; however, hair can be clipped at the base of the penis as necessary. If patient is uncircumcised, ensure that the foreskin is in the normal nonretracted position. Hand hygiene and glove application is adequate for this procedure.

A nurse is caring for a patient who is receiving treatment for a urinary elimination problem. After a few days of taking the prescribed medications, the patient reports a dry mouth, constipation, and blurred vision. Which medication is the most likely cause of the patient's symptoms? A nurse is caring for a patient who is receiving treatment for a urinary elimination problem. After a few days of taking the prescribed medications, the patient reports a dry mouth, constipation, and blurred vision. Which medication is the most likely cause of the patient's symptoms? Atropine Mirabegron Fesoterodine Phenazopyridine

Fesoterodine Antimuscarinic agents, such as fesoterodine, are used to treat different types of urinary incontinence. These medications may cause dry mouth, constipation, and blurred vision. Anticholinergics, such as atropine, inhibit bladder contractility and thereby increase the risk for urinary retention. Mirabegron may also be used to treat different types of urinary incontinence, but it is not an antimuscarinic agent and does not result in the side effects of dry mouth, constipation, and blurred vision. Patients with painful urination associated with urinary tract infections may be prescribed urinary analgesics such as phenazopyridine, which will turn the urine orange.

A patient who has undergone urological surgery is prescribed urinary catheterization. Which diameter of catheter does the nurse anticipate will be used for this patient? A patient who has undergone urological surgery is prescribed urinary catheterization. Which diameter of catheter does the nurse anticipate will be used for this patient? 5 to 6 Fr 8 to 10 Fr 12 Fr Greater than 16 Fr

Greater than 16 Fr Large catheters with diameters greater than 16 Fr should be used in patients who have undergone urological surgery. Catheters with diameters of 5 to 6 Fr are used for infants. Catheters with diameters of 8 to 10 Fr are used for children. Catheters with diameters of 12 Fr are used for young girls.

A patient who presents with dribbling of urine is diagnosed with stress incontinence. What should the nurse include in the assessment of this patient? Select all that apply. Height and weight History of osteoarthritis Menopausal status Number of live births Alcohol use

Height and weight Menopausal status Number of live births There are many risk factors associated with stress incontinence. Determining the patient's height and weight can help determine whether the patient is obese. Patients who are overweight have extra weight putting pressure on the bladder, which can lead to stress incontinence. Patients who are postmenopausal are also at risk for incontinence. When a woman has a decrease in estrogen production, the pelvic muscles weaken, sometimes leading to stress incontinence. In addition, pregnancy puts pressure on the bladder and over time can lead to stress incontinence. Osteoarthritis does not cause stress incontinence, but it may cause functional incontinence if it interferes with mobility. The use of alcohol does not cause incontinence of any kind.

The patient has to provide a urine sample. Which actions should the nurse perform? Select all that apply. Instruct patient to obtain a midstream sample. Instruct patient to obtain a last-stream sample. Instruct patient to obtain a sample at the beginning of urination. Transport specimen to the laboratory within 15-30 minutes. Refrigerate specimen if it does not reach the laboratory within 30 minutes.

Instruct patient to obtain a midstream sample. Instruct patient to obtain a sample at the beginning of urination. Transport specimen to the laboratory within 15-30 minutes. The nurse should collect a midstream urine sample as that is free from urethral and dermal contaminants. Because bacteria grow quickly in urine, the specimen should be transported to the laboratory within 15 to 30 minutes. Urine not received by the laboratory within 30 minutes should be refrigerated to prevent bacteria from growing. However, refrigeration should not exceed 2 hours. Last-stream samples usually contain dermal contaminants. Initial-stream samples contain urethral contaminants.

A patient who is a smoker complains of involuntary passage of urine after a strong sense of urgency to void. Which nursing interventions would be helpful to this patient? Select all that apply. A patient who is a smoker complains of involuntary passage of urine after a strong sense of urgency to void. Which nursing interventions would be helpful to this patient? Select all that apply. Credé method Smoking cessation Intermittent catheterization Antimuscarinic agents Behavioral interventions

Smoking cessation Antimuscarinic agents Behavioral interventions Urge incontinence is characterized by an involuntary passage of urine following a strong urge to void. Smoking can irritate the bladder and worsen the incontinence; therefore, the patient should be instructed to quit smoking. Antimuscarinic agents help to prevent the involuntary contraction of the bladder muscles and prevent passage of urine. Behavioral interventions are helpful in making lifestyle changes to adjust for incontinence. The Credé method is helpful for patients with overflow incontinence. Intermittent catheterization is used when a patient has urinary retention with overflow incontinence.

While caring for a female patient with altered urinary elimination, the nurse instructs the patient to assume a squatting position when voiding. What is the reason behind this recommendation? <p>While caring for a female patient with altered urinary elimination, the nurse instructs the patient to assume a squatting position when voiding. What is the reason behind this recommendation? To prevent infections To promote normal micturition To promote complete bladder emptying To help relieve stress urinary incontinence

To promote complete bladder emptying

A postoperative patient has difficulty voiding after surgery and is feeling "uncomfortable" in the lower abdomen. Which action should the nurse implement first? A postoperative patient has difficulty voiding after surgery and is feeling "uncomfortable" in the lower abdomen. Which action should the nurse implement first? Encourage fluid intake. Administer pain medication. Catheterize the patient. Turn on the bathroom faucet as the patient tries to void.

Turn on the bathroom faucet as the patient tries to void. The sound of running water helps many patients to void through the power of suggestion.

A patient is experiencing difficulty in voiding. Which nursing interventions may help to stimulate the micturition reflex in the patient? Select all that apply. A patient is experiencing difficulty in voiding. Which nursing interventions may help to stimulate the micturition reflex in the patient? <b>Select all that apply. Induce sound of running water. Stroke the outer aspect of the thigh. Pour cool water over patient's perineum. Stroke the outer aspect of the abdomen. Help the patient assume the normal position for voiding.

Induce sound of running water. Help the patient assume the normal position for voiding. The sound of running water helps many patients void through the power of suggestion. The micturition reflex can be stimulated by asking the patient to assume the normal position for voiding. Stroking the inner aspect of the thigh stimulates the sensory nerves and promotes the micturition reflex. Pouring warm water over the patient's perineum creates the sensation to urinate. Stroking the outer aspect of thigh and abdomen is not helpful in initiating the reflex.

What instructions regarding bladder training should be included in the teaching plan for the family of a patient who is incontinent because of a stroke? "Use an indwelling catheter at night to prevent accidents." "Offer the patient the commode or urinal every 2 hours." "Decrease the patient's oral fluid intake to 1 L per day." "Instruct the patient to hold the urine as long as possible to restore bladder tone."

"Offer the patient the commode or urinal every 2 hours." To begin a bladder-training program, the nurse should teach the family to offer the patient the commode, bedpan, or urinal every 2 hours. Making this offer frequently enough prevents accidents and establishes a routine. Using an indwelling catheter in a home setting increases the possibility of trauma or infections to the urethra and bladder. Decreasing the patient's fluid intake could cause secondary complications of dehydration and electrolyte imbalance. The patient is incontinent so is unable to hold the urine.

A nurse is caring for an elderly patient who has recently started taking an antimuscarinic medication to treat urinary continence. Which nursing intervention is most important in this situation? Teaching pelvic muscle exercises Assessing the patient for mental status changes Reminding the patient to drink adequate amounts of water Instructing the patient to restrict fluid intake 2 hours before bedtime

Antimuscarinic medications may cause cognitive impairment in older adults; therefore, the nurse should assess the patient carefully for mental status changes. Pelvic muscle exercises should be taught to patients with stress incontinence. To promote bladder health through adequate hydration, the nurse should remind patients to drink adequate amounts of water. To reduce nocturia, older adults should be instructed to restrict fluid intake 2 hours before bedtime.

A 55-year-old man is admitted to the hospital with urinary retention. The patient is catheterized to relieve retention. Which actions are necessary to prevent infection in the patient? Select all that apply. Ensure a closed drainage system. Monitor the patency of the catheter. Hang the drainage bag on the bed rail. Ensure that the spigot does not touch any contaminated surfaces. Follow good hand-hygiene techniques.

Ensure a closed drainage system. Monitor the patency of the catheter. Ensure that the spigot does not touch any contaminated surfaces. Follow good hand-hygiene techniques. Bacteria grow quickly in pooled urine. Ensuring a closed drainage system prevents microorganisms from entering the system. Maintaining the patency of the catheter ensures that the urine does not pool. The spigot of the drainage system is a site at high risk for infection; therefore, it should not be allowed to touch any contaminated surfaces. Good hand hygiene should be followed to prevent development and spread of infection. The drainage bag should not be hung on the bed rail, because it could be accidentally raised above the bladder level, allowing the urine to backflow. A backflow of contaminated urine can cause infection.

An obese patient reports leaking urine while coughing. Which management strategies should be included in the patient's treatment plan? Select all that apply. Adequate fluid intake Kegel exercises Heavy weight lifting Weight-control measures Caffeinated beverages

Kegel exercises Weight-control measures The symptoms are suggestive of stress incontinence related to the weakening of pelvic musculature due to obesity. Kegel exercises should be taught to the patient to strengthen the pelvic muscles. Weight-control measures should be instituted to help the patient lose weight and maintain a healthy weight. Maintaining fluid intake is helpful for patients who are at risk of infection, not for stress incontinence. Lifting heavy weights can put pressure on the bladder and worsen incontinence. The patient suffering from stress incontinence should avoid the intake of caffeinated beverages. Caffeine irritates the bladder mucosa and can cause bladder spasms, worsening the incontinence.

A nurse is caring for an elderly patient who is receiving treatment for urinary incontinence. After reviewing the patient's prescription, the nurse knows to observe the patient for cognitive impairment. Which medication is the patient most likely taking? A nurse is caring for an elderly patient who is receiving treatment for urinary incontinence. After reviewing the patient's prescription, the nurse knows to observe the patient for cognitive impairment. Which medication is the patient most likely taking? Atropine Diuretics Oxybutynin Phenazopyridine

Oxybutynin Antimuscarinic agents such as oxybutynin are used to treat different types of urinary incontinence. These drugs may cause cognitive impairment in older adults. Anticholinergics, such as atropine, inhibit bladder contractility, thereby increasing the risk for urinary retention. Diuretics increase urinary output by preventing the resorption of water and certain electrolytes. Phenazopyridine is a urinary analgesic that may be prescribed to patients with painful urination associated with urinary tract infections; patients who take drugs with phenazopyridine will void orange urine.

What skill is the nurse least likely to perform during the physical assessment of a patient with urinary elimination problems? Palpating the lower abdomen to assess for bladder fullness Percussing the costovertebral angle to assess for tenderness Auscultating the kidney to detect the presence of a renal artery bruit Positioning the female patient into a supine position to examine the genitalia

Positioning the female patient into a supine position to examine the genitalia To examine a female patient, the nurse should place the patient in dorsal recumbent position to allow for full exposure of the genitalia. Bladder fullness can be assessed via gentle palpation of the lower abdomen. A full bladder feels like a smooth and rounded mass. To discern if the kidneys are infected or inflamed, percussion of the costovertebral angle is done. Auscultation of the renal artery is also done to detect the presence of a bruit, which may arise because of turbulent blood flow through a narrowed artery.

What nursing intervention should the nurse provide to a patient who has wet skin due to urinary incontinence and is at risk for impaired skin integrity? Encouraging the patient to lose weight Advising the patient to maintain adequate hydration Using pictures to teach the patient about pelvic anatomy Teaching the patient to apply a moisture barrier product as needed

A patient who is at risk for impaired skin integrity due to having wet skin caused by incontinence or old age should be taught to apply moisture barrier products as needed. A patient who has stress urinary incontinence related to a weakened pelvic musculature should be encouraged to lose weight and maintain adequate hydration. The nurse should use pictures to teach a patient who has deficient knowledge pertaining to urinary incontinence about pelvic anatomy.

A female patient requires an indwelling catheter. What body position should the patient be placed in? Supine position Fowler's position Semi-sitting position Dorsal recumbent position

Dorsal recumbent position For placing an indwelling catheter in a female patient, the nurse should have the patient in dorsal recumbent position. A male patient who requires an indwelling catheter should be in supine or Fowler's position. Semi-sitting position is the preferred position for a patient to void for collecting urine specimens.

A 55-year-old man is admitted to the hospital with urinary retention. Which interventions should the nurse perform to stimulate the micturition reflex? Select all that apply. Help the patient to relax and void in a standing position. Tell the patient to run water while trying to void. Stroke the outer aspect of the thigh. Pour warm water over the patient's perineum. Obtain orders to catheterize the patient.

Help the patient to relax and void in a standing position. Tell the patient to run water while trying to void. Pour warm water over the patient's perineum. Helping the patient relax can stimulate the micturition reflex and relieve urinary retention. Assuming a normal position of voiding also helps in micturition. The patient should stand up and void. The sound of running water may stimulate micturition through suggestion. Pouring warm water over the patient's perineum creates a sensation of urination and helps to stimulate the micturition reflex. Stroking the inner, not outer, thigh stimulates sensory nerves and helps in voiding. Catheterization relieves retention but does not stimulate the micturition reflex.

Which intervention is most appropriate for a patient with functional urinary incontinence? Which intervention is most appropriate for a patient with functional urinary incontinence? Insert an indwelling catheter. Increase fluid intake to flush the kidneys. Provide normal fluid intake and establish a toilet schedule. Restrict fluid intake to decrease the episodes of incontinence.

Increase fluid intake to flush the kidneys. For physiological health, a patient must maintain normal fluid intake. A toileting schedule based on the patient's elimination patterns can help reduce episodes of incontinence. Catheters are used as a last choice, because of the potential for infection and body self-image issues. Fluid intake should be kept at normal levels; there is no need to increase it. Restricting the fluid intake may cause dehydration.

The patient's urine specific gravity is 1.05. The urine tests positive for ketone bodies. Which could be possible causes? Select all that apply. The patient's urine specific gravity is 1.05. The urine tests positive for ketone bodies. Which could be possible causes?Select all that apply. Starvation Dilute urine Dehydration Overhydration Diabetes mellitus

Starvation Dehydration Diabetes mellitus Presence of ketone bodies supports the possibility of starvation. Specific gravity would be increased if the patient were dehydrated. Increased specific gravity and ketone bodies in the urine also support the possibility of diabetes mellitus. A high specific gravity and the presence of ketone bodies do not indicate urine dilution or overhydration. Study Tip: The more concentrated the urine, the higher its specific gravity. The specific gravity of distilled water is 1.000, and normal urine may range from 1.010 to 1.030. Therefore, a specific gravity of 1.050 is high, indicating the urine is more concentrated than normal, or lower in water content than normal. A dilute urine would have a lower-than-normal specific gravity. You also know the patient is not overhydrated. Thus you can eliminate the choices "Dilute urine" and "Overhydration,"