Fundamentals Nursing Prep U Chapter 36 Urinary Elimination

A client could experience increased urination when using which classification of medication?

Cholinergic agents

An older adult client is experiencing urinary retention. What age related physiological changes does the nurse discuss with the client that may be a contributing factor?

Older adults may have a decrease in contraction of the bladder.

Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence?

Boys may take longer for daytime continence than girls.

Which symptom will have a great impact on the extracellular fluid for water conservation?

Burns

A client has a cerebrovascular accident and is incontinent of bowel and bladder. Incontinence of urine in this client is related to a:

neurogenic bladder.

A client at a health care facility is being treated for cancer of the bladder. The physician uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion?

one or both of the ureters are surgically implanted elsewhere

The nurse is caring for a male client with weakness who has been ordered to stay on bed rest for several days. Which method for urinary elimination does the nurse provide?

urinal

The nurse measures a client's residual urine by catheterization after the client voids. Which condition would this test verify?

urinary retention

The nurse is teaching the Crede maneuver to a client who has difficulty urinating. Which nursing teaching is appropriate?

"Bend forward and apply pressure over your bladder."

The nurse has an order to obtain a 24-hour urine from a client. Which of the following instructions would be accurate for collection of the specimen?

"Discard your first urine and begin the collection after that."

The nurse is collecting data on a client with reflex incontinence. Which information would the nurse ask the client during the physical assessment?

"Do you have the sensation to urinate?"

The nurse educator is presenting a lecture on clients at risk for developing urinary tract infections (UTIs). Which response made by the staff nurse would indicate to the educator a need for further teaching?

"Having sexual relationships does not put a woman at risk for developing an UTI."

A client is diagnosed with frequent urinary tract infections. Which of the following would be an appropriate question for the nurse to ask the client?

"How frequently do you urinate each day?"

Several of the clients on a geriatric subacute medicine unit are experiencing urinary incontinence from differing causes. Which statement suggests that the client requires further education?

"I make sure to limit how much I drink so that I don't have accidents."

Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine?

24-hour specimen

The health care provider notifies a client of a diagnosis of glycosuria. When the provider leaves the room, the client states to the nurse, "I don't know what glycosuria means." What is the appropriate nursing response?

"Laboratory findings indicate there is glucose in your urine."

A 70-year-old client confides to the nurse that she is "terribly embarrassed" that she has developed urinary incontinence over the past year. Which nursing response supports the client's self-esteem?

"Let's explore structuring activities and toileting breaks."

The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response?

"Let's review the types of fluids that your child drinks in the morning."

A client reports an episode of losing control of urination when a bathroom wasn't close by. The client states, "I'm worried this means that I'm starting to lose control of my bladder." What is the appropriate nursing response?

"Let's review your medication history and whether you consume bladder irritants."

A woman informs the nurse that when she is experiencing stress it is difficult to void and wonders why this happens. What is the nurse's best explanation?

"Stress causes the muscles to become tense."

The nurse is caring for a client with a prescription for a midstream urine specimen. The nurse would provide which information to the client?

"Void a small amount, stop, and discard it."

An older adult client has come to the emergency room stating, "I have not been able to urinate for 24 hours. Which statement made by the client is an indicator for the inability to void?

"Yesterday I was congested so I took several doses of Benadryl."

The nurse has an order to obtain a urine specimen from a client with an indwelling Foley catheter. Which supplies would the nurse need to gather? (Select all that apply.)

* 10-mL (milliliter) syringe * Sterile specimen container * Antiseptic swab

Three days post-surgery for breast reconstruction, the nurse assesses that the client is ambulating several times daily. The health care provider has not yet written an order to discontinue the client's urinary catheter. What is the appropriate nursing action? Select all that apply.

* Contact the health care provider to ask for an order for catheter discontinuation. * Perform, or allow client to perform, perineal hygiene at least once daily.

The client is preparing to obtain a clean-catch midstream urine specimen. List in order the steps needed to complete the diagnostic test.

1. Provide instruction to the client. 2. Clean the area surrounding the urinary meatus with the provided cloth. 3. Void a small amount into stool. 4. Void into the provided collection device. 5. Secure the lid on the specimen container. 6. Submit collected specimen to the health care professional.

A client is preparing to give a clean-catch specimen. Which instruction will the nurse provide?

After the initial stream is initiated, collect the sample.

An infant is born with spina bifida. She may have:

Alterations in urinary elimination

A client with chronic kidney disease reports not being able to urinate for the past 24 hours. A bladder scan shows no urine in the bladder. How does the nurse document this data?

Anuria

Which is true regarding the normal urination?

Catheterized clients should drain a minimum of 30 mL of urine per hour.

A client is preparing to give a clean-catch specimen. What action should the nurse have the client do first?

Clean each side of the urinary meatus with a separate wipe.

The UAP reports that a client on furosemide has voided 4000 mL in a 24-hour period. What is the appropriate nursing action?

Contact the health care provider to decrease furosemide.

A nurse is caring for a client with an external condom catheter. What is a guideline for applying and caring for this type of catheter?

Fasten the condom securely enough to prevent leakage without constricting the blood vessels.

The health care provider has ordered a Foley catheter for a male client. When the nurse explains the procedure, the client refuses to allow placement of the catheter. What is the appropriate nursing intervention?

Inform the client that the health care provider can be contacted to discuss other catheter options.

What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence?

It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.

The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle exercises (Kegel exercises) will the nurse include?

Keep muscles contracted for at least 10 seconds.

A client is suspected of having a disease process affecting the functional unit of the kidney. Which structure is most likely involved?

Nephron

Which statement should be included in the nurse's education plan for older adults regarding urinary elimination?

Nocturia and urinary retention are more common in older adults.

A nurse is caring for a client who is catheterized following a surgery of the prostate. When caring for the client, the nurse performs continuous bladder irrigation. Which intervention should the nurse perform when providing continuous bladder irrigation?

Purge air from the tubing

While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which of the following would the nurse document as an abnormal finding?

Reddened perineal skin

The health care provider requests an indwelling urinary catheter to be inserted into a woman who has had a total hip replacement and is on strict bed rest. When inserting the catheter, the nurse would place the client in which position?

Sims position

A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing?

Stress incontinence

Which is not true of urine color?

The appearance of urine streaked with blood is always abnormal.

The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client?

The birth can cause perineal swelling.

The nurse is providing education to a client who is being discharged to home with an indwelling urinary catheter in place. What information is important for the nurse to discuss with the client?

The catheter can be connected to a smaller leg bag for ambulation.

The clinic nurse is collecting data from a female client with frequent, recurrent urinary tract infections who was discharged from the hospital. Which data collection would indicate to the nurse that the client is adhering to discharge instructions?

The client drinks two glasses of water before and after sexual intercourse.

A client's BUN test results are significantly elevated. When reviewing the client's history, which finding is consistent with BUN elevation other than renal compromise?

The client is dehydrated

Which statements about suprapubic catheters is true?

They are often preferred over an indwelling urethral catheter for long-term urinary drainage.

The nurse is caring for a client with concerns of urinary incontinence. A review of the client's data collection reveals the client has a history of spinal surgery and states, "I urinate all the time and cannot predict when I will urinate." This data collection would suggest to the nurse that this client is experiencing which type of urinary incontinence?

Total incontinence

Use of an indwelling urinary catheter leads to the loss of bladder tone.

True

The nurse is choosing a collection device to collect urine from a nonambulatory male client? What would be the nurse's best choice?

Urinal

The nurse is reviewing the chart of an elderly client who exhibits signs of confusion. Which laboratory value would indicate to the nurse that intervention is needed?

Urine culture sensitivity - 100,000/mL

A nurse is preparing to measure a client's urine output. Which of the following interventions would be of highest priority?

Wearing gloves when handling the urine

A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen?

Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle.

A nurse is caring for an older adult client at his home. The client has had a condom catheter applied. Which describes a condom catheter?

a flexible sheath that is rolled around the penis

A woman is reporting bladder urgency. It is most important to assess:

caffeine intake

The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate?

cloudy, foul odor

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain?

dark brown, cloudy

The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate?

dehydration

A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample?

first thing in the morning

A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance?

intermittent urethral catheter

A client at the health care facility has been diagnosed with total urinary incontinence. How could the nurse describe the condition of the client?

loss of urine without any identifiable pattern or warning

Which catheter would the nurse use to drain a client's bladder for short periods (5 to 10 minutes)?

straight catheter

A 70-year-old client who has four children and six grandchildren states that she "wets" herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate?

stress

A client reports to the nurse that after delivering a baby, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate?

stress

The nurse is caring for a client who has been experiencing nausea, vomiting, and diarrhea for 3 days. Which urine characteristics does the nurse anticipate?

strongly aromatic, dark amber

The doctor has ordered the collection of a fresh urine sample for a particular examination. Which urine sample would the nurse discard?

the first voiding of the day

The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order.

• Clean each labial fold, then the area directly over the meatus. • Insert the lubricated catheter into the urethra. • Advance the catheter until there is a return of urine. • Inflate the balloon with the correct amount of sterile saline. • Discard used supplies.

The nurse is planning care for a client with a newly placed urostomy. What priority problems will the nurse address and provide interventions for? Select all that apply.

• Impaired urinary elimination • Situational low self-esteem • risk for Infection

Which assessment data, collected by the nurse, indicates that a client may have the nursing diagnosis of Urge Urinary Incontinence? Select all that apply.

• loses urine when a toilet is not readily available • urinates 20 times in 24 hours • experiences accidental loss of urine when there is an urgent need to urinate