Nurs 107 PrepU Chapter 49 Management of Patients with Urinary Disorders

Which objective symptom of a UTI is most common in older adults, especially those with dementia? Change in cognitive functioning Back pain Hematuria Incontinence

Change in cognitive functioning

Which factor contributes to UTI in older adults? Active lifestyle Sporadic use of antimicrobial agents Immunocompromise Low incidence of chronic illness

Immunocompromise

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

Peritonitis

The nurse is caring for a client recovering from extracorporeal shock wave lithotripsy (ESWL). Which client statement(s) indicates that teaching about self-care has been effective? Select all that apply. "Blood in my urine should go away by day 4 or 5." "I need to increase my intake of fluids every day." "I may expect to experience some pain and discomfort." "I will take my temperature every day." "The bruise on my back is from the treatment."

"Blood in my urine should go away by day 4 or 5." "I need to increase my intake of fluids every day." "I may expect to experience some pain and discomfort." "I will take my temperature every day." "The bruise on my back is from the treatment."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? "A catheter will drain urine directly from my kidney." "My urine will be eliminated through a stoma." "My urine will be eliminated with my feces." "I will not need to worry about being incontinent of urine."

"My urine will be eliminated through a stoma."

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? Cholinergic Anticonvulsant Anticholinergic Diuretics

Anticholinergic

Which type of medication may be used to inhibit bladder contraction in a client with incontinence? Anticholinergic agent Tricyclic antidepressants Over-the-counter decongestant Estrogen hormone

Anticholinergic agent

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? Restricting fluid intake to reduce the need to void Encouraging the client to increase the time between voidings Establishing a predetermined fluid intake pattern for the client Assessing present voiding patterns

Assessing present voiding patterns

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what? Interval voiding Voiding at given intervals Prompted voiding Bladder retraining

Bladder retraining

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention? Change the wafer and pouch. Secure or patch it with barrier paste. Secure or patch it with tape. Empty the pouch.

Change the wafer and pouch.

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? Cloudy urine Urine with a specific gravity of 1.005-1.022 An output of 200mL with each voiding Rebound tenderness at McBurney's point

Cloudy urine

The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client? Ginger ale at dinner time Coffee in the morning Milk at lunch Fruit juice midmorning

Coffee in the morning

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? Reveals causative microorganisms Shows damage to the kidneys Detects calculi, cysts, or tumors If risk for chronic pyelonephritis is likely

Detects calculi, cysts, or tumors

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following? Hyperuricemia Pancreatitis Hyperparathyroidism Diabetes mellitus

Diabetes mellitus

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence? Consulting with a dietitian Giving the client a glass of soda before bedtime Encouraging intake of at least 2 L of fluid daily Taking the client to the bathroom twice per day

Encouraging intake of at least 2 L of fluid daily

Which of the following is a cause of a calcium renal stone? Neurogenic bladder Excessive intake of vitamin D Gout Foreign bodies

Excessive intake of vitamin D

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder? Incontinence Hematuria Frequency Dysuria

Hematuria

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? Incomplete bladder emptying Incontinence Urgency Urinary retention

Incontinence

The nurse advises the patient with chronic pyelonephritis that he should: Decrease his intake of calcium rich foods to prevent kidney stones. Increase fluids to 3 to 4 L/24 hours to dilute the urine. Decrease his sodium intake to prevent fluid retention. Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys.

Increase fluids to 3 to 4 L/24 hours to dilute the urine.

Patients with urolithiasis need to be encouraged to: Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. Supplement their diet with calcium needed to replace losses to renal calculi. Limit their voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system. Increase their fluid intake so that they can excrete up to 4 liters every day.

Increase their fluid intake so that they can excrete up to 4 liters every day.

The treatment of choice for a spinal cord-injured patient with impaired bladder emptying would include which of the following? Intermittent self-catheterization Condom catheterization No catheterization is necessary Indwelling catheterization

Intermittent self-catheterization

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? It's a normal finding associated with the client's nothing-by-mouth status. It's an abnormal finding that requires further assessment. It's an abnormal finding that will correct itself when the client ambulates. It's a normal finding caused by blood loss during surgery.

It's an abnormal finding that requires further assessment.

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform? Determine the client's ability to manage stoma care Suggest a visit to a local ostomy group Maintain skin and stoma integrity Show photographs and drawing

Maintain skin and stoma integrity

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? Need to wear underwear made from synthetic material Importance of urinating every 4 to 6 hours while awake Suggestion to take tub baths instead of showers Need to urinate after engaging in sexual intercourse

Need to urinate after engaging in sexual intercourse

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer? Painless, gross hematuria Decreasing kidney function associated with fever and hematuria Deep flank and abdominal pain Muscle spasm and abdominal rigidity over the flank

Painless, gross hematuria

A client postoperatively reports to the nurse the need to urinate, but is unable to void. What should the nurse expect the healthcare provider to order? Select all that apply. Perform a bladder scan. Complete a straight catheterization. Place an indwelling catheterization. Schedule a suprapubic catheter insertion. Ambulate the client.

Perform a bladder scan. Complete a straight catheterization.

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? Use a sterile technique to disconnect the catheter from the tubing to obtain urine specimens Perform meticulous perineal care daily with soap and water Use a clean technique during insertion Place the catheter bag on the client's abdomen when moving the client

Perform meticulous perineal care daily with soap and water

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? Occupational history Smoking habits History of allergies Physical and environmental conditions

Physical and environmental conditions

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. Encourage patients to wear briefs. Provide careful perineal care. Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. For those patients who are incontinent, insert indwelling catheters.

Provide careful perineal care. Perform hand hygiene prior to patient care. Assist the patients with frequent toileting.

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? Septra Bactrim Pyridium Levaquin

Pyridium

The nurse is reviewing the results of a urinalysis on a client with acute pyelonephritis. Which of the following would the nurse most likely expect to find? High specific gravity Pyuria Absent proteinuria Slightly acidic pH

Pyuria

A female patient visits her primary health care provider with a complaint of frequency of urination and incontinence when she sneezes. The health care provider suspects the patient is experiencing cystitis. The nurse knows that this is most likely due to which of the following? Interruption in the protective effect of glycosaminoglycan Dysfunction of the bladder neck or urethra. Disturbance in the normal bacterial flora of the vagina Reflux of urine from the urethra into the bladder

Reflux of urine from the urethra into the bladder

Sympathomimetics have which of the following effects on the body? Decrease of heart rate Constriction of pupils Relaxation of bladder wall Constriction of bronchioles

Relaxation of bladder wall

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? Urge Stress Overflow Reflex

Stress

Which nursing intervention should the nurse caring for the client with pyelonephritis implement? Restrict fluid intake to 1 liter per day. Teach client to increase fluid intake up to 3 liters per day. Straight catheterize the client every 4 to 6 hours. Administer acetaminophen (Tylenol).

Teach client to increase fluid intake up to 3 liters per day.

The nurse knows that which of the following body parts explains why cystitis is more common in women? The bladder The ureters The urethra The rectum

The urethra

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? Stress Functional Overflow Urge

Urge

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

Uric acid

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction? Urinary retention Urethral stricture Cystitis Bladder stones

Urinary retention

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to: evaluate the client's need for mental health intervention. assess suicidal risk postoperatively. assess whether the client is a good candidate for surgery. help the client cope with the anxiety associated with changes in body image.

help the client cope with the anxiety associated with changes in body image.

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization? administration of cleansing enemas type and size of the catheter to be used placement of the catheter procedure for insertion of the catheter

type and size of the catheter to be used

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site? Bladder Urethra Kidney Ureter

Kidney

Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? Low oxalate High sodium Low purine High protein

Low purine

Which medication may be ordered to relieve discomfort associated with a UTI? Ciprofloxacin Phenazopyridine Levofloxacin Nitrofurantoin

Phenazopyridine