Porth's PrepU: Chapter 43: Disorders of the Bladder and Lower Urinary Tract

A nurse is caring for a patient in spinal shock. Which of the following interventions is appropriate in relation to the patient's urinary status?

Perform intermittent catheterization

A 56-year-old client complains of urinary incontinence when she laughs. The nurse documents this as which type of incontinence?

Stress

A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises, because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?

Stress incontinence

A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as which of the following?

Stress incontinence

A patient is describing difficulty with urinating and informs the nurse that every time she coughs or laughs, she urinates and has begun to wear a thin pad. Which of the following types of urinary incontinence is the patient describing?

Stress incontinence

The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which of the following statements?

"Alterations in bladder function can only occur when there is incontinence."

A young mother asks,"Why can my 3-year-old daughter have a bowel movement on the toilet but she wets her pants?" Which of the following is the nurse's best response?

"Bowel control occurs earlier than bladder control."

The nursing instructor who is teaching about incontinence in the elderly recognizes a need for further instruction when one of the students makes which of the following statements?

"Frequency is not a major problem for the elderly."

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis."

A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer?

"More than ever, I guess it would worthwhile for me to quit smoking."

The client has just been diagnosed with bladder cancer and asks the nurse what causes it. Which of the following would be the nurse's best response to the client?

"The cause is unknown."

A patient has a postvoid residual (PVR) volume of 40 mL. Which of the following information would the nurse teach the patient?

"This is a normal value."

A bladder cancer client asks the nurse, "What did the doctor mean by intravesicular chemotherapy? Am I going to lose all my hair and have to do for treatments over months and months?" The best response would be:

"This is when they put the chemotherapy directly into the bladder to kill any cancer cells."

The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following? Select all that apply.

-Structural changes in the bladder -Structural changes in the urethra -Impairment of neurologic control of bladder function

Which statements identify bladder function? Select all that apply.

-The parasympathetic nervous system promotes emptying. -Control of function involves the autonomic and somatic nervous systems. -The sympathetic nervous system promotes bladder filling

One of the many tests done during urodynamic studies is the sphincter electromyelogram. What does this test study?

Activity of the voluntary muscles of the perineal area

A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?

Administration of a-adrenergic agonistic drugs as ordered

Which of the following types of pharmacological therapy does the nurse anticipate administering to a patient for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is which of the following?

Bladder

A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and best way to remember the transient and treatable causes of urinary incontinence is to use which of the following acronyms?

DIAPPERS

The nurse is conducting a staff development program on urinary disorders. The nurse evaluates that the participants are understanding the information when they identify that disruption of which muscle's contraction can lead to the inability to expel urine from the bladder.

Detrusor

While studying about the process of urination, the nursing student learns that which of the following is known as the "muscle of micturition"?

Detrusor muscle

An older male comes to the clinic with the chief complaint of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. Which of the following should the nurse suspect to be the most frequent cause of this client's problem?

Enlargement of the prostate gland

A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?

Gross hematuria

The patient who has been admitted with a problem with his bladder has a postvoid residual (PVR) of 250 ml. The nurse understands that this indicates which of the following?

Inadequate bladder emptying

Which of the following assessments indicates to the nurse that a patient may have a spastic bladder dysfunction?

Incontinence

After reviewing the 24-hour intake and output of a hospital client, the nurse suspects that the client may be experiencing flaccid bladder dysfunction. Which of the following diagnostic methods is most likely to confirm or rule out whether the client is retaining urine?

Measurement of postvoid residual (PVR) by ultrasound

A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. Which is the most likely diagnosis and possible underlying pathophysiologic problem?

Overactive bladder that may result from both neurogenic and myogenic sources

A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse?

Painless hematuria

Which of the following patients should have a feeling of bladder fullness?

The patient with 200 mL of urine in their bladder

A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:

Urge incontinence

The nurse understands that medications although very beneficial to clients can also have harmful effects. When working with elderly clients the nurse should recognize which of the following is a common result of potent, fast-acting diuretics?

Urge incontinence

A patient is admitted with lower urinary tract obstruction and stasis. Which of the following is the primary intervention?

Urinary catheterization

Which of the following clinical manifestations would tell a nurse that a patient is having progressive decompensation related to obstruction of urinary outflow?

When tested for residual urine volume, 1400 mL of urine is obtained when patient is catheterized

A 65-year-old Caucasian female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include:

cytoscopy

A patient has a postvoid residual (PVR) volume of 250 mL. Which of the following information would the nurse tell the patient?

"This value indicates you are having difficulty emptying your bladder."

A mother asks, "why can't my 1 year old go to the bathroom by himself?" Which of the following is the nurse's best response?

"Your child is too young to begin toilet training."

A 45-year-old man is being treated for bladder cancer. Which therapy would have the least complications?

Intravesical chemotherapy

What is the most common sign of epithelial cell bladder cancer?

Painless hematuria

A patient is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which of the following assessment data obtained by the nurse would indicate that the patient should be screened for this disease?

Patient reports that he occasionally has blood in his urine but has no pain with it