Prep-U Urinary Disorders Chapter 49

Which term refers to inflammation of the renal pelvis?

Pyelonephritis

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

Pyridium -The urinary analgesic agent phenazopyridine (Pyridium) is used specifically for relief of burning, pain, and other symptoms associated with UTI.

Which condition or laboratory result supports a diagnosis of pyelonephritis?

Pyuria -Pus in the urine

A client asks the nurse why cystitis is more common in women than in men. Which of the following body parts will the nurse include in the answer?

The Urethra Because it is shorter in women!

Which client is at highest risk for developing a hospital-acquired infection?

A client with an i1619 (Urinary Catheter)

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Acute Pain

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. A: For those patients who are incontinent, insert indwelling catheters. B: Perform hand hygiene prior to patient care. C: Assist the patients with frequent toileting. D: Provide careful perineal care. E: Encourage patients to wear briefs.

B, C, D B: Perform hand hygiene prior to patient care. C: Assist the patients with frequent toileting. D: Provide careful perineal care.

The nurse recognizes that which risk factor does NOT predispose a client to the development of kidney stones? A: Hyperparathyroidism B: Hypoparathyroidism C: Immobilization D: Gout

B: HYPOPARATHYROIDISM

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?

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?

Diabetes mellitus -Increased urinary glucose levels create an infection-prone environment in the urinary tract.

The nurse recognizes that test results that most likely indicate a urinary tract infection include:

Elevated WBC

Which of the following is a cause of a calcium renal stone?

Excessive intake of vitamin D -Potential causes of calcium renal stones include excessive intake of vitamin D, hypercalcemia, hyperparathyroidism, excessive intake of milk and alkali, and renal tubular acidosis.

A client has a suspected bladder cancer. What is the most common first symptom of a malignant tumor of the bladder?

Painless hematuria is the MOST COMMON sign. -Additional early symptoms include UTI with symptoms such as fever, dysuria, urgency, and frequency.

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

Perform meticulous perineal care daily with soap and water

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:

Loss of motor control of the detrusor muscle.

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

Low Purine.

Which factor contributes to UTI in older adults?

Immunocompromised

The nurse is teaching a client how to perform self-catheterization. Which direction should the nurse include?

catheterization should occur every 4 to 6 hours and before bedtime. The average daytime clean intermittent catheterization schedule is every 4 to 6 hours and just before bedtime. The catheter is rinsed with tap water after soaking in a cleaning solution. Either antibacterial soap or povidone-iodine solution is recommended for cleaning urinary catheters at home. The nurse uses sterile technique in the hospital setting.

Bladder retraining following removal of an indwelling catheter begins with

instructing the client to follow a 2- to 3-hour timed voiding schedule.

Which nursing diagnosis is appropriate for a client with renal calculi?

Risk for Infection

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?

Risk for Infection -Percutaneous nephrolithotomy is an invasive procedure for the removal of renal calculi. The client would be at risk for infection.

The nurse is caring for a client who is prescribed an anticholinergic for urge incontinence. The nurse understands that this drug is an effective treatment for which reason(s)? Select all that apply. A: increases relaxation of the detrusor muscle B: increases bladder neck resistance C: reduces bladder spasticity D: decreases involuntary bladder contractions E: increases how much urine the bladder can hold

A, D, E A: increases relaxation of the detrusor muscle D: decreases involuntary bladder contractions E: increases how much urine the bladder can hold

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located?

Away from skin folds! The nurse plans to have the stoma located away from skin folds and creases, bony prominences, the belt line, and the umbilicus. The stoma should be located in an area where the client can see and reach it.

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

A client who has a history of neurogenic bladder uses a permanent, indwelling catheter to facilitate urine elimination. What can this client consume to decrease the likelihood of bladder infection?

Cranberry Juice

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 an abnormal finding that requires further assessment.

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action?

Maintain skin and stomal integrity.

The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?

Permanent drainage with a urethral catheter

Which medication may be ordered to relieve discomfort associated with a urinary tract infection?

Phenazopyridine

An 82-year-old client experiences urinary incontinence. Which factor should the nurse assess before beginning a bladder training program for this client?

Physical and environmental conditions

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?

Relieve the pain

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?

Urinary calculi

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report?

When did you last urinate?"

A client is prescribed amitriptyline (an antidepressant) for incontinence. The nurse understands that this drug is an effective treatment because it:

increases bladder neck resistance. Some tricyclic antidepressant medications (amitriptyline, nortriptyline, and amoxapine) are useful in treating incontinence because they decrease bladder contractions and increase bladder neck resistance. Anticholinergic drugs such as oxybutynin chloride (Ditropan), reduce bladder spasticity and involuntary bladder contractions. Bethanechol (Urecholine) helps to increase contraction of the detrusor muscle, which assists with emptying of the bladder.

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:

notify the physician about cloudy or foul-smelling urine

The nurse is giving discharge instructions to the client with uric acid renal calculi. Which statement by the client indicates the client understands the prescribed diet?

"I should limit my intake of meat and fish." A low-purine diet is prescribed for the client with uric acid renal calculi. Organ meats, shellfish, anchovies, asparagus, and mushrooms are foods high in purine.

A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply. A; Empty the collection bag at least every 8 hours to reduce bacterial growth. B: Disconnect the tubing to collect urine samples. C; Suspend the drainage bag off the floor. D; Wash the perineal area with soap and water at least twice daily. E; Irrigate the catheter every 24 hours.

A, C, D A; Empty the collection bag at least every 8 hours to reduce bacterial growth. C; Suspend the drainage bag off the floor. D; Wash the perineal area with soap and water at least twice daily.

The nurse is caring for a client with an ileal conduit is created after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

The nurse is caring for a client who has been diagnosed with a mild urinary tract infection and is prescribed an antibiotic. What class of antibiotics is used as an effective first-line agent in treating urinary tract infections?

Fluoroquinolones -Ciprofloxacin is a fluoroquinolone commonly used to treat UTIs. The other classifications are not used as commonly.

The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select?

Ileal conduit When the physician is discussing a stoma, the nurse recognizes that the client will have an ileal conduit which is a cetaceous urinary diversion. Both the Kock Pouch and Indiana Pouch are continent urinary diversions. The ureterosigmoidostomy connects with the rectum for urinary drainage.

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease?

Incontinence Incontinence is noted in clients diagnosed with Parkinson disease. Urinary retention is associated with spinal cord injury. Urgency is associated with an overactive bladder. Incomplete bladder emptying is associated with diabetes mellitus.

Which type of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?

Stress Stress incontinence may occur with sneezing, coughing, or changing position.

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?

The pouch faceplate doesn't fit the stoma. If the pouch faceplate doesn't fit the stoma properly, the skin around the stoma will be exposed to continuous urine flow from the stoma, causing excoriation and red, weeping, and painful skin. A lubricant shouldn't be used because it would prevent the pouch from adhering to the skin. When properly applied, a skin barrier prevents skin excoriation. Stoma dilation isn't performed with an ileal conduit, although it may be done with a colostomy if ordered.

The nurse is assessing the client's ileal conduit stoma in the clinic. Which assessment finding would be of greatest concern to the nurse?

The stoma is dusky red. A dusky red color indicates the blood supply of the stoma is compromised and suggests superficial necrosis of the stoma.

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?

This medication will help relieve pain

Which of the following is the procedure of choice for men with recurrent or complicated urinary tract infections (UTIs)?

Transrectal ultrasonography

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?

Uric Acid