PrepU Adult 2 Assignment 14

A nurse is presenting at a community health promotion fair that is focused on disease prevention and screening. A middle-aged participant has brought up an article that she recently read about bladder cancer and has asked the nurse about prevention measures. How should the nurse respond to this woman's inquiry?

"If you smoke cigarettes, quitting will greatly reduce your risk of bladder cancer."

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?

"My urine will be eliminated through a 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 relieve your pain."

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

Incontinence

A nurse is preparing a care plan for a client with Alzheimer's disease. The client is unable to communicate or feel the pain and discomfort associated with acute urinary retention. Which nursing measures should be taken while caring for such a client? Select all that apply.

-Measure fluid intake and output. -Palpate the abdomen to check for distended bladder.

A client has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What contributes to the likelihood of developing urinary tract or bladder infections? Select all that apply.

-indwelling catheter -decreased fluid intake

A 32-year-old client has been admitted to the renal unit of the hospital with acute pyelonephritis. She is undergoing parenteral antibiotic treatment. What signs and symptoms would you expect the client to exhibit?

All options are correct

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?

Anticholinergic agents

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

Assessing present voiding patterns

Which of the following is the most effective intravesical agent for recurrent bladder cancer?

Bacillus Calmette-Guérin (BCG)

John Ericsson, a 57-year-old railroad worker, is a client on the hospital unit where you practice nursing. As a result of trauma, Mr. Ericsson has developed urinary incontinence and is beginning bladder training to regain control over his urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter?

Clamp the catheter

As a result of trauma, a client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter?

Clamp the catheter.

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

Patricia O'Connor, a 17-year-old high school student, is returning to the medical-surgical unit where you practice nursing from surgery. She has just undergone an appendectomy. She reports the need to urinate and cannot do so. What is your response to her situation as ordered by the physician?

Intermittent catheterization

Which of the following is the most common symptom of bladder cancer?

Painless gross hematuria

Which finding is an early indicator of bladder cancer?

Painless hematuria

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

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

Perform meticulous perineal care daily with soap and water

Which medication may be ordered to relieve discomfort associated with a UTI?

Phenazopyridine

Which nursing intervention should the nurse caring for the client with pyelonephritis implement?

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

A client has been admitted for an outpatient cystoscopy because of a suspected interstitial cystitis. Which statement best describes the pathology of this disorder?

The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa.

The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily:

at the same time, on the same scale, with similar clothing.

A client who was involved in an MVA which resulted in paraplegia is working toward living at home. The client is currently developing an individualized CIC schedule, preferring not to wear a leg bag. Insufficient CIC does not cause decreased:

urine production.

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?

type and size of the catheter to be used

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem?

urinary tract infection

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

painless hematuria

A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is:

placement of small amounts of collagen in urethral walls to aid the closing pressure.

A client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. The catheter would be clamped and unclamped to:

promote normal bladder function.

A client has been admitted to the renal unit with acute pyelonephritis, and is undergoing parenteral antibiotic treatment. What would be a significant aspect of this client's discharge education?

recurring infection prevention

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

WBC 50

A client who is diagnosed with calcium oxalate stones is instructed to limit calcium intake. The client is instructed to consume ______ mg of calcium per day, or less, as part of dietary treatment.

1000

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.

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

In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the client's residual urine must be less than which amount?

100 mL

Ron Davidson, a 45-year-old editor, is a client on the rehab unit where you practice nursing. Ron was involved in an MVA which left him with paraplegia and he is working toward living at home with his wife. He is currently developing an individualized CIC schedule, as he prefers to not wear a leg bag. What is the maximum amount of urine he should allow to collect before catheterization?

350 mL

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following?

By ascending infection (transurethral)

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

Catheterization should occur 4 to 6 hours and before bedtime.

Which objective symptom of a UTI is most common in older adults, especially those with dementia?

Change in cognitive functioning

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.

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?

Take the antibiotic for 3 days as prescribed.

A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?

Low-purine diet

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 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?

Medication usage

A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care?

Monitor urine output hourly and report output less than 30 mL/hr.

A 60-year-old woman has begun a course of oral antibiotics for the treatment of a urinary tract infection (UTI). The patient's nurse should recognize that the causative microorganisms most likely originated from:

Fecal contamination from the patient's perineum

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

Cipro

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include?

Implement a 2- to 3-hour voiding schedule

A 17-year-old high school student is returning to the medical-surgical unit following an appendectomy. She reports the need to urinate and cannot do so. What type of procedure will you perform to resolve her difficulty?

Intermittent catheterization under sterile conditions

Which of the following nursing actions is most important in caring for the client following lithotripsy?

Strain the urine carefully for stone fragments.

Which instruction would be included in a teaching plan for a client diagnosed with a UTI?

Drink liberal amount of fluids.

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone?

Ketoralac (Toradol)

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

Phenazopyridine

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?"

Which statement describing urinary incontinence in an older adult client is true?

Urinary incontinence isn't a disease.

Which of the following is a strategy to promote urinary continence?

Void regularly, 5 to 8 times a day