Urinary Elimination
The health care provider has requested a urine sample from a female client for urinalysis. Which method should the nurse instruct the client to use to obtain a clean-catch urine?
"Begin to urinate while continuing to hold the labia apart. Allow the first urine to flow into the toilet." Explanation: After cleansing, the client should begin to urinate while continuing to hold the labia apart. Allowing the first urine to flow into the toilet will wash microorganisms and cellular debris out of the meatus. The specimen can then be collected. The client will not collect all of the urine. The specimen is not required to be from the first urine of the day. Reference: Chapter 37: Urinary Elimination - Page 1352
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." Explanation: The Crede maneuver involves the act of bending forward and applying hand pressure over the bladder. Other answers do not reflect this maneuver. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.
A client with urinary incontinence is prescribed incontinence briefs. Which factors should be included in the client education the nurse provides?
"Cleanse the skin each time you change the briefs." Explanation: Clients need to change the protective pads or briefs frequently to avoid odor and to prevent skin irritation from prolonged exposure to moisture. Clients should not use cologne or perfume to mask odor, as it may irritate the perineal area. Clients wearing absorbent products should bathe at least daily. Each time the product is changed, the perineal area should be cleansed and examined for any areas of irritation. To reduce the incidence of incontinence, the client should use the bathroom at least every 2 hours during waking hours. Reference: Chapter 37: Urinary Elimination - Page 1362
A client reports a recurrent pattern of signs and symptoms that are consistent with urinary tract infections. What would be the most appropriate assessment question for the nurse to ask the client?
"How often do you urinate each day and night?" Explanation: The client with frequent urinary tract infections may have infrequent urination, which can lead to stagnation of urine in the bladder; this potentially leads to growth of bacteria and a UTI. Diuretics, recent antibiotic use and acidic foods do not increase the risk for urinary tract infections. Reference: Chapter 37: Urinary Elimination - Page 1358
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." Explanation: Limiting fluid intake is not a healthy practice, and clients should be encouraged not to use fluid restriction as an incontinence management strategy. Promoting fluid intake is beneficial for most clients who do not possess a contraindication, and it is appropriate and useful to take diuretics in the morning to avoid nocturia. Even though it may involve work for both the client and the nurse, clients who want to use a bathroom or commode rather than an adult absorbent brief should be encouraged to do so. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.
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." Explanation: The nurse will promote the client's self-esteem by exploring ways in which the client can verbalize feelings, maintain dignity, and become empowered to participate in self-care. Telling the client to get adult undergarments (referring to these as "diapers" is not therapeutic), sending her to a urologist, and telling her not to worry discounts the client's concern. Reference: Chapter 37: Urinary Elimination - Page 1385
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." Explanation: Bladder irritants such as caffeine can cause urge incontinence; it is appropriate to determine whether the child is consuming fluids that contain caffeine. The child's urge incontinence is not extremely abnormal, and this physiological response is not related to gender. It is too soon to refer the client to the health care provider without taking a history, and it is impractical to simply recommend incontinence undergarments. Reference: Chapter 37: Urinary Elimination - Page 1345
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." Explanation: When collecting a midstream urine specimen, the client voids a small amount, stops, and discards it; the first small amount helps to flush away organisms near the urinary meatus. The midstream urine specimen is a sterile specimen, so it is not collected in the hat in the toilet bowl. The client will not need to be catheterized. It is a one-time specimen, so urine will not be collected for 24 hours. Pausing to introduce the container is preferable to introducing it mid-stream, which could result in urine on the outside of the container. Reference: Chapter 37: Urinary Elimination - Page 1352
The nurse is providing instructions to a client with kidney stones on measures to help prevent urinary tract infections (UTIs). Which statement made by the client would indicate to the nurse that further teaching is necessary? Select all that apply. - "I will drink 10 ounces of cranberry juice every day." - "I will bathe in the bathtub rather than take a shower." - "I will drink about ten 8-oz glasses of water a day." - "I will notify my health care provider if my urine starts smelling again." - "I will start wearing underwear with a cotton crotch."
**"I will drink 10 ounces of cranberry juice every day." **"I will bathe in the bathtub rather than take a shower." Explanation: Even though cranberry juice is encouraged to prevent bacteria from adhering to the urinary bladder wall, it is not recommended for the client with kidney stones. The client should take showers instead of bathing in the bathtub to prevent UTIs. Drinking eight to ten 8-oz glasses of water daily, notifying the health care provider of any signs of infection (e.g., foul urine odor), and wearing underwear with a cotton crotch are measures to prevent UTIs. Reference: Chapter 37: Urinary Elimination - Page 1346
A female client is diagnosed with recurrent urinary tract infections (UTIs) and the nurse is providing education about preventative methods. What information is important for the nurse to give to the client to prevent another UTI? Select all that apply. -Dry the perineal area after urination or defecation from the back to the front. -Take baths instead of showers. -Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse. -Wear underwear with a cotton crotch. -Avoid clothing that is tight and restrictive on the lower half of the body.
-Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse. -Wear underwear with a cotton crotch. -Avoid clothing that is tight and restrictive on the lower half of the body. Explanation: Client education can help prevent UTI recurrence. Teaching the client about measures that promote health and decrease the severity and incidence of UTIs is a major nursing responsibility. The nurse should instruct the client to drink eight to ten 8-oz glasses (1,920 to 2,400 mL) of water daily, drink two 8-oz glasses (480 mL) of water before and after sexual intercourse, void immediately after sexual intercourse, wear underwear with a cotton crotch, and avoid clothing that is tight and restrictive on the lower half of the body. Instruction should include drying the perineal area after urination or defecation from the front to the back, or from the urethra toward the rectum, as well as taking showers instead of baths. Reference: Chapter 37: Urinary Elimination - Page 1360
Information needed to calculate glomerular filtration rate (GFR) includes which data? Select all that apply. -The client's normal daily fluid intake range. -The client's age. -The client's gender. -The client's serum creatinine levels.
-The client's age. -The client's gender. -The client's serum creatinine levels. Explanation: The glomerular filtration rate (GFR) is the amount of plasma filtered through glomeruli per unit of time and is the best indicator of kidney function. Many labs now calculate an estimated GFR for all clients who have a serum creatinine test. To calculate the GFR you need the client's age, race, gender, and serum creatinine. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.
Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine?
24-hour specimen Explanation: A 24-hour urine specimen is required for accurate measurement of the kidney's excretion of substances that the kidney does not excrete at the same rate throughout the day. A clean-catch or midstream-voided specimen is used when a specimen relatively free from microorganisms is required. Random urine specimen collection is used when sterile urine is not required. Reference: Chapter 37: Urinary Elimination - Page 1353
A client has not voided for 8 hours after surgery. Which finding indicates the client has a distended bladder?
A bulge between the symphysis pubis and the umbilicus Explanation: When the bladder is distended with urine, it rises above the symphysis pubis and may reach to just below the umbilicus. The other choices are anatomically incorrect for assessing a distended bladder. Reference: Chapter 37: Urinary Elimination - Page 1348-1349
A male client who has had outpatient surgery is unable to void while lying supine. Which intervention would be most effective in assisting the client to urinate?
Assist the client to a standing position. Explanation: Helping clients assume their usual voiding positions may be all that is necessary to resolve an inability to void. If male clients cannot void lying down, the nurse will encourage them to void while standing at the bedside, unless this is contraindicated. While running water often helps relax clients so voiding can occur, it is not addressing the clients' true need. Telling the client that he needs to void prior to discharge is putting stress on performing the activity, which is counterproductive. Asking the spouse to assist with holding the urinal may also make the client uncomfortable. Reference: Chapter 37: Urinary Elimination - Page 1357
A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take?
Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. Explanation: The nurse should auscultate over the hemodialysis access site with the bell of a stethoscope, listening for a bruit or vibration, to assess the patency of the access. The nurse should not measure the client's blood pressure, perform a venipuncture, or start an IV on the access arm, as doing so could lead to infection or clotting of the graft or fistula. Reference: Chapter 37: Urinary Elimination - Page 1376
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. Explanation: Children in North American cultures usually achieve daytime urinary continence by 3 years of age; boys may take longer than girls. Nighttime continence may not occur until 4 or 5 years of age. Reference: Chapter 37: Urinary Elimination - Page 1346
Which symptom will have a great impact on the extracellular fluid for water conservation?
Burns Explanation: The water saving, to regulate the concentration of solutes in the ECF, results in decreased urine output. Increased loss of body fluids can occur with vomiting, diarrhea, excessive diaphoresis secondary to fever or exercise, excessive wound drainage, extensive burns, or blood loss from trauma or surgery. Reference: Chapter 37: Urinary Elimination - Page 1348
The nurse has placed a urine collection bag on an infant. How often should the nurse check the bag to see if the infant has voided?
Every 15 minutes Explanation: The nurse should check the bag every 15 minutes. An infant does not have voluntary control over the bladder, so voiding occurs when the bladder is full. Checking the bag too frequently is not necessary. If the length of time is too long, the bag may overfill with urine and become unattached. The nurse should make sure the bag is secured in place. Reference: Chapter 37: Urinary Elimination - Page 1353-1354
A nurse is caring for a client with an external condom catheter. Which guideline should be implemented when applying and caring for this type of catheter?
Fasten the condom securely enough to prevent leakage without constricting blood flow. Explanation: Nursing care of a client with a condom catheter includes vigilant skin care to prevent excoriation. This includes removing the condom catheter daily, washing the penis with soap and water and drying carefully, and inspecting the skin for irritation. In hot and humid weather, more frequent changing may be required. In all cases, care must be taken to fasten the condom securely enough to prevent leakage, yet not so tightly as to constrict the blood vessels in the area. In addition, the tip of the tubing should be kept 1 to 2 in. (2.5 to 5 cm) beyond the tip of the penis to prevent irritation to the sensitive glans area. Reference: Chapter 37: Urinary Elimination - Page 1389-1391
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. Explanation: The external condom catheter is not in the bladder. It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters which are placed in the bladder. Because it is not sterile, a sterile urine specimen cannot be obtained. Often, the client does not place the external condom catheter by himself. The catheter is changed every day and the skin of the penis is assessed. Reference: Chapter 37: Urinary Elimination - Page 1364
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. Explanation: Kegel exercises should be performed by tightening the internal muscles used to prevent or interrupt urination for 10 seconds, followed by a period of 10 seconds of relaxation. The client should be instructed to perform this regimen 3-4 times daily for 2 weeks to 1 month. Reference: Chapter 37: Urinary Elimination - Page 1345
A nurse notes that the volume of the client's urinary elimination is less than 50 mL/day. What could be the possible cause for the low volume of urination by the client?
Kidney dysfunction Explanation: Kidney dysfunction could be a possible cause for the client's low volume of urination. Diuretic medication and endocrine disease would increase the volume of urination. Liver disease would cause the urine to appear brown in color. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.
The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate?
Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. Explanation: Leaving the catheter in place as a marker assists in the correct placement of the second catheter into the bladder. It is not necessary to contact the health care provider. The vagina is not sterile, so insertion of a sterile catheter poses little risk for infection. Asking the client to bear down is not necessary because the catheter is not typically completely inserted. Removing the catheter from the vagina and attempting to insert it into the bladder will cause cross-contamination. Reference: Chapter 37: Urinary Elimination - Page 1396
A nurse prepares a client with a recently created ileal conduit to be discharged from the hospital. Which is an expected assessment finding?
Mucus in the urine is a normal finding. Explanation: The isolated segment of small intestine continues to produce mucus (seen in the urine), as part of its normal functioning. The stoma should be dark pink to red and moist. The size of the stoma usually stabilizes within 6 to 8 weeks. Most stomas protrude 0.5 inch to 1 inch (1.25 to 2.5 cm) from the abdominal surface. Reference: Chapter 37: Urinary Elimination - Page 1405-1409
A client is suspected of having a disease process affecting the functional unit of the kidney. Which structure is most likely involved?
Nephron Explanation: The functional unit of the kidney is called the nephron. Each kidney has more than 1 million nephrons, and each nephron is capable of forming urine. The nephron consists of the glomerulus, Bowman's capsule, proximal convoluted tubules, loop of Henle, distal tubule, and collecting duct. The glomerulus is a network of blood vessels, surrounded by Bowman's capsule, where urine formation begins. The tubules, loop of Henle, and collecting ducts are passageways that permit urine to flow to the renal pelvis and then to the ureters. Reference: Chapter 37: Urinary Elimination - Page 1342
A client with an emergently placed central venous catheter (CVC) is to have emergent hemodialysis. Upon assessment of the CVC the nurse visualizes redness, drainage, and odor to the area around the CVC. Palpation of the surrounding skin causes the client pain. Which intervention is the priority?
Notifying the health care provider of the assessment findings Explanation: The assessment is indicative of hospital-acquired catheter infection associated with the CVC. The medical provider may request laboratory studies, but these cannot be obtained until a prescription is received. There is no indication to withhold oral food or fluids from the client at this time. Checking for blood return is not indicated and access to the CVC used for hemodialysis should not be attempted without a prescription to do so from the health care provider. Reference: Chapter 37: Urinary Elimination - Page 1375-1376
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 sign/symptom would the nurse document as an abnormal finding?
Reddened perineal skin Explanation: The presence of reddened perineal skin is an abnormal finding. The healthy skin should be moist and noninflamed with no discharge present. Smegma (an accumulation of white, odorous secretions from sebaceous glands found under the labia minora in women and under the foreskin in men) is considered a normal finding. Reference: Chapter 37: Urinary Elimination - Page 1378
A client who is a paraplegic as a result of an auto accident has incontinence. The nurse correctly recognizes that which type of incontinence is most likely?
Reflex Explanation: An involuntary loss of urine that occurs at somewhat predictable intervals when a specific bladder volume is reached is called reflex incontinence. The person is unable to sense bladder fullness because of neurologic impairment, and the bladder simply empties when a certain degree of bladder stretch occurs. Bladder emptying occurs at the sacral reflex level because of impairment of the connection to the cerebrum that allows voluntary inhibition of voiding. Reflex incontinence is seen in clients with neurologic impairment, such as a spinal cord lesion, cerebrovascular accident, or brain tumor. The sudden, involuntary loss of small amounts (less than 50 mL) of urine that accompanies a sudden increase in intra-abdominal pressure is called stress incontinence, termed urge incontinence. The person with urge incontinence is unable simultaneously to perceive a full bladder and to hold urine until reaching the bathroom. Functional incontinence involves the inability or unwillingness of a person with normal bladder and sphincter control to reach the bathroom in time to void. Reference: Chapter 37: Urinary Elimination - Page 1361
A nurse is performing a client's intermittent closed catheter irrigation and realizes that the tubing was not clamped before introducing the irrigation solution. What would be the nurse's best response to this situation?
Repeat the irrigation. Explanation: If the tubing was not clamped before introducing the irrigation solution, the nurse should repeat the irrigation. If the tubing is not clamped, the irrigation solution will drain into the urinary drainage bag and not enter the catheter. There is no immediate need to contact the primary care provider or to change the catheter. Reference: Chapter 37: Urinary Elimination - Page 1372
Which is not true of urine color?
The appearance of urine streaked with blood is always abnormal. Explanation: Urine may appear cloudy, dark reddish-brown, or streaked with blood when a woman is menstruating. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.
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. Explanation: Trauma from vaginal birth causes swelling in the perineal area, which can obstruct the flow of urine and cause urinary retention during the early postpartum period. Reference: Chapter 37: Urinary Elimination - Page 1364
The nurse is inserting a urinary catheter into a 63-year-old male client and encounters resistance. What is the most likely cause of the resistance?
The client has an enlarged prostate. Explanation: Enlargement of the prostate gland is commonly seen in men over age 50 and may interfere with urinary catheterization. The client does not have an occult abscess in the urethra as the nurse was able to pass some of the catheter and then had resistance. The resistance is not caused by the balloon as this inflation had not occurred. The diameter of the catheter is not too large. Reference: Chapter 37: Urinary Elimination - Page 1403
A nurse is preparing a discharge teaching plan for a client being sent home with a peritoneal dialysis catheter in place. Which guideline should be included in the instructions?
The client should avoid wearing tight clothes or belts near the site. Explanation: Clients should avoid baths and public pools as well as wearing tight clothes and belts around the exit site. Once the site is healed, some health care providers do not require clients to wear a dressing unless the site is leaking. Clean technique is sometimes allowed in the home. Reference: Chapter 37: Urinary Elimination - Page 1377
The nurse mentor is observing a novice nurse preparing to insert an indwelling catheter for a female client with urinary retention. The mentor would intervene if which action by the novice nurse is noted?
The novice nurse selects an 18 French Foley catheter to insert. Explanation: A 14F to 16F catheter should be used when catheterizing an adult client. Size 18F can distend the urethra and cause more discomfort to the client during the procedure, as well as increase erosion of the bladder. If resistance is met, having the client take a deep breath helps relaxes the external sphincter. Placing a trash receptacle within easy reach trash allows for prompt disposal of used supplies and reduces the risk of contaminating the sterile field. The dorsal recumbent position allows adequate visualization of the urinary meatus. Reference: Chapter 37: Urinary Elimination - Page 1365
A nurse who is right-handed is inserting a woman's indwelling urinary catheter. The nurse will use cotton balls and antiseptic solution to cleanse the woman's meatus and perineum. Which of the nurse's actions is most appropriate?
Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted. Explanation: Using the thumb and one finger of the nondominant hand, the nurse should spread the client's labia and identify the meatus. The nurse should be prepared to maintain separation of labia with one hand until the catheter is inserted and urine is flowing well and continuously. The nurse does not let go of the labia to perform hand hygiene after cleansing. The catheter is inserted with the dominant hand. Reference: Chapter 37: Urinary Elimination - Page 1391-1398
The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately?
Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well. Explanation: The nurse would ensure prescription is obtained, explain procedure to the client, use an antiseptic swab to cleanse the access port, then attach syringe and aspirate urine into the syringe. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. Always observe sterile technique while collecting a urine specimen from an indwelling catheter. Gather equipment, including a syringe, an antiseptic swab, a sterile specimen container, nonsterile gloves, and only tube tubing if needed; remember to unclamp the catheter after obtaining specimen to avoid reflux of urine into bladder. Reference: Chapter 37: Urinary Elimination - Page 1352-1353
A nurse is preparing to measure a client's urine output. Which interventions would be of highest priority?
Wearing gloves when handling the urine Explanation: All of these interventions would be important to ensure safety in handling the client's urine and obtaining an accurate output. However, safety with handling body fluids would be a priority for the nurse to decrease risk of exposure to pathogens or blood that may be in the client's urine. Reference: Chapter 37: Urinary Elimination - Page 1349
A nurse collects a clean-catch specimen from a client at a health care facility. Which statement describes a clean-catch urine sample?
a sample of urine that is considered sterile Explanation: A clean-catch specimen is a sample of urine that is considered sterile. A clean-catch specimen is preferred to a randomly voided specimen. This method of collection is preferred when a urine specimen is needed during a client's menstrual cycle. A void specimen is a sample of fresh urine collected in a clean container. A catheter specimen is a sample of urine collected in a sterile environment using a catheter. A 24-hour specimen is a sample of urine collected over a 24-hour period. Reference: Chapter 37: Urinary Elimination - Page 1352
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 Explanation: Absence of urine for a 24-hour period reflects anuria. Reference: Chapter 37: Urinary Elimination - Page 1347
When collecting a urine sample from a client for examination, the nurse notes that the sample appears reddish-brown in color. What could cause this variation in color of the urine?
blood Explanation: A reddish-brown urine sample is indicative of the presence of blood. The urine appears dark amber in color due to dehydration. Infection and stasis would cause the urine to appear cloudy. Reference: Chapter 37: Urinary Elimination - Page 1347
A woman is reporting bladder urgency. It is most important to assess:
caffeine intake. Explanation: Fluids or food containing alcohol or caffeine, such as coffee, tea, cola, or chocolate, irritate the bladder and contain a diuretic that can increase urine output when ingested in large amounts. Reference: Chapter 37: Urinary Elimination - Page 1358
The nurse is inserting a urinary catheter into a female client and has begun to inflate the balloon, an action that has caused the client to wince and cry out in pain. Consequently, the nurse should:
deflate the balloon, insert the catheter further, and slowly attempt reinflation. Explanation: If the client reports pain during balloon inflation, the nurse should stop inflation of balloon, which is most likely still in the client's urethra. The nurse should withdraw the solution from the balloon, insert the catheter an additional 0.5 to 1 in (1.25 to 2.5 cm), and slowly attempt to inflate the balloon again. Re-attempting inflation in the same location or after slight withdrawal could cause trauma to the client's urethra. It is not necessary to utilize a smaller gauge catheter. Reference: Chapter 37: Urinary Elimination - Page 1371
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 Explanation: The nurse anticipates that the client may be dehydrated, which is characterized by strongly aromatic, dark amber urine. The symptoms are not associated with hypovolemia, balanced fluids, nor renal failure. Reference: Chapter 37: Urinary Elimination - Page 1350
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 Explanation: While the specimen can be collected at any time during the day, the first urine voided in the morning is preferred. The first urine is usually more concentrated because the client does not usually consume fluid during the night and the effects of diet and activity are minimized. Reference: Chapter 37: Urinary Elimination - Page 1352-1353
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 Explanation: An intermittent urethral catheter (straight catheter) is a catheter inserted through the urethra into the bladder to drain urine for a short period of time (5 to 10 minutes). With an indwelling urethral catheter (retention or Foley catheters), a catheter (tube) is inserted through the urethra into the bladder for continuous drainage of urine; a balloon is then inflated to ensure that the catheter remains in the bladder once it is inserted. Reference: Chapter 37: Urinary Elimination - Page 1365
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. Explanation: Neurologic injury after a stroke or spinal cord injury can disrupt normal patterns of urinary elimination. This condition is called neurogenic bladder. A cystocele is a herniation of the urinary bladder. Enuresis is the clinical term for bedwetting. An overactive bladder is the term used when a person has increased urinary urge, increased urinary frequency, or both. Reference: Chapter 37: Urinary Elimination - Page 1364
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 Explanation: The client with weakness who has been ordered to stay on bed rest will benefit from use of a urinal. The client should not be moved to the bedside commode or regular bathroom. A fracture pan may be useful for bowel movements. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.