Urinary Elimination
Several of the patients on a geriatric subacute medicine unit are experiencing urinary incontinence from differing causes. Which of the following statements suggests that the patient requires further teaching?
"I make sure to limit how much I drink so that I don't have accidents."
A patient informs the nurse that he is concerned about dribbling and incontinence of small amounts of urine after the removal of his indwelling urinary catheter. The nurse is aware that the catheter was in place for three weeks prior to being removed. Which of the following is the nurse's best response to the patient?
"It will take a little while for the bladder to re-establish control, and an accident is not unusual."
A woman informs the nurse that when she is experiencing stress it is difficult to void, and wonders why this happens. What is the nurse's best explanation?
"Stress causes the muscles to become tense."
A female client is diagnosed with a urinary tract infection (UTI) and states this is her second one in the last 6 months. In teaching the client about health promotion, the nurse would include which statement?
"Try to urinate immediately after sexual intercourse."
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."
The nurse is assessing a female patient who states that she notices an involuntary loss of urine following a coughing episode. What would be the nurse's best reply?
"You are experiencing stress incontinence. Do you know how to do Kegel exercises?"
You are attempting to insert a urinary catheter into a female patient's bladder and realize the catheter has been inserted into the vagina. Which of the following actions is most appropriate?
Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.
A nurse is inserting a catheter into a female urinary bladder. Which nursing action is performed correctly?
Use dominant hand to inflate the catheter balloon, and inject entire volume of sterile water supplied in prefilled syringe.
During data collection, the client expresses concern over a change in the color of the urine from tea-colored to green since beginning a new medication. Which appropriate question would the nurse ask this client?
"Are you taking any B-complex vitamins?"
The nurse educator is presenting a lecture on clients at risk for developing urinary tract infections (UTIs). Which response made by the staff nurse would indicate to the educator a need for further teaching?
"Having sexual relationships does not put a woman at risk for developing an UTI."
A client is diagnosed with frequent urinary tract infections. Which of the following would be an appropriate question for the nurse to ask the client?
"How frequently do you urinate each day?"
A nurse is caring for an elderly client at his home. The client has had a condom catheter applied. Which of the following describes a condom catheter?
A flexible sheath that is rolled around the penis
A nurse collects a clean-catch specimen from a client at a health care facility. Which of the following statements describes a clean-catch urine sample?
A sample of urine that is considered sterile
When collecting a urine sample from a client for examination, the nurse notes that the sample appears reddish-brown in color. Which of the following could cause this variation in color of the urine?
Blood
Which of the following statements 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
A woman complains of bladder urgency. It is most important to assess
Caffeine intake
A home care nurse visits a client diagnosed with depression who informs the nurse that he has been prescribed amitriptyline. Which of the following would the nurse include when teaching the client about the effects of this mediation?
Causes urine to turn blue-green
When a client is diagnosed with a urinary tract infection, the nurse anticipates that the client's urine will be
Cloudy with an offensive odor
To promote drainage of a client's Foley catheter, which intervention would be most important for the nurse to implement?
Confirming the catheter tubing is not lying under the client
A client has been NPO after midnight for surgery. It is 11 AM and the nurse has asked her to void before being transferred to the surgical suite. The nurse should expect her urine to be what color?
Dark amber
A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen?
Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle.
Which information listed below most directly relates with an elderly client with urinary retention?
Elderly clients may have a decrease in contraction of the bladder.
A nurse is caring for a client with an external condom catheter. Which of the following is a guideline for applying and caring for this type of catheter?
Fasten the condom securely enough to prevent leakage without constricting the blood vessels.
The nurse is caring for a client with a history of renal insufficiency and Type II diabetes mellitus. Which prescription, if noted in the client's chart, would alert the nurse to discuss with the health care practitioner?
Gentamicin (Garamycin) 70 mg intramuscular (IM) every 8 hours
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
Which of the following is an advantage of using a condom catheter for a male patient who has frequent episodes of urinary incontinence?
It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.
hich of the following is an advantage of using a condom catheter for a male patient who has frequent episodes of urinary incontinence?
It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.
A patient is suspected of having a disease process affecting the functional unit of the kidney. The nurse correctly recognizes which of the following stuctures is most likely involved?
Nephron
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 of the following would the nurse document as an abnormal finding?
Reddened perineal skin
The physician orders an indwelling urinary catheter to be inserted into a woman who has had a total hip replacement and is on strict bed rest. When inserting the catheter, the nurse would place the client in which position?
Sims (side) position
What catheter would the nurse use to drain a patient's bladder for short periods (5 to 10 minutes)?
Straight catheter
A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing?
Stress incontinence
A physician orders a long-term continuous drainage system to monitor a critically ill patient. What type of catheter would best suit this patient's needs?
Suprapubic catheters are recommended for long-term continuous drainage because they are associated with a decreased risk of contamination with organisms from fecal material, the elimination of damage to the urethra, a higher rate of patient satisfactions, and a lower risk of UTIs
The nurse is providing teaching to a client who is being discharged to home with an indwelling urinary catheter in place. What information is important for the nurse to discuss with the client?
The catheter can be connected to a smaller leg bag for ambulation.
The doctor has ordered the collection of a fresh urine sample for a particular examination. Which urine sample would the nurse discard?
The first voiding of the day
The nurse mentor is observing a novice nurse prepare 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 selected an 18 French Foley catheter to insert. A 14F to 16F size 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
You are inserting a urinary catheter into a 63-year-old male patient and encounter resistance. Which of the following is the most likely cause of the resistance?
The patient has an enlarged prostate.
Which of the following statements about suprapubic catheters is true?
They are often preferred over an indwelling urethral catheter for long-term urinary drainage.
Use of an indwelling urinary catheter leads to the loss of bladder tone.
True
The nurse is observing the unlicensed assistive personnel (UAP) assist the client with the bedpan. The nurse would intervene if which action, by the UAP, is noted?
UAP positions the bedpan so the client's buttocks rest on the shallow end of the regular bedpan.
The nurse measures a patient's residual urine by catheterization after the patient voids. What condition would this test verify?
Urinary retention
Urinary catheterization is the most common cause of hospital acquired infection.
true
The nurse is choosing a collection device to collect urine from a nonambulatory male patient? What would be the nurse's best choice?
urinal
When planning care for a client with a Foley catheter, which actions should the nurse include? (Select all that apply.)
• Maintain a closed urinary catheter system. • Record volume and character of the urine. • Encourage fluid intake, unless contraindicated.
The nurse is catheterizing a male urinary bladder, and urine leaks out of the meatus around the catheter. What actions would the nurse perform next? (Select all that apply.)
• Make sure the smallest sized catheter with a 10-mL balloon is used. • Consider an evaluation for urinary tract infection. • Ensure that the correct amount of solution was used to inflate the balloon.
A nurse is collecting a urine specimen for urinalysis. What factors should the nurse consider when performing this procedure? (Select all that apply.)
• Sterile urine specimens may be obtained by catheterizing the patient's bladder. • Strict aseptic technique must be used when collecting and handling urine specimens. • A clean-catch specimen of urine may be collected in midstream.
A nurse assesses the urine of a patient who is using a bedpan and finds that it is a dark brown color. What medication might be causing this effect?
Levodopa and injectable iron compounds can cause brown or black urine
A client at the health care facility has been diagnosed with total urinary incontinence. How could the nurse describe the condition of the client?
Loss of urine without any identifiable pattern or warning
A client with frequent urinary tract infections (UTIs) has returned to the ambulatory clinic with symptoms of another UTI. The nurse reviews measures to follow to promote health and decrease the risk of contracting a UTI. Which measure is appropriate for the client to follow?
Drink two glasses of water before and after sexual intercourse.
The nurse has entered a patient's room to empty the patient's urine collection bag at the end of a busy shift. The nurse realizes that the patient's urine output is 75 mL over the past 8 hours. The nurse would recognize that the patient is experiencing which of the following?
Oliguria
An older adult woman tells the nurse that she has trouble controlling her urine. She states, "The urine starts dripping even before I feel like I have to go." The nurse interprets this as which of the following?
Overflow incontinence
You are the guest speaker at a women's club. Most of the women are over the age of 40 years. The women have asked you to speak on health promotion topics. In the area of urinary urgency, you instruct the women to
Perform Kegel exercises
A nurse is caring for a client who is catheterized following a surgery of the prostate. When caring for the client, the nurse performs a continuous irrigation of the catheter. Which of the following interventions should the nurse perform when providing continuous irrigation?
Prime the tubing with the solution.
A nurse notes that the volume of the client's urinary elimination is less than 50 mL/day. Which of the following could be the possible cause for the low volume of urination by the client?
Kidney dysfunction
