URINARY SAUNDERS

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most specifically elicit information regarding this disorder?

"Does your infant have foul-smelling, ribbon-like stools?"

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia (BPH), the nurse questions the client about use of which medication?

Decongestants

A client who sustained a closed head injury has a new onset of copious urinary output. Urine output for the previous 8-hour shift was 3300 mL, and 2800 mL for the shift before that. The findings have been reported to the health care provider, and the nurse anticipates a prescription for which medication?

Desmopressin (DDAVP)

A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder?

Diabetes mellitus

The nurse is preparing the client for transfer to the operating room (OR). The nurse should take which action in the care of this client at this time?

Ensure that the client has voided.

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which signs/symptoms are indicative of this disorder?

Excessive thirst and urine output

The nurse is providing instructions to the client regarding the complications of peritoneal dialysis. The nurse instructs the client that which symptom is likely associated with the onset of peritonitis?

Fever

The nurse is collecting data from a client with a history of bladder cancer. Which sign/symptom is the client most likely to report?

Hematuria

The nurse is collecting data on a newly admitted client with a diagnosis of bladder cancer. Which sign/symptom should be noted first?

Hematuria

The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data?

Hourly urine output

Which conditions places the client at risk for developing acute postrenal failure?

Hydronephrosis

The nurse is caring for a client with acute pancreatitis and a history of alcoholism and is monitoring the client for complications. Which data should be indicative of paralytic ileus?

Inability to pass flatus

The nurse is caring for a client diagnosed with Parkinson's disease who is prescribed benztropine mesylate (Cogentin) daily. The nurse reinforces instructions to both the client and the spouse regarding the side effects of this medication and the need to report which side effect if it occurs?

Inability to urinate

The nurse is inserting an indwelling urinary catheter into a male client. As the catheter is inserted into the urethra, urine begins to flow into the tubing. The nurse should take which step next?

Insert the catheter 2.5 to 5 cm and inflate the balloon.

The nurse is reinforcing discharge instructions to a client receiving sulfadiazine. Which should be included in the list of instructions?

Maintain a high fluid intake.

The nurse is preparing a plan of care to monitor for complications in a client who will be returning from the operating room following transsphenoidal resection of a pituitary adenoma. Which intervention does the nurse document in the plan as the priority nursing intervention for this client?

Monitor urine output.

A client is admitted to the emergency department following a fall from a horse. The health care provider (HCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action should the nurse take?

Notify the health care provider.

The client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). When should the nurse plan to administer this medication?

On return from dialysis

A client with complaints of mild shortness of breath and weakness comes to the medical clinic. The nurse reviews the client's chart and immediately contacts the health care provider about which life-threatening finding? Refer to chart.

Potassium level

A clinic nurse has given a client the materials needed to test the stool for occult blood as part of a routine screening for colorectal cancer. When the client asks the nurse whether there are any special precautions that must be followed in doing this test, the nurse tells the client to avoid eating which food for at least a day before performing the test?

Red meat

The nurse is performing colostomy irrigation on a client. During the irrigation, the client begins to complain of abdominal cramps. Which is the appropriate nursing action?

Stop the irrigation temporarily.

A client complains of leaking urine whenever she sneezes, coughs, or laughs. The nurse recognizes that this report is consistent with which type of incontinence?

Stress

A long-term care nurse notes that a female client has leakage of urine when sneezing, coughing, or laughing. The nurse reports that this client has which type of incontinence?

Stress incontinence

The nurse should anticipate that which medication is the most likely to be prescribed prophylactically for a child with spina bifida (myelomeningocele) who has a neurogenic bladder?

Sulfisoxazole

The nurse is reviewing the health records of assigned clients. The nurse should plan care knowing that which client is at risk for fluid volume deficit?

The client with a colostomy

A 2-year-old child is diagnosed with constipation due to encopresis. Which description is a characteristic of this disorder?

The infrequent and difficult passage of dry stools

The nurse is collecting data from a child with a diagnosis of diabetes insipidus. Which clinical finding is consistent with this diagnosis?

Urinary output is increased

A client who had knee surgery 4 days ago reports to the home health nurse that he has not had a bowel movement since before the surgery. Which question would assist the nurse in the collection of data regarding the client's problem?

"What have you been eating and drinking since the surgery?"

The nurse is preparing to administer an enema to an adult client. Which interventions should the nurse plan to perform for this procedure? Select all that apply.

1. Apply disposable gloves. 2. Lubricate the enema tube and insert it approximately 4 inches. 3. Clamp the tubing if the client expresses discomfort during the procedure. 4. Ensure that the temperature of the solution is between 100° F (37.8° C) and 105° F (40.5° C).

The client has a three-way closed continuous catheter irrigation system. Which information should be included in the documentation for this client? Select all that apply

1. Character of drainage 2. Presence of blood clots 3. Amount of drainage emptied 4. Client complaint of pain/spasms 5. Type and amount of irrigation fluid used

A client who has calcium phosphate kidney stones tells the nurse, "Tell me what I can do, so that I never have this pain again." Which instructions should the nurse plan to include in the reinforcement of dietary instructions? Select all that apply.

1. Decrease sodium intake. 2. Limit the intake of whole grains. 3. Limit protein to 5 to 7 servings per week.

A client has been diagnosed as having syndrome of inappropriate antidiuretic hormone (SIADH) secretion following cranial surgery. The nurse interprets that this complication is not resolving if which urine specific gravity measurement is obtained?

1.030

The nurse is preparing to administer a soapsuds enema to a client. Into which position does the nurse place the client to administer the enema? Refer to figure.

3

The nurse is preparing to auscultate a client's abdomen for bowel sounds. The nurse listens for bowel sounds in which abdominal quadrant first? Refer to figure.

3

A 1-year-old child is diagnosed with intussusception. The mother of the child asks the nurse to describe the disorder. The nurse should base the response on which description of this disorder?

A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel

A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate?

Aluminum intoxication

A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce instructing the client to take which action?

Ambulate in the home.

The nurse is inserting an indwelling urinary catheter into the urethra of a client. As the nurse inflates the balloon, the client complains of discomfort. Which is the appropriate nursing action?

Aspirate the fluid, advance the catheter further, and reinflate the balloon.

The nurse is performing a postpartum fundal assessment on a client 6 hours after delivery. The nurse finds the fundus above the umbilicus and displaced to the right. Which intervention should the nurse do first?

Assist the client to the bathroom to void and then reassess the fundus.

The nurse is reviewing the record of a child scheduled for a health care provider's visit. Before data collection, the nurse notes documentation that the child has enuresis. Based on this diagnosis, the nurse plans to focus on which factor when collecting data?

Bladder function

The nurse is caring for a child with a diagnosis of intussusception. Which manifestation should the nurse expect to note in this child?

Blood and mucus in the stools

The nurse is monitoring a postoperative client on an hourly basis. The nurse notes that the client's hourly urine output is 25 mL. Based on this finding, what should be the nurse's first action?

Check the client's overall intake and output record.

The nurse is reading the health care provider's (HCP's) progress notes in the client's record and sees that the HCP has documented "insensible fluid loss of approximately 800 mL daily." Which client is at risk for this loss?

Client with a fast respiratory rate

A client with chronic kidney disease is receiving ferrous sulfate (Feosol). The nurse should monitor the client for which common side effect associated with this medication?

Constipation

A health care provider has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse reinforces instructions given to the client about the medication and tells the client to monitor for which side effect?

Constipation

The nurse is evaluating goal achievement for a client in traction with impaired physical mobility. The nurse determines that the client has not successfully met all of the goals formulated if which outcome is noted?

Bowel movement every 5 days

The nurse is caring for a client with a diagnosis of multiple sclerosis who has been prescribed oxybutynin (Ditropan). The nurse evaluates the effectiveness of the medication by asking the client which question?

"Are you getting up at night to urinate?"

A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The nurse appropriately asks which question first?

"Have you experienced any constipation recently?"

The nurse is reinforcing instructions to a female client regarding the procedure for collecting a midstream urine sample. Which statement by the client indicates an understanding of the procedure?

"I need to collect the urine in the cup after I start to urinate."

The nurse evaluates that there is a need for further teaching on bowel elimination when the client makes which statement?

"I need to decrease fiber in my diet."

A client has a continuous catheter irrigation postoperatively after having a transurethral resection of the prostate. The nurse notes that fluid is entering the bladder, but none appears to be draining. In priority order, which actions should the nurse take? Arrange the actions in the order they should be performed. All options must be used.

1. Check to ensure drainage tubing is not kinked. 2. Check the bladder for distention. 3. Ask the client about bladder spasms and discomfort. 4. Review intake and output record.

A client is seen in the health care clinic and acute pyelonephritis is suspected. The nurse reviews the client's record and should expect to note which associated signs and symptoms documented? Select all that apply.

1. Chills 2. General weakness 3. Nausea and vomiting

The nurse is auscultating bowel sounds. Which are appropriate data collection methods? Select all that apply.

1. Divide the abdomen into four quadrants at the umbilicus. 2. Do not feed the client if no sounds are audible in 5 minutes. 3. Listen in each quadrant for gurgling sounds indicating movement.

A client, who had experienced significant blood loss in an automobile crash, was admitted to the hospital 2 days earlier. The nurse observes the client for which signs/symptoms that indicate acute kidney injury (AKI)? Select all that apply.

1. Elevated urine specific gravity 2. Rising serum blood urea nitrogen (BUN) and creatinine levels 3. Urine output averaging 25 mL per hour while receiving an intravenous infusion at 150 mL/hour

Which information should the nurse include when reinforcing client teaching regarding ostomy care? Select all that apply.

1. Empty pouch when 1/3 to ½ full. 2. The stoma should be moist and pink to red. 3. The skin barrier should be within 1/16 to 1/8 inch of the stoma. 4. Change the appliance about every 3 days, or sooner if it is leaking effluent.

What are the steps in order of priority for application of an ostomy appliance? Arrange the actions in the order they should be performed. All options must be used.

1. Perform hand hygiene and don gloves. 2. Remove the used pouch and barrier. 3. Cleanse the peristomal area with warm water. 4. Assess the stoma and skin. 5. Cut the opening on the appliance 1/16 inch larger than stoma. 6. Press the adhesive backing of the pouch against the skin.

A client has been diagnosed with functional incontinence. Which interventions are appropriate to care for this type of incontinence? Select all that apply.

1. Schedule toileting every 2 hours. 2. Modify clothing for easy removal. 3. Assess environment for obstacles. 4. Set up schedule of cues such as mealtimes, awakening, and bedtime.

A client tells the nurse she completed an educational program to manage her stress incontinence but is now discouraged. Which information from the client indicates the need for further teaching? Select all that apply.

1. She performs the Kegel exercises every other day. 2. She quit drinking coffee with cream but drinks diet cola. 3. She has begun an exercise program that includes lifting weights.

The nurse is inspecting the stoma of a client after creation of an ureterostomy. Which appearance should the nurse expect to note?

A red and moist stoma

A client has been receiving nitrofurantoin sodium (Macrodantin). The nurse determines that the therapy is effective if which result is noted?

Absence of dysuria

A client with cancer has undergone a total abdominal hysterectomy and has a Foley catheter in place. The nurse should expect to note which type of urinary drainage immediately following this surgery?

Blood tinged

The nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which result noted in the first few hours following the procedure indicates the need to notify the registered nurse?

Bloody urine with clots

Following hypophysectomy, a client complains of being very thirsty and having to urinate frequently. Which is the initial nursing action?

Check the urine specific gravity.

A client with chronic glaucoma is being started on medication therapy with acetazolamide. The nurse reinforces instructions to the client that which symptom can occur early but subsides or disappears with continued treatment?

Diuresis

A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse monitors for which gastrointestinal (GI) side effect of this medication?

Dry mouth

The nurse is developing a plan of care for a client who is scheduled for surgery. The nurse should include which activity in the nursing care plan for the client on the day of surgery?

Have the client void immediately before surgery.

The nurse reviews the record of a 3-week-old infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse understands that which manifestation led the mother to seek health care for the infant?

Foul-smelling, ribbon-like stools

The nurse is admitting a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to note?

Frothy stools

The nurse is administering medications to a 6-year-old child with nephrotic syndrome. To reduce proteinuria, the nurse would expect which medication to be prescribed?

Furosemide (Lasix)

The nurse is assisting with gathering admission assessment data on a 2-year-old child who has been diagnosed with nephrotic syndrome. The nurse collects data knowing that which is a common characteristic associated with nephrotic syndrome?

Generalized edema

The nurse is interpreting the laboratory results of a client who has a history of chronic ulcerative colitis. Which result indicates a complication of ulcerative colitis?

Hemoglobin 10.2 g/dL

A client has asymptomatic diverticular disease. Which type of diet should the nurse anticipate being prescribed?

High-fiber diet

The nurse is told by an older woman that she has begun to be incontinent of urine at night and now drinks no fluids after 6:00 pm. The nurse's response should be guided by which knowledge?

Incontinence at any age deserves urological attention.

A child is diagnosed with intussusception. The nurse collects data on the child, knowing that which is a characteristic of this disorder?

Invagination of a section of the intestine into the distal bowel

A mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. The nurse plans to base the response on which information?

It is a congenital aganglionosis or megacolon.

The nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which should be included in the plan of care for instructions?

Maintain a high fluid intake.

A client underwent creation of an ileostomy 2 days ago. The nurse checks the client for signs of which acid-base disorder that can occur in a client with an ileostomy?

Metabolic acidosis

The nurse is assisting in the care of a client who had an ileostomy created a few days ago. Owing to the normally high output of drainage from this type of ostomy, the nurse monitors the client for which sign?

Metabolic acidosis

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?

Nausea and vomiting

The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic?

Pale yellow or slightly pink

A child is seen in the clinic, and the primary health care provider documents a diagnosis of primary nocturnal enuresis. The mother asks the nurse about the diagnosis. Which should the nurse relay to the mother about primary nocturnal enuresis?

Primary nocturnal enuresis is common, and most children will outgrow bed-wetting without therapeutic intervention.

The nurse caring for a client taking tamsulosin (Flomax) determines that which finding indicates the need for follow-up?

Pulse rate of 120 beats per minute

The chart describes characteristics of various types of enemas. Which type of enema has the highest risk of complications? Refer to chart.

Tap water

A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. Which information about this procedure should the nurse give to the client?

The client must void while the micturition process is filmed.

The nurse is reviewing the health records of assigned clients. The nurse should plan care knowing that which client is at risk for a potassium deficit?

The client receiving nasogastric suction

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. The nurse understands that which is unassociated with this disorder?

The passage of currant jelly-like stools

A 24-hour urine specimen for creatinine and electrolytes has been prescribed for a hospitalized client to evaluate kidney function. The nurse explains the procedure to the client. The client voids at 0900, and the urine is discarded. The client voids at 1200 and the urine is measured and placed in the collection container. At which time the next day should the 24-hour urine collection be complete? Fill in the blank with the correct military time.

The urine collection should be complete by 0900 the next day when a full 24 hours of urine produced by the client will have been collected. The purpose of the urine collection is to measure the total amount of creatinine and electrolytes excreted in the urine over a 24-hour period. Recall that the bladder is a storage container and the time the bladder is emptied starts the time that urine is produced and collected.

The nurse just reassessed the condition of a postoperative client who was admitted 1 hour ago to the surgical unit. The nurse plans to carefully monitor which parameter during the next hour?

Urinary output of 20 mL/hr

Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which should the nurse monitor as a side effect of this medication?

Urinary retention

A nursing student is assigned to care for an infant with a diagnosis of heart failure (HF). The student develops a plan of care for the child that is focused on monitoring for fluid overload. The student plans to best assess the urine output of the infant by taking which action?

Weighing the diapers

The nurse is reinforcing post-procedure teaching after a client underwent an upper gastrointestinal (GI) series. The nurse reminds the client that the stools will remain white for approximately how long?

1 to 2 days

The nurse is caring for a client with severe diarrhea. The nurse monitors the client closely, understanding that this client is at risk for developing which acid-base disorder?

Metabolic acidosis

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client closely for which acid-base disorder that is most likely to occur in this situation?

Metabolic alkalosis

The nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client. Which should the nurse include in the plan of care while the client is taking this medication?

Monitor bowel activity.

The nurse is assigned to care for a child who is suspected of having glomerulonephritis. The nurse reviews the child's record and notes that which finding is associated with the diagnosis of glomerulonephritis?

Red-brown urine

The nurse is reinforcing instructions to the family of a client with Alzheimer's disease regarding tacrine (Cognex). Which statement by the family would indicate an understanding of the side/adverse effects related to this medication?

"Increased urination may be an indication of an adverse effect."

The nurse is evaluating the data results of a client with sepsis and acute kidney injury with related azotemia and oliguria. Which are the primary features of azotemia and oliguria? Select all that apply.

1. Increase in serum creatinine 2.Increase in blood urea nitrogen (BUN) 3. Urine output less than 0.5 mL/kg/hour

A client who has undergone barium enema is being readied for discharge. The nurse determines that the client has understood discharge instructions when the client makes which statement?

"I will be sure the barium passes and watch for my stools to return to normal."

A client is taking docusate sodium (Colace). The nurse monitors which result to determine whether the client is having a therapeutic effect from this medication?

Regular bowel movements

A client is to have an upper gastrointestinal (GI) series. Which nursing action should be done concerning the procedure?

Administer a laxative after the procedure because barium was administered.