CH 38 BASICS Prep Us
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.
A nurse has been asked to speak about health promotion topics for a group of women older than 40 years of age. The nurse states that exercises may help with urinary urgency. Which exercise instruction will the nurse provide to the group?
Contract the pubic muscles for 3 seconds, then relax. Explanation: Pelvic floor muscle (Kegel) exercises, strengthen the pubococcygeal muscles and effectively promote urinary control.
The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle (Kegel) exercises will the nurse include?
Keep muscles contracted for at least 10 seconds. Explanation: Pelvic floor muscle (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 to 4 times daily for 2 weeks to 1 month.
The health care provider requests 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 Explanation: The Sims, or side-lying, position is especially used for clients who have limited hip mobility because it permits excellent visualization of the urinary meatus.
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.
A nurse is caring for a client who has just undergone surgery to create an ileal conduit for urinary elimination via a stoma. Which fact about this procedure should the nurse mention to the client?
The client will have to wear an external appliance to collect urine. Explanation: An ileal conduit involves a surgical resection of the small intestine, with transplantation of the ureters to the isolated segment of small bowel. Such diversions are usually permanent, and the client wears an external appliance to collect the urine because urine elimination from the stoma cannot be controlled voluntarily. Appliances are usually changed every 3 to 7 days, although they could be changed more often.
A nurse is assisting a client with the use of a bedpan. The nurse understands that which statement about bedpans is true?
The largest part of a regular bedpan should be placed under the client's buttocks. Explanation: The rounded, smooth upper end of the regular bedpan is designed to be placed under the buttocks. Because a regular bedpan is much larger than a fracture bedpan, it is usually less comfortable. Choice of bedpan is based on client characteristics rather than type of elimination. A fracture bedpan can be used for any client.
Which statements about suprapubic catheters is true?
They are often preferred over an indwelling urethral catheter for long-term urinary drainage. Explanation: Suprapubic catheters are associated with: decreased risk of contamination with organisms from fecal material; elimination of damage to the urethra; a higher rate of client satisfaction; and a lower risk of catheter-associated urinary tract infections. Suprapubic catheters are used for long-term continuous drainage. This type of catheter is inserted surgically through a small incision above the pubic area. Suprapubic bladder drainage diverts urine from the urethra when injury, stricture, prostatic obstruction, or gynecologic or abdominal surgery has compromised the flow of urine through the urethra. A suprapubic catheter may be preferred over indwelling urethral catheters for long-term urinary drainage in clients for whom no other alternative is possible.
The nurse is reviewing the chart of an older adult client who exhibits signs of confusion. Which laboratory value would indicate to the nurse that intervention is needed?
Urine culture sensitivity - 100,000/mL Explanation: 100,000 organisms per milliliter in a urine culture and sensitivity specimen is positive of a urinary tract infection.
Transient incontinence
appears suddenly and lasts for 6 months or less.
levodopa may cause the urine to turn
brown or black
Which client should the nurse monitor most closely for signs of urinary retention?
client with an enlarged prostate
Vitamin B-complexes can turn the urine
green.
Total incontinence
may be the result of surgery, trauma, or physical malformation; the client has continuous and unpredictable loss of urine.
Phenazopyridine may cause the urine to turn
orange or orange-red,
Diuretics may cause the urine to turn
pale yellow
Urge incontinence
state in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void
Functional incontinence occurs because
the client is unable to reach the toilet.
A clean-catch or midstream-voided specimen is used
when a specimen relatively free from microorganisms is required.
reflex incontinence,
which occurs when the bladder muscle distends and urine is forced out.
