Ch 55. Management and Care of Urinary Disorders

Which of the following nursing actions is most important in caring for the client following lithotripsy? Monitor the continuous bladder irrigation. Administer allopurinol (Zyloprim). Strain the urine carefully for stone fragments. Notify the physician of hematuria.

Strain the urine carefully for the stone fragments The nurse should strain all the urine and any stones should be sent to the lab for analysis

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomitting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis.? Acute pain Risk for infection Impaired urinary elimination Imbalanced nutrition: Less than body requirements

Acute pain Kidney stones typically causes major pain that is so severe that the patient can not rest and becomes increasingly anxious.

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located? Over a bony prominence Away from skin folds At the belt line At the umbilicus

Away from skin folds The nurse plans to have the stoma located away from skin folds and creases, bony prominences, the belt line, and the umbilicus

Which objective symptom of a UTI is most common in older adults, especially those with dementia? Incontinence Change in cognitive funtion hematuria Back pain

Change in cognitive function Patients usually exhibit profound cognitive changes with a UTI

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply Urinary retention Deficient knowledge: management of urinary diversion Disturbed body image Risk for impaired skin integrity Chronic pain

Deficient knowledge: management of urinary diversion Disturbed Body Image Risk for impaired skin integrity

Which term refers to inflammation of the renal pelvis? Pyelonephritis Cystitis urethritis Interstitial nephritis

Pyelonephritis Pyelonephritis is the inflammation of the upper urinary tract.

Which instruction would be included in a teaching plan for a client diagnosed with a UTI? Take tub baths instead of showers Drink coffee or tea to increase diuresis Drink liberal amounts of fluids Void every 4-6 hrs

Drink Liberal amounts of fluid

Which of the following is a cause of a calcium renal stone? Gout Excessive intake of vitamin D Neurogenic bladder foreign bodies

Excessive intake of vitamin D causes of excess renal stones includes excessive intake of vitamin D, hypercalcemia, hyperparathyroidism, excessive intake of milk and renal tubular acidosis.

Which type of voiding dysfunction is seen in patients diagnosed with Parkinson's disease? incontinence Incomplete bladder emptying Urgency Urinary retention

Incontinence This is noted in patients with parkinsons.

A nurse caring for a patient with a neurogenic bladder knows to assess for the major complication of: Permanent distention Infection Consistent pain Daily and painful spasms

Infection Infection is caused by an increase urinary bacterial count that results from incomplete and delayed emptying of the bladder.

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? Morphine sulfate Aspirin Ketoralac (Toradol) Meperidine (Demerol)

Ketoralac (Toradol) Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketorolac (Toradol) are effective in treating renal stone pain because they provide specific pain relief.

A patient who has been treated for uric stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient? Low Calcium High protein Low phosphorus low purine

Low purine For uric acid stones, a low purine diet is needed to reduce the excretion of uric acid. Foods like shellfish, anchovies, asparagus, mushrooms, and organ meats are high in uric acid

A client with bladder cancer had his bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude? The skin wasn't lubricated before the pouch was applied. The pouch faceplate doesn't fit the stoma. A skin barrier was applied properly. Stoma dilation wasn't performed.

The pouch faceplate doesn't fit the stoma. If the pouch faceplate doesn't fit the stoma properly, the skin around the stoma will be exposed to continuous urine flow from the stoma, causing excoriation and red, weeping, and painful skin.

The nurse knows that which of the following body parts explains why cystitis is more common in women? The urethra the bladder the rectum the ureters

The urethra The urethra is shorter in women , so ascending bacteria is more common.

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances? Calcium Uric acid Struvite Cystine

Uric acid All of these foods are high in purine and create uric acid

Which statement describing urinary incontinence in an older adult client is true? Urinary incontinence is a normal part of aging. Urinary incontinence isn't a disease. Urinary incontinence in the elderly population can't be treated. Urinary incontinence is a disease.

Urinary incontinence isn't a disease.

The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include: Glucose trace WBC 50 RBC 3 Proteinuria

WBC 50 Increased wbc count occurs in all clients with a UTI and indicates an infection

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? a) "Be aware that your urine will be cherry-red for 5 to 7 days." b) "Increase your fluid intake to 2 to 3 L per day." c) "Apply an antibacterial dressing to the incision daily." d) "Take your temperature every 4 hours."

increase your fluid intake to 2-3 L per day Doing this will help pass any kidney stones that were dislodged or broken by the shock wave

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? Risk for altered urinary elimination Risk for infection Risk for deficient knowledge: self catheterization Risk for fluid volume excess

risk for infection A percutaneous nephrolithostomy is a procedure to remove a kidney stone, meaning that it is invasive, meaning that there is a risk for an infection.

A nurse is providing post procedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasound probe inserted through a nephrostomy tube into the renal pelvis generates ultra high frequency sound waves to shatter renal calculi. The nurse should instruct the client to: limit oral fluid intake for 1 to 2 weeks. report the presence of fine, sandlike particles through the nephrostomy tube. notify the physician about cloudy or foul-smelling urine. report bright pink urine within 24 hours after the procedure.

Notify the physician about cloudy or foul smelling urine. All of the other answer choices are normal after a percutaneous lithotripsy

Which medication may be ordered to relieve discomfort associated with a UTI? Nutrofurantoin Phenazopyridine Ciprofloxacin Levofloxacin

Phenazopyridine Phenazopyridine is a urinary analgesis ordered to relieve discomfort related to UTI's. The rest are antibiotics.

A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom? Urinary retention Fever Frequency Painless hematuria

Painless hematuria.

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate? "Use scented powders to disguise any odor." "Make sure to eat enough fiber to prevent constipation." "Try drinking coffee throughout the day." "Limit the number of times you urinate during the day."

"Make sure to eat enough fiber to prevent constipation" Avoiding constipation would manage urinary incontinence. Stimulants should be avoided.

Which lab value supports a diagnosis of pyelonephritis? Myoglobinemia Ketonuria Pyuria Low WBC count

Pyuria Pyelonephritis is diagnosed by the presence of pyuria, leukocytosis, hematuria, and bacteriuria.

The nurse is caring for a client who has a type of urinary diversion that requires an external ostomy bag to collect the urine. This client has: an incontinent urinary diversion. a continent urinary diversion. a urethroplasty. a cystectomy.

an incontinent urinary diversion. An incontinent urinary diversion requires an external ostomy bag to collect the urine.

If an indwelling catheter is necessary, which of the following nursing interventions should be implemented to prevent infection? a) Using clean technique during insertion b) Placing the catheter bag on the patient's abdomen when moving the patient c) Performing meticulous perineal care daily with soap and water d) Using sterile technique to disconnect the catheter from tubing to obtain urine specimens

c) Performing meticulous perineal care daily with soap and water Cleanliness of the area will reduce infections