ch 55- management of patients with urinary disorders

The nurse is caring for a patient recently diagnosed with renal calculi. The nurse should instruct the patient to increase fluid intake to a level where the patient produces at least how much urine each day? a.1,250 mL b.2,000 mL c.2,750 mL d.3,500 mL

.2,000 mL

7. A female patients most recent urinalysis results are suggestive of bacteriuria. When assessing this patient, the nurses data analysis should be informed by what principle? a. Most UTIs in female patients are caused by viruses and do not cause obvious symptoms. b. A diagnosis of bacteriuria requires three consecutive positive results. c. Urine contains varying levels of healthy bacterial flora. d.Urine samples are frequently contaminated by bacteria normally present in the urethral area.

.Urine samples are frequently contaminated by bacteria normally present in the urethral area.

12. A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The nurse is monitoring the patients urine output hourly and notifies the physician when the hourly output is less than what? a. 30 mL b. 50mL c. 100mL d.125mL

30mL

32. A nurse on a busy medical unit provides care for many patients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which patient? a. A patient whose diagnosis of chronic kidney disease requires a fluid restriction b. A patient who has Alzheimers disease and who is acutely agitated c. A patient who is on bed rest following a recent episode of venous thromboembolism d.A patient who has decreased mobility following a transmetatarsal amputation

A patient who has Alzheimers disease and who is acutely agitated

22. The nurse is assessing a patient admitted with renal stones. During the admission assessment, what parameters would be priorities for the nurse to address? Select all that apply. a. dietary history b. family history of renal stones c. medication history d. surgical history e. vaccination history

A,B,C

A nurse is working with a female patient who has developed stress urinary incontinence. Pelvic floor muscle exercises have been prescribed by the primary care provider. How can the nurse best promote successful treatment? a.Clearly explain the potential benefits of pelvic floor muscle exercises. b.Ensure the patient knows that surgery will be required if the exercises are unsuccessful. c.Arrange for biofeedback when the patient is learning to perform the exercises. d. Contact the patient weekly to ensure that she is performing the exercises consistently.

Arrange for biofeedback when the patient is learning to perform the exercises.

10. The nurse has implemented a bladder retraining program for an older adult patient. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient typically has approximately 50 mL of urine remaining in her bladder after voiding. What would be the nurses best response to this finding? a. Perform a straight catheterization on this patient. b. Avoid further interventions at this time, as this is an acceptable finding. c. Place an indwelling urinary catheter. d. Press on the patients bladder in an attempt to encourage complete emptying.

Avoid further interventions at this time, as this is an acceptable finding.

24. A gerontologic nurse is assessing a patient who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply. a. food cravings b. upper abdominal pain c. insatiable thirst d. uncharacteristic fatigue e. new onset of confusion

D

An adult patient has been hospitalized with pyelonephritis. The nurses review of the patients intake and output records reveals that the patient has been consuming between 3 L and 3.5 L of oral fluid each day since admission. How should the nurse best respond to this finding? a. Supplement the patients fluid intake with a high-calorie diet. b.Emphasize the need to limit intake to 2 L of fluid daily. c. Obtain an order for a high-sodium diet to prevent dilutional hyponatremia. d.Encourage the patient to continue this pattern of fluid intake.

Encourage the patient to continue this pattern of fluid intake.

38. Resection of a patients bladder tumor has been incomplete and the patient is preparing for the administration of the first ordered instillation of topical chemotherapy. When preparing the patient, the nurse should emphasize the need to do which of the following? a.Remain NPO for 12 hours prior to the treatment. b. Hold the solution in the bladder for 2 hours before voiding. c. Drink the intravesical solution quickly and on an empty stomach. d. Avoid acidic foods and beverages until the full cycle of treatment is complete.

Hold the solution in the bladder for 2 hours before voiding.

31. A patient has had her indwelling urinary catheter removed after having it in place for 10 days during recovery from an acute illness. Two hours after removal of the catheter, the patient informs the nurse that she is experiencing urinary urgency resulting in several small-volume voids. What is the nurses best response? a.Inform the patient that urgency and occasional incontinence are expected for the first few weeks post-removal. b.Obtain an order for a loop diuretic in order to enhance urine output and bladder function. c.Inform the patient that this is not unexpected in the short term and scan the patients bladder following each void. d.Obtain an order to reinsert the patients urinary catheter and attempt removal in 24 to 48 hours.

Inform the patient that this is not unexpected in the short term and scan the patients bladder following each void.

An older adult has experienced a new onset of urinary incontinence and family members identify this problem as being unprecedented. When assessing the patient for factors that may have contributed to incontinence, the nurse should prioritize what assessment? a. Reviewing the patients 24-hour food recall for changes in diet b. Assessing for recent contact with individuals who have UTIs c. Assessing for changes in the patients level of psychosocial stress d. Reviewing the patients medication administration record for recent changes

Reviewing the patients medication administration record for recent changes

30. A patient with a sacral pressure ulcer has had a urinary catheter inserted. As a result of this new intervention, the nurse should prioritize what nursing diagnosis in the patients plan of care? a. Impaired physical mobility related to presence of an indwelling urinary catheter b. Risk for infection related to presence of an indwelling urinary catheter c. Toileting self-care deficit related to urinary catheterization d. Disturbed body image related to urinary catheterization

Risk for infection related to presence of an indwelling urinary catheter

19. A patient with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the patients post-procedure care? a. Strain the patients urine following the procedure. b. Administer a bolus of 500 mL normal saline following the procedure. c. Monitor the patient for fluid overload following the procedure. d.Insert a urinary catheter for 24 to 48 hours after the procedure.

Strain the patients urine following the procedure.

A patient who has recently undergone ESWL for the treatment of renal calculi has phoned the urology unit where he was treated, telling the nurse that he has a temperature of 101.1F (38.4C). How should the nurse best respond to the patient? a. Remind the patient that renal calculi have a noninfectious etiology and that a fever is unrelated to their recurrence. b. Remind the patient that occasional febrile episodes are expected following ESWL. c. Tell the patient to report to the ED for further assessment. d. Tell the patient to monitor his temperature for the next 24 hours and then contact his urologists office.

Tell the patient to report to the ED for further assessment.

14. The nurse is teaching a health class about UTIs to a group of older adults. What characteristic of UTIs should the nurse cite? a.Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic. b.The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group. c.Men of all ages are less prone to UTIs, but typically experience more severe symptoms. d. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.

The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group.

17. A nurses colleague has applied an incontinence pad to an older adult patient who has experienced occasional episodes of functional incontinence. What principle should guide the nurses management of urinary incontinence in older adults? a.Diuretics should be promptly discontinued when an older adult experiences incontinence. b. Restricting fluid intake is recommended for older adults experiencing incontinence. c. Urinary catheterization is a first-line treatment for incontinence in older adults with incontinence. d. Urinary incontinence is not considered a normal consequence of aging.

Urinary incontinence is not considered a normal consequence of aging.

4. A 52-year-old patient is scheduled to undergo ileal conduit surgery. When planning this patients discharge education, what is the most plausible nursing diagnosis that the nurse should address? a. impaired mobility related to limitations posed by the ileal conduit b. deficient knowledge related to care of the ileal conduit c. rick for deficiet fluid volume related to urinary diversion d. risk for autonomic dysreflexia related to disruption of the sacral plexus

deficient knowledge related to care of the ileal conduit

29. A patient has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this patients high risk for urinary retention and should implement what intervention in the patients plan of care? a. relaxation techniques b. sodium restriction c. lower abdominal massage d. double voiding

double voiding

1. A female patient has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this patient? a. bathe daily and keep the perineal region clean b. avoid voiding immediately after sexual intercourse c. drink liberal amounts of fluid d. void at least every 6 to 8 hours

drink liberal amounts of fluids

13. The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a patient with an indwelling catheter? A. vigorously clean the meatus are daily b. apply powder to the perineal area twice daily c. empty the drainage bag at least every 8 hours d. irrigate the catheter every 8 hours with normal saline

empty the drainage bag at least every 8 hours

21. A patient is undergoing diagnostic testing for a suspected urinary obstruction. The nurse should know that incomplete emptying of the bladder due to bladder outlet obstruction can cause what? a. hydronephrosis b. nephritic syndrome c. pylonephritis d. nephrotoxicity

hydronephrosis

35. A patient has been successfully treated for kidney stones and is preparing for discharge. The nurse recognizes the risk of recurrence and has planned the patients discharge education accordingly. What preventative measure should the nurse encourage the patient to adopt? a. increasing intake of protein from plant sources b. increasing fluid intake c. adopting a high calcium diet d. eating several small meals each day

increasing fluid intake

9. The nurse and urologist have both been unsuccessful in catheterizing a patient with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the physician using to drain the patients bladder? a. insertion of a suprapubic catheter b. Scheduling the patient immediately for a prostatectomy c. Application of warm compresses to the perineum to assist with relaxation d.Medication administration to relax the bladder muscles and reattempting catheterization in 6 hours

insertion of a suprapubic catheter

23. A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population? a. administer prophylactic antibitocs as ordered b. limit the use of indwelling urinary catheters c. encourage frequent mobility and repositioning d.toilet residents who are immobile on a scheduled basis

limit the use of indwelling catheters

6. The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the patient? a. limit oral fluid intake for 1 to 2 days b. report the presences of find, sand like particles through the nephrostomay tube c. notify the physician about cloudy or foul smelling urine d. report any pink tinged urine within 24 hours after the procedure

notify the physician about any cloudy or foul- smelling urine

A patient with a recent history of nephrolithiasis has presented to the ED. After determining that the patients cardiopulmonary status is stable, what aspect of care should the nurse prioritize? a. IV fluid administration b. insertion of an indwelling urinary catheter c. pain management d. assisting with aspiration of the stone

pain management

16. A patient being treated in the hospital has been experiencing occasional urinary retention. What nursing action should the nurse take to encourage a patient who is having difficulty voiding? a. use a slipper bedpan b. apply a cold compress to the perineum c. have the patient lie in a supine position d. provide privacy fo the patient

provide privacy for the patient

5. The nurse on a urology unit is working with a patient who has been diagnosed with oxalate renal calculi. When planning this patients health education, what nutritional guidelines should the nurse provide? a. restrict protein intake as ordered b. increase intake of potassium rich-foods c. follow a low calcium diet d. encourage intake of food containing oxalates

restrict protein intake as ordered

37. The nurse who is leading a wellness workshop has been asked about actions to reduce the risk of bladder cancer. What health promotion action most directly addresses a major risk factor for bladder cancer? a. smoking cessation b. reduction of alcohol intake c. maintenence of a diet high in vitamins and nutrients d. vitamin D supplementation

smoking cessation

2. A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence? a. stress incontinence b. reflex incontinence c. overflow incontinence d. functional incontinence

stress incontinence

The clinic nurse is preparing a plan of care for a patient with a history of stress incontinence. What role will the nurse have in implementing a behavioral therapy approach? a. provide medication teaching related to pseudoephedrine sulfate b. teach the patient to perform pelvic floor muscle exercises c. prepare the patient for an anterior vaginal repair procedure d. provide information on periurethral bulking

teach the patient to perform pelvic floor muscle exercises

18. The nurse is working with a patient who has been experiencing episodes of urinary retention. What assessment finding would suggest that the patient is experiencing retention? a. the patients suprapubic region is dull on percusiion b. the patient is uncharacteristically drowsy c. the patient claims to void large amounts of urine 2-3 times daily d. the patient takes a beta adrenergic blocker for the treatment of hypertension

the patients suprapubic region is dull on percussion

25. A female patient has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the patient, the nurse should address what topic? a. the risk of developing a vaginal yeast infection as a consequent of antibiotic therapy b. the need to expect a heavy menstrual period following the course of antibitoics c. the risk of developing antibiotic resistance after the course of antibitocis d. the need to undergo a series of thee urine cultures after the antibiotics have been completed

the risk for developing a vaginal yeast infection as a consequent antibiotic therapy

3. A nurse is caring for a female patient whose urinary retention has not responded to conservative treatment. When educating this patient about self-catheterization, the nurse should encourage what practice? a. assuming supine position for self-catherization b. using clean technique at home to catherize c. inserting the catheter 1-2 inches into the urethra d. self catheterizing every2 hours at home

using clean technique at home to catetherize