Ch 59 Disorders of the Bladder and Urethra

A client with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The client weighs 60 kg. The nurse is monitoring the client's urine output hourly and notifies the health care provider when the hourly output is less than what? 30 mL 50 mL 100 mL 125 mL

30 mL

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

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

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? Establishing a predetermined fluid intake pattern for the client Encouraging the client to increase the time between voidings Restricting fluid intake to reduce the need to void Assessing present voiding patterns

Assessing present voiding patterns

The nurse is caring for an older client whose chart reveals that the client has a reversible cause of urinary incontinence. The nurse creates a plan of care for which condition? Asthma Bladder cancer Constipation Decreased progesterone levels

Constipation

A gerontologic nurse is assessing a client who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply. Food cravings Upper abdominal pain Insatiable thirst Fever New onset of confusion

Fever New onset of confusion

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? Bactrim Levaquin Pyridium Septra

Pyridium

A client regularly recognizes the sensation of needing to void but cannot control voiding in time to reach a toilet. How would the nurse document this type of incontinence? Urge Reflex Total Overflow

Urge

In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the client's residual urine must be less than which amount? 30 mL 50 mL 100 mL 400 mL

100 mL

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

2,000 mL

Which of the following is the most effective intravesical agent for recurrent bladder cancer? Bacillus Calmette-Guérin (BCG) Methotrexate Cisplatin Vinblastine

Bacillus Calmette-Guérin (BCG)

A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is: placement of small amounts of collagen in urethral walls to aid the closing pressure. a procedure that increases storage capacity of the bladder. implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination. a procedure that increases support to the bladder by tightening the vaginal wall under the urethra.

placement of small amounts of collagen in urethral walls to aid the closing pressure.

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

Phenazopyridine

Which characteristic is seen with a healthy stoma? Painful Pink color No bleeding when cleansing the stoma Dry in appearance

Pink color

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

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

A 52-year-old client is scheduled to undergo ileal conduit surgery. When planning this client's discharge education, what is the most plausible nursing diagnosis that the nurse should address? Impaired mobility related to limitations posed by the ileal conduit Deficient knowledge related to care of the ileal conduit Risk for deficient fluid volume related to urinary diversion Risk for autonomic dysreflexia related to disruption of the sacral plexus

Deficient knowledge related to care of the ileal conduit

A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client? "This medication will relieve your pain." "This medication should be taken at bedtime." "This medication will prevent re-infection." "This will kill the organism causing the infection."

"This medication will relieve your pain."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? "I will not need to worry about being incontinent of urine." "My urine will be eliminated through a stoma." "My urine will be eliminated with my feces." "A catheter will drain urine directly from my kidney."

"My urine will be eliminated through a stoma."

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report? "Have you had a fever and chills?" "How much fluid are you drinking?" "Do you get up at night to urinate?" "When did you last urinate?"

"When did you last urinate?"

A client who was involved in an MVA which resulted in paraplegia is working toward living at home. The client is currently developing an individualized CIC schedule, preferring not to wear a leg bag. What is the maximum amount of urine the client should allow to collect before catheterization? 350 mL 500 mL 100 mL 600 mL

350 mL

A client is a victim of an MVA and is unconscious. In compliance with a physician's order to insert an indwelling catheter, the nurse places the catheter and notes the drainage of a large amount of yellow urine with normal odor. How much urine will the nurse allow to drain before clamping the tube? 700 mL 250 mL 500 mL 1000 mL

700 mL

A nurse on a busy medical unit provides care for many clients 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 client? A client whose diagnosis of chronic kidney disease requires a fluid restriction A client who has Alzheimer disease and who is acutely agitated A client who is on bed rest following a recent episode of venous thromboembolism A client who has decreased mobility following a transmetatarsal amputation

A client who has Alzheimer disease and who is acutely agitated

The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms? Antispasmodic agents Urinary analgesics Antibiotics Anticholinergic agents

Anticholinergic agents

The nurse is conducting discharge teaching for a client who was admitted with a kidney stone. The nurse includes which instruction as a measure to prevent additional kidney stones? Increase protein intake. Adhere to a low-calcium diet. Avoid drinking water before bedtime. Avoid drinking tea.

Avoid drinking tea.

The nurse is collaborating with the wound-ostomy-continence (WOC) nurse to teach a client how to manage her new ileal conduit in the home setting. To prevent leakage or skin breakdown, the nurse should encourage which of the following practices? Empty the collection bag when it is between one-half and two-thirds full. Limit fluid intake to prevent production of large volumes of dilute urine. Reinforce the appliance with tape if small leaks are detected. Avoid using moisturizing soaps and body washes when cleaning the peristomal area.

Avoid using moisturizing soaps and body washes when cleaning the peristomal area.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? Bactrim Cipro Macrodantin Septra

Cipro

Which information is important when teaching a client how to perform self-catheterization? Peroxide is recommended for cleaning the urinary catheter. Catheterization should occur every 4 to 6 hours and before bedtime. The nurse uses nonsterile technique in the hospital setting. The catheter is rinsed with sterile normal saline after being soaked in a cleaning solution.

Catheterization should occur every 4 to 6 hours and before bedtime.

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? Rebound tenderness at McBurney's point An output of 200mL with each voiding Cloudy urine Urine with a specific gravity of 1.005-1.022

Cloudy urine

A client postoperatively reports to the nurse the need to urinate, but is unable to void. What should the nurse expect the healthcare provider to order? Select all that apply. Complete a straight catheterization. Place an indwelling catheterization. Schedule a suprapubic catheter insertion. Perform a bladder scan. Ambulate the client.

Complete a straight catheterization. Perform a bladder scan.

A client is admitted with nephrolithiasis. What symptoms does the nurse expect the client to experience? Select all that apply. Difficulty starting a urine stream Suprapubic pain Elevated temperature Hematuria Constipation

Difficulty starting a urine stream Suprapubic pain Elevated temperature Hematuria

Nursing management of the client with a urinary tract infection should include: Teaching the client to douche daily Discouraging caffeine intake Instructing the client to limit fluid intake Administering morphine sulfate

Discouraging caffeine intake

The nurse is caring for the client following surgery for a urinary diversion. The client refuses to look at the stoma or participate in its care. The nurse formulates a nursing diagnosis of: Anticipatory grieving Situational low self esteem Deficient knowledge: stoma care Disturbed body image

Disturbed body image

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? Use tub baths as opposed to showers. Drink coffee or tea to increase diuresis. Drink liberal amount of fluids. Void every 4 to 6 hours.

Drink liberal amount of fluids.

The nurse is caring for a client with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a client with an indwelling catheter? Vigorously clean the meatus area daily. Apply powder to the perineal area twice daily. Empty the drainage bag at least every 8 hours. Irrigate the catheter every 8 hours with normal saline.

Empty the drainage bag at least every 8 hours.

An adult client has been hospitalized with pyelonephritis. The nurse's review of the client's intake and output records reveals that the client 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? Supplement the client's fluid intake with a high-calorie diet. Emphasize the need to limit intake to 2 L of fluid daily. Obtain an order for a high-sodium diet to prevent dilutional hyponatremia. Encourage the client to continue this pattern of fluid intake.

Encourage the client to continue this pattern of fluid intake.

A client has undergone the creation of an Indiana pouch for the treatment of bladder cancer. The nurse identified the nursing diagnosis of "disturbed body image." How can the nurse best address the effects of this urinary diversion on the client's body image? Emphasize that the diversion is an integral part of successful cancer treatment. Encourage the client to speak openly and frankly about the diversion. Allow the client to initiate the process of providing care for the diversion. Provide the client with detailed written materials about the diversion at the time of discharge.

Encourage the client to speak openly and frankly about the diversion.

A client has been admitted to the medical unit with a diagnosis of ureteral colic secondary to urolithiasis. When planning the client's admission assessment, the nurse should be aware of the signs and symptoms that are characteristic of this diagnosis? Select all that apply. Diarrhea High fever Hematuria Urinary frequency Acute pain

Hematuria Urinary frequency Acute pain

Which factor contributes to UTI in older adults? Low incidence of chronic illness Immunocompromise Sporadic use of antimicrobial agents Active lifestyle

Immunocompromise

The nurse is assisting in the development of a protocol for bladder retraining following removal of an indwelling catheter. Which item should the nurse include? Encourage voiding immediately after catheter removal Avoid drinking fluids for 6 hours Perform straight catheterization every 4 hours Implement a 2- to 3-hour voiding schedule

Implement a 2- to 3-hour voiding schedule

The nurse caring for a client after urinary diversion surgery monitors the client closely for peritonitis by assessing for which sign(s)? Select all that apply. Leukocytosis Abdominal distention Hyperactive bowel sounds Muscle flaccidity

Leukocytosis Abdominal distention

The nurse is caring for a client who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurse's assessment reveals that the stoma is a dark purplish color. What is the nurse's most appropriate response? Document the presence of a healthy stoma. Assess the client for further signs and symptoms of infection. Inform the primary provider that the vascular supply may be compromised. Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.

Inform the primary provider that the vascular supply may be compromised.

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? Administer prophylactic antibiotics as prescribed. Limit the use of indwelling urinary catheters. Encourage frequent mobility and repositioning. Toilet residents who are immobile on a scheduled basis.

Limit the use of indwelling urinary catheters.

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

Low-purine diet

A client undergoes surgery to remove a malignant tumor followed by a urinary diversion procedure. Which postoperative procedure is the most important for the nurse to perform? Maintain skin and stomal integrity. Suggest a visit to a local ostomy group. Determine the client's ability to manage stoma care. Show photographs and drawings of the placement of the stoma.

Maintain skin and stomal integrity.

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? Medication usage History of allergies Occupational history Smoking habits

Medication usage

The nurse is caring for a client who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the client? Limit oral fluid intake for 1 to 2 days. Report the presence of fine, sand like particles through the nephrostomy tube. Notify the health care provider about cloudy or foul-smelling urine. Report any pink-tinged urine within 24 hours after the procedure.

Notify the health care provider about cloudy or foul-smelling urine.

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. For those patients who are incontinent, insert indwelling catheters. Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care. Encourage patients to wear briefs.

Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care.

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? Use clean technique during insertion Use sterile technique to disconnect the catheter from the tubing to obtain urine specimens Place the catheter bag on the client's abdomen when moving the client Perform meticulous perineal care daily with soap and water

Perform meticulous perineal care daily with soap and water

A client is a victim of an MVA and is unconscious. In compliance with a physician's order to insert an indwelling catheter, the nurse places the catheter and notes the drainage of a large amount of yellow urine with normal odor. The nurse clamps the catheter tubing to prevent: bladder spasms. dehydration. urinary retention. bladder collapse.

bladder spasms.

A client being treated in the hospital has been experiencing occasional urinary retention. What is the best nursing action? Use a slipper bedpan. Apply a cold compress to the perineum. Have the client lie in a supine position. Provide privacy for the client.

Provide privacy for the client.

One of the potential problems for a client with a urinary diversion is disturbed body image related to change in appearance and function. The expected outcome is that the client will accept the altered appearance and perform self-care. Which activities would help in achieving that expected outcome? Select all that apply. Reassure the client that nursing staff will provide care until he or she is ready. Discuss the change in function and let the client know what to expect when recovery from surgery is complete. Help the client gain independence by reinforcing that self-care is quite manageable and providing time for practice. Begin exposure to the stoma immediately to help the client adapt properly.

Reassure the client that nursing staff will provide care until he or she is ready. Discuss the change in function and let the client know what to expect when recovery from surgery is complete. Help the client gain independence by reinforcing that self-care is quite manageable and providing time for practice.

The nurse on a urology unit is working with a client who has been diagnosed with oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide? Restrict protein intake as prescribed. Increase intake of potassium-rich foods. Follow a low-calcium diet. Encourage intake of food containing oxalates.

Restrict protein intake as prescribed.

A client 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 client's plan of care? Impaired physical mobility related to presence of an indwelling urinary catheter Risk for infection related to presence of an indwelling urinary catheter Toileting self-care deficit related to urinary catheterization Disturbed body image related to urinary catheterization

Risk for infection related to presence of an indwelling urinary catheter

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? Smoking cessation Reduction of alcohol intake Maintenance of a diet high in vitamins and nutrients Vitamin D supplementation

Smoking cessation

A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedure care? Strain the client's urine following the procedure. Administer a bolus of 500 mL normal saline following the procedure. Monitor the client for fluid overload following the procedure. Insert a urinary catheter for 24 to 48 hours after the procedure.

Strain the client's urine following the procedure.

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? Reflex Urge Stress Overflow

Stress

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? Stress incontinence Reflex incontinence Overflow incontinence Functional incontinence

Stress incontinence

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do? Take the antibiotic as well as an antifungal for the yeast infection she will probably have. Take the antibiotic for 3 days as prescribed. Understand that if the infection reoccurs, the dose will be higher next time. Be sure to take the medication with grapefruit juice.

Take the antibiotic for 3 days as prescribed.

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.

Which nursing intervention should the nurse caring for the client with pyelonephritis implement? Straight catheterize the client every 4 to 6 hours. Administer acetaminophen (Tylenol). Teach client to increase fluid intake up to 3 liters per day. Restrict fluid intake to 1 liter per day.

Teach client to increase fluid intake up to 3 liters per day.

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

Teach the client to perform pelvic floor muscle exercises.

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? The client sets the drainage bag on the floor while sitting down. The client keeps the drainage bag below the bladder at all times. The client clamps the catheter drainage tubing while visiting with the family. The client loops the drainage tubing below its point of entry into the drainage bag.

The client keeps the drainage bag below the bladder at all times.

A patient has a suprapubic catheter inserted postoperatively. What would be the advantages of the suprapubic catheter versus a urethral catheter? Select all that apply. The suprapubic catheter can be kept in longer than a urethral catheter. The patient can void sooner than with a urethral catheter. The suprapubic catheter allows for more mobility. The patient is not at risk for a UTI with a suprapubic catheter. The suprapubic catheter permits measurement of residual urine without urethral instrumentation.

The patient can void sooner than with a urethral catheter. The suprapubic catheter allows for more mobility. The suprapubic catheter permits measurement of residual urine without urethral instrumentation.

A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic? The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy The need to expect a heavy menstrual period following the course of antibiotics The risk of developing antibiotic resistance after the course of antibiotics The need to undergo a series of three urine cultures after the antibiotics have been completed

The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy

The nurse is assessing a client's new stoma and observes that the stoma color is now dark purple. The appropriate nursing intervention is to contact the physician. change the pouching system. remove the urinary stents. apply Karaya powder.

contact the physician.

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

Urinary incontinence is not considered a normal consequence of aging.

A client is being seen by a physician because of symptoms indicating urinary tract infection. Especially in women, what is important education information in preventing urinary tract infections? Select all that apply. appropriate post-bowel movement hygiene appropriate bathing procedure appropriate toilet paper selection All options are correct.

appropriate post-bowel movement hygiene appropriate bathing procedure

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: proteinuria WBC 50 RBC 3 glucose trace

WBC 50

A client who has had a urinary diversion procedure is going to be discharged. What information would the nurse include when instructing the client on care of the stoma and collection pouch? Select all that apply. When changing the adhesive wafer (to which the urostomy collection bag is attached), remove all remaining adhesive before applying a new wafer. Drain the continent urostomy four times a day or as directed by the physician. Wash the urinary collection pouch thoroughly after changing. The pouch only requires cleaning weekly.

When changing the adhesive wafer (to which the urostomy collection bag is attached), remove all remaining adhesive before applying a new wafer. Drain the continent urostomy four times a day or as directed by the physician. Wash the urinary collection pouch thoroughly after changing.

A patient taking an alpha-adrenergic medication for the treatment of hypertension is having a problem with incontinence. What does the nurse tell the patient? The medication has caused permanent damage to the bladder sphincter and will require surgical correction. Relaxation of the supporting ligaments has occurred and the patient will need to perform pelvic floor exercises to strengthen them. The patient will require a medication regimen to decrease the overactivity of the bladder. When the medication is discontinued or changed, the incontinence will resolve.

When the medication is discontinued or changed, the incontinence will resolve.

A client who has a history of neurogenic bladder uses a permanent, indwelling catheter to facilitate urine elimination. What can this client consume to decrease the likelihood of bladder infection? cranberry juice increased protein red meat prune juice

cranberry juice

Urethral strictures may be caused by infections such as untreated gonorrhea or chronic nongonococcal urethritis, or by trauma to the lower urinary tract or pelvis. They may also be congenital. What are possible modes of medical or surgical management for urethral strictures? Select all that apply. dilatation urethroplasty fulguration antibiotic treatment

dilatation urethroplasty

A client is scheduled to undergo surgical creation of an ileal conduit. The primary nurse educates the client about surgery and the postoperative period. The nurse informs the client that many members of the health care team (including a mental health practitioner) will see him. A mental health practitioner should be involved in the client's care to: assess whether the client is a good candidate for surgery. help the client cope with the anxiety associated with changes in body image. assess suicidal risk postoperatively. evaluate the client's need for mental health intervention.

help the client cope with the anxiety associated with changes in body image.

A client has a suspected bladder tumor. What is the most common first symptom of a malignant tumor of the bladder? painless hematuria fever dysuria urgency

painless hematuria

A client has been admitted to the renal unit with acute pyelonephritis, and is undergoing parenteral antibiotic treatment. What would be a significant aspect of this client's discharge education? recurring infection prevention anti-inflammatory incompatibilities needed dietary changes No option is correct.

recurring infection prevention

A client is being treated for a malignant bladder tumor. What would be included in treatment of a small tumor? Select all that apply. resection and fulguration topical application of an antineoplastic drug cystectomy urinary diversion

resection and fulguration topical application of an antineoplastic drug

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization? type and size of the catheter to be used administration of cleansing enemas procedure for insertion of the catheter placement of the catheter

type and size of the catheter to be used

A client who was involved in an MVA which resulted in paraplegia is working toward living at home. The client is currently developing an individualized CIC schedule, preferring not to wear a leg bag. Insufficient CIC does not cause decreased: urine production. bladder circulation. bladder tone. mucin.

urine production.

The nurse has tested the pH of urine from a client's newly created ileal conduit and obtained a result of 6.8. What is the nurse's best response to this assessment finding? Obtain an order to increase the client's dose of ascorbic acid. Administer IV sodium bicarbonate as prescribed. Encourage the client to drink at least 500 mL of water and retest in 3 hours. Irrigate the ileal conduit with a dilute citric acid solution as prescribed.

Obtain an order to increase the client's dose of ascorbic acid.

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

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

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

As a result of trauma, a client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. What is the initial step to begin bladder training for a client with an indwelling catheter? Clamp the catheter. Unclamp the catheter. Remove the catheter. Perform catheter care.

Clamp the catheter.

The nurse is educating a patient who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection? Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion. Sterilize the catheter by boiling it in water for 20 minutes. Insert the catheter for urine drainage three times per day. A new catheter must be used each time catheterization is required.

Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.

The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply. Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. Drink caffeinated beverages twice a day to increase urination. Drink liberal amounts of fluid to flush out bacteria. Void every 2-3 hours to prevent overdistention of the bladder Bathe in warm water to soak the affected area.

Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. Drink liberal amounts of fluid to flush out bacteria. Void every 2-3 hours to prevent overdistention of the bladder

A client has just undergone a urinary diversion procedure. What management issues related specifically to urinary diversion would be included in this client's care plan? Select all that apply. Observe for leakage of urine or stool from the anastomosis. Maintain renal function. Assess for signs and symptoms of peritonitis. Encourage oral intake.

Observe for leakage of urine or stool from the anastomosis. Maintain renal function. Assess for signs and symptoms of peritonitis.

A client 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 101.1ºF (38.4ºC). How should the nurse best respond to the client? Remind the client that renal calculi have a noninfectious etiology and that a fever is unrelated to their recurrence. Remind the client that occasional febrile episodes are expected following ESWL. Tell the client to report to the ED for further assessment. Tell the client to monitor his temperature for the next 24 hours and then contact his urologist's office.

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

A client has been admitted for an outpatient cystoscopy because of a suspected interstitial cystitis. Which statement best describes the pathology of this disorder? The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa. It is caused by infection with Chlamydia trachomatis. It is caused by bacterial infection. The surface of the bladder becomes edematous and reddened, and ulcerations may develop. The bladder can contract without warning, fail to accommodate adequate volumes of urine, or fail to empty completely.

The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa.

A client has been admitted to the postsurgical unit following the creation of an ileal conduit. What should the nurse measure to determine the size of the appliance needed? The circumference of the stoma The narrowest part of the stoma The widest part of the stoma Half the width of the stoma

The widest part of the stoma

The nurse caring for a client with a urinary diversion notices mucus around the stents and in the client's urine. Which is the appropriate nursing intervention? Contact the physician. Document the separation of the mucocutaneous junction. Remove the urinary stents. Document presence of mucus in the urine.

Document presence of mucus in the urine.

A client has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this client's high risk for urinary retention and should implement what intervention in the client's plan of care? Relaxation techniques Sodium restriction Lower abdominal massage Double voiding

Double voiding

A female client has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this client? Bathe daily and keep the perineal region clean. Avoid voiding immediately after sexual intercourse. Drink liberal amounts of fluids. Void at least every 6 to 8 hours.

Drink liberal amounts of fluids.

The nurse is educating a patient with urolithiasis about preventive measures to avoid another occurrence. What should the patient be encouraged to do? Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation. Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. Add calcium supplements to the diet to replace losses to renal calculi. Limit voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system.

Increase fluid intake so that the patient can excrete 2,500 to 4,000 mL every day, which will help prevent additional stone formation.

A nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point should the nurse include? Limit fluid intake to reduce the need to urinate. Take medication ordered for a UTI until the symptoms subside. Notify the physician if urinary urgency, burning, frequency, or difficulty occurs. Wear only nylon underwear to reduce the chance of irritation.

Notify the physician if urinary urgency, burning, frequency, or difficulty occurs.

A client is postoperative day 3 following the creation of an ileal conduit for the treatment of invasive bladder cancer. The client is quickly learning to self-manage the urinary diversion, but expresses concern about the presence of mucus in the urine. What is the nurse's most appropriate response? Report this finding promptly to the primary provider. Obtain a sterile urine sample and send it for culture. Obtain a urine sample and check it for pH. Reassure the client that this is an expected phenomenon.

Reassure the client that this is an expected phenomenon.

A client who is diagnosed with calcium oxalate stones is instructed to limit calcium intake. The client is instructed to consume ______ mg of calcium per day, or less, as part of dietary treatment. 1000 1250 1500 2000

1000

A nurse catheterized an elderly client and confirmed the presence of residual urine. What residual urine volume would be considered abnormal for an elderly client? 25 mL 50 mL 100 mL 150 mL

150 mL

A nurse is conducting a health history on a patient who is seeing her health care provider for symptoms consistent with a UTI. The nurse understands that the most common route of infection is which of the following? Through the bloodstream (hematogenous spread) By ascending infection (transurethral) Due to a fistula (direct extension) The result of urethra abrasion (sexual intercourse)

By ascending infection (transurethral)

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia? Incontinence Change in cognitive functioning Hematuria Back pain

Change in cognitive functioning

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention? Secure or patch it with tape. Empty the pouch. Change the wafer and pouch. Secure or patch it with barrier paste.

Change the wafer and pouch.

The nurse is assessing a client admitted with renal stones. During the admission assessment, what parameters should the nurse address? Select all that apply. Dietary history Family history of renal stones Medication history Surgical history Vaccination history

Dietary history Family history of renal stones Medication history

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? Incontinence Urinary retention Urgency Incomplete bladder emptying

Incontinence

A client 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 client informs the nurse that she is experiencing urinary urgency resulting in several small-volume voids. What is the nurse's best response? Inform the client that urgency and occasional incontinence are expected for the first few weeks postremoval. Obtain an order for a loop diuretic in order to enhance urine output and bladder function. Inform the client that this is not unexpected in the short term and scan the client's bladder following each void. Obtain an order to reinsert the client's urinary catheter and attempt removal in 24 to 48 hours.

Inform the client that this is not unexpected in the short term and scan the client's bladder following each void.

The nurse and urologist have both been unsuccessful in catheterizing a client with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the health care provider to use to drain the client's bladder? Insertion of a suprapubic catheter Scheduling the client immediately for a prostatectomy Application of warm compresses to the perineum to assist with relaxation Medication administration to relax the bladder muscles and reattempting catheterization in 6 hours

Insertion of a suprapubic catheter

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)

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. The nurse's postoperative plan of care should include which action? Determine the client's ability to manage stoma care. Show pictures and drawings of placement of the stoma. Maintain skin and stomal integrity. Suggest a visit to a local ostomy group.

Maintain skin and stomal integrity.

A nurse is preparing a care plan for a client with Alzheimer's disease. The client is unable to communicate or feel the pain and discomfort associated with acute urinary retention. Which nursing measures should be taken while caring for such a client? Select all that apply. Measure fluid intake and output. Palpate the abdomen to check for distended bladder. Promote catheterization. Instruct the client on how to minimize urinary odor.

Measure fluid intake and output. Palpate the abdomen to check for distended bladder.

A client with a recent history of nephrolithiasis has presented to the ED. After determining that the client's cardiopulmonary status is stable, what aspect of care should the nurse prioritize? IV fluid administration Insertion of an indwelling urinary catheter Pain management Assisting with aspiration of the stone

Pain management

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer? Painless, gross hematuria Deep flank and abdominal pain Muscle spasm and abdominal rigidity over the flank Decreasing kidney function associated with fever and hematuria

Painless, gross hematuria

A client has developed urinary incontinence after having a urinary catheter in place for a few weeks. What is the initial nursing intervention the nurse should use to start the client with bladder training? Immediately after voiding, perform a bladder scan. Instruct the client to drink more fluids at night for a full bladder in the morning. Place client on a timed voiding schedule. Perform staight catheterizations at specific times each day.

Place client on a timed voiding schedule.

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

Reviewing the client's medication administration record for recent changes

What is true about extracorporeal shock wave lithotripsy (ESWL)? Select all that apply. Stones are shattered into smaller particles that are passed from the urinary tract. ESWL is administered with the client in a water bath or surrounded by a soft cushion while under light anesthesia or sedation. ESWL is a ureteroscopic approach. ESWL is done while the patient is undergoing a percutaneous nephrolithotomy.

Stones are shattered into smaller particles that are passed from the urinary tract. ESWL is administered with the client in a water bath or surrounded by a soft cushion while under light anesthesia or sedation.

The nurse is working with a client whose health history includes occasional episodes of urinary retention. What assessment finding would suggest that the client is currently retaining urine? The client's suprapubic region is dull on percussion. The client is uncharacteristically drowsy. The client claims to void large amounts of urine two to three times daily. The client takes a beta adrenergic blocker for the treatment of hypertension.

The client's suprapubic region is dull on percussion.

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

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

A female client's most recent urinalysis results are suggestive of bacteriuria. When assessing this client, the nurse's data analysis should be informed by what principle? Most UTIs in female clients are caused by viruses and do not cause obvious symptoms. A diagnosis of bacteriuria requires three consecutive positive results. Urine contains varying levels of healthy bacterial flora. 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.

A nurse is caring for a female client whose urinary retention has not responded to conservative treatment. When educating this client about self-catheterization, the nurse should encourage what practice? Assuming a supine position for self-catheterization Using clean technique at home to catheterize Inserting the catheter 1 to 2 inches (2.5 to 5 cm) into the urethra Self-catheterizing every 2 hours at home

Using clean technique at home to catheterize

The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily: at the same time, on the same scale, with similar clothing. once in the morning, on the same scale, with similar clothing. at the same time, using a different scale every time, with similar clothing. at the same time, on the same scale, with only minimal clothing.

at the same time, on the same scale, with similar clothing.

A client has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What contributes to the likelihood of developing urinary tract or bladder infections? Select all that apply. indwelling catheter decreased fluid intake frequent catheter hygiene increased ingestion of Vitamin C

indwelling catheter decreased fluid intake

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem? urinary tract infection urinary incontinence urinary retention urethral strictures

urinary tract infection