CH.55 Prep U's- Management of Patients With Urinary Disorders
A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?
"Increase your fluid intake to 2 to 3 L per day."
A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?
"I should take at least 1,000 mg of vitamin C each day."
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.
- Perform hand hygiene prior to patient care. - Provide careful perineal care. - Assist the patients with frequent toileting.
A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. 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
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
Anticholinergic
What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?
Change in cognitive functioning
Which of the following accounts for the majority of ureteral injuries?
Crashes, falls, and assaults
After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence?
Decreased pelvic muscle tone due to multiple pregnancies
An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?
Detects calculi, cysts, or tumors
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?
Document presence of mucus in the urine.
Which instruction would be included in a teaching plan for a client diagnosed with a UTI?
Drink liberal amount of fluids.
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-purine diet
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?
Maintain skin and stomal integrity.
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?
Permanent drainage with a urethral catheter
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?
Perform meticulous perineal care daily with soap and water
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?
Physical and environmental conditions
Sympathomimetics have which of the following effects on the body?
Relaxation of bladder wall
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
Stress
The nurse knows that which of the following body parts explains why cystitis is more common in women?
The urethra Because the urethra is short in women, ascending infections or microorganisms carried from the vagina or rectum are common.
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?
Urinary Retention
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?
"My urine will be eliminated through a stoma."
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."
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.
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 for 3 days as prescribed.
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
