Chapter 19: Urinary Elimination PrepU

The nurse is assisting an older adult client with changing the client's sanitary briefs, which revealed that the client was incontinent of urine. Which statement by the client requires further follow up by the nurse?

"I have found this is something that happens from time to time at my age."

The nurse reviews an older adult client's urinary symptoms. Which statement by the client requires further follow up by the nurse?

"I have trouble making it to the restroom on time."

The nurse is reviewing lifestyle changes with an older adult client in order to support urinary continence. Which statement by the client requires further follow up by the nurse?

"I will stay at home to ensure that I can remain close to the toilet."

The nurse is evaluating the effectiveness of the care plan for an older adult client with urinary incontinence. Which statement by the client indicates that the care plan has been effective?

"I'm going longer periods of time between episodes of incontinence."

An older client is discouraged that urinary incontinence continues despite performing Kegel's exercises for a week. What should the nurse respond to this client?

"It takes several months to see an improvement."

An older client is embarrassed because of an episode of urinary incontinence associated with a fecal impaction. What should the nurse explain to the client about this type of incontinence?

"It was probably because of your bowel problem."

The nurse educator who directs care at an assisted living facility is conducting a health promotion session with residents. Which statement about maintaining and promoting bladder health would the nurse include?

"Making your urine more acidic through your diet can reduce the incidence of infections."

A 75-year-old client tells the nurse, "When I feel the need to urinate, I cannot hold it until I get to the toilet." Which suggestion would be appropriate?

"Remind yourself to urinate every two hours during the day."

A nurse conducts a class for family members who are providing care to older adult relatives. An attendee asks, "My mother has had frequent urinary tract infections. What can I do?" Which suggestion would be most appropriate?

"Try making changes to your mother's diet to include eggs, cheese, and fish."

While the nurse is educating an older adult client about urinary function, the client asks, "What are some changes that happen with age that affect urination?" Which statement will the nurse include in the response?

"Urinary tract muscles decrease in elasticity, contributing to urinary frequency and urgency."

An older female admits to experiencing urinary incontinence. Which question is a priority for the nurse to ask first?

"When did it start?"

The nurse in the emergency department assesses a 76-year-old female client. The client's bladder is visibly distended and the client has not voided since the previous evening. Which assessment question would be most important to determine the source of the client's condition?

"When was your last bowel movement?"

The nurse educates an older adult client with stress incontinence. Which statement will the nurse include in the education?

"Your condition is a result of increased pressure in the abdomen."

The nurse is assisting the urologist who is performing a cystoscopy on an older adult client. Which finding noted during the cystoscopy are considered age-related changes in the bladder and urinary tract? Select all that apply.

-Difficulty controlling the muscles of the lower urinary tract. -Inability to tolerate a volume of urine greater than 350 mL.

A gerontological nurse is providing care to several older adult clients. On which client's plan of care would the nurse most likely include teaching of Kegel exercises?

A 67-year-old female client living with stress incontinence since having her children

A nurse is assessing an older adult male client. The client tells the nurse, "I am urinating quite often but it feels like I am not emptying my bladder completely." The nurse interprets the client's statement as suggesting which condition?

Enlargement of the prostate

Which of the following should a nurse include in a urinary health promotion webinar for aging clients?

Adequate fluid intake

While the nurse is performing an assessment on an older adult client, the client states, "Someone my age can expect to be incontinent of urine from time to time." How will the nurse respond?

Assess the client's attitudes and knowledge about urinary function.

The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older clients. Which unit-based protocol most likely contributed to this outcome?

Cranberry juice with breakfast

Which nursing diagnosis is most lkely to apply to an older adult client who has prostate enlargement?

Impaired urinary elimination

A nurse is providing care to a 75-year-old client who is experiencing urinary incontinence. Assessment reveals that the client is not fully emptying the bladder with each voiding, which contributes to urinary incontinence. Which intervention would the nurse implement to promote the client's ability to empty the bladder?

Massaging the bladder area with each voiding

The older client has impaired urinary elimination. Which goal is the most important to facilitate physiologic balance?

The client achieves partial or complete restoration of bladder control.

The home health nurse is assessing an older adult client for behavioral cues of incontinence. Which assessment findings indicate that the client may be incontinent? Select all that apply

The client has disposable pads on hand. The client's favorite chair is malodorous. The client participates in few social activities.

The nurse is performing a urinary assessment on an older adult client with urinary incontinence. Which of the client's conditions may be contributing to this problem?

The client has overactive bladder syndrome.

The nurse is assessing an older adult client's overall urinary wellness. Which assessment finding places the client at risk for socially inappropriate urination?

The client has severe macular degeneration.

The older client has risk of injury related to urinary incontinence. Which goal is the most important to facilitate physiologic balance?

The client is free from falls related to escaped urine.

On admission to the hospital, an 81-year-old client is recognized to be at risk for polypharmacy. When reviewing the client's medication history, which component would the nurse identify as posing the greatest threat to the client's continence?

The client takes a diuretic for treatment of hypertension and over-the-counter antihistamines during allergy season.

The nurse is assessing an older adult client with an indwelling urinary catheter. Which finding places the client at increased risk for a catheter associated urinary tract infection?

The client's catheter has been in place for 72 hours.

The home health nurse is assessing the older adult client's home for environmental influences on incontinence. Which findings in the client's home will the nurse note as having an influence on incontinence? Select all that apply.

The client's toilet is on a different floor than the bedroom. The client's hallway to the toilet is unlit. The client's bathroom has a throw rug in front of the door. The client's bathroom door does not latch closed.

Which age-related change is most important in determining nursing care for an older client with an adverse drug reaction?

The filtration efficiency of the kidneys decrease with age.

The nurse is caring for an older adult client with urinary urgency, chronic constipation, and frequent urinary tract infections. Which nursing intervention will the nurse implement to promote urinary wellness for this client?

The nurse will provide education on the management of constipation.

The nurse is assessing an older adult client for risk factors of urinary incontinence. Which assessment findings place the client at risk for urinary incontinence? Select all that apply.

Unsteady gait Severe visual impairment Alcoholism Lisinopril therapy

The nurse instructs an older client on performance of Kegel exercises. Which direction should the nurse provide to help the client identify the appropriate muscle to exercise?

Void and stop the stream

An older client experiences frequent urinary tract infections. Which dietary change should the nurse suggest to help reduce infections in the future?

increase the intake of plums

The nurse identifies the diagnosis of Impaired Urinary Elimination for an older client. What identifying factor did the nurse use when selecting this nursing diagnosis?

retention

The nurse identifies interventions to prevent the development of a urinary tract infection (UTI) in an older client. What assessment finding caused the nurse to add these interventions to the plan of care?

treatment for diabetes mellitus