Chapter 49- Urinary Problems

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." "Be aware that your urine will be cherry-red for 5 to 7 days." "Apply an antibacterial dressing to the incision daily." "Take your temperature every 4 hours."

"Increase your fluid intake to 2 to 3 L per day."

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what? Voiding at given intervals Prompted voiding Interval voiding Bladder retraining

Bladder retraining

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 Constipation Decreased progesterone levels Bladder cancer

Constipation

Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications? Urge Iatrogenic Overflow Reflex

Iatrogenic

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? Implement a 2- to 3-hour voiding schedule Perform straight catheterization every 4 hours Avoid drinking fluids for 6 hours Encourage voiding immediately after catheter removal

Implement a 2- to 3-hour voiding schedule

Which finding is an early indicator of bladder cancer? Dysuria Painless hematuria Occasional polyuria Nocturia

Painless hematuria

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

Pyelonephritis

Which of the following is a strategy to promote urinary continence? Void regularly, 5 to 8 times a day Implement a low fiber diet Take diuretics after 4 PM Use caffeine in moderation

Void regularly, 5 to 8 times a day

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 with my feces." "My urine will be eliminated through a stoma." "A catheter will drain urine directly from my kidney."

"My urine will be eliminated through a stoma."

Which client is at highest risk for developing a hospital-acquired infection? A client with an i1619 A client who's taking prednisone (Deltasone) A client with Crohn's disease A client with a laceration to the left hand

A client with an i1619

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest? A low-purine diet A diet high in calcium A diet high in fruits and vegetables A low-sodium diet

A low-purine diet

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? Cholinergic Anticholinergic Diuretics Anticonvulsant

Anticholinergic

A client diagnosed with bladder cancer wants to avoid surgery. For which intravesical treatment will the nurse prepare teaching for this client? Periodic cystoscopy Radiation therapy Infusion of a cytotoxic agent Bacillus Calmette Guerin (BCG) Live

Bacillus Calmette Guerin (BCG) Live

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? If risk for chronic pyelonephritis is likely Reveals causative microorganisms Detects calculi, cysts, or tumors Shows damage to the kidneys

Detects calculi, cysts, or tumors

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: evaluate the client's need for mental health intervention. assess whether the client is a good candidate for surgery. assess suicidal risk postoperatively. help the client cope with the anxiety associated with changes in body image.

Help the client cope with the anxiety associated with changes in body image

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder? Hematuria Frequency Dysuria Incontinence

Hematuria

The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which factor is contributing to UTIs in older adults? Active lifestyle Sporadic use of antimicrobial agents Immunocompromise Low incidence of chronic illness

Immunocompromise

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? High sodium High protein Low purine Low oxalate

Low purine

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: Compromised ligament and pelvic floor support of the urethra. A stricture or tumor in the bladder. Loss of motor control of the detrusor muscle. Uninhibited detrusor contractions.

Loss of motor control of the detrusor muscle

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? Suggest a visit to a local ostomy group. Maintain skin and stomal integrity. Determine the client's ability to manage stoma care. Show photographs and drawings of the placement of the stoma.

Maintain skin and stomal integrity

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? Need to urinate after engaging in sexual intercourse Suggestion to take tub baths instead of showers Importance of urinating every 4 to 6 hours while awake Need to wear underwear made from synthetic material

Need to urinate after engaging in sexual intercourse

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

Phenazopyridine

Sympathomimetics have which of the following effects on the body? Relaxation of bladder wall Decrease of heart rate Constriction of pupils Constriction of bronchioles

Relaxation of bladder wall

A client asks the nurse why cystitis is more common in women than in men. Which of the following body parts will the nurse include in the answer? The bladder The rectum The ureters The urethra

The urethra

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? administration of cleansing enemas type and size of the catheter to be used procedure for insertion of the catheter placement of the catheter

Type and size of the catheter to be used

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? Urethral stricture Bladder stones Cystitis Urinary retention

Urinary retention

Which of the following is the most common site of a nosocomial infection? Gastrointestinal tract Respiratory tract Skin Urinary tract

Urinary tract

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

Pink color

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 Incontinence Back pain Hematuria

Change in cognitive functioning

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

Drink liberal amount of fluids

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 Bladder irritation related to urinary tract infections Obstruction due to fecal impaction or enlarged prostate Increased urine production due to metabolic conditions

Decreased pelvic muscle tone due to multiple pregnancies

The nurse recognizes that which risk factor does NOT predispose a client to the development of kidney stones? hypoparathyroidism hyperparathyroidism gout immobilization

Hypoparathyroidism

A female client who suffers from urethral strictures undergoes a dilation procedure and experiences a burning sensation while voiding. Which nursing instruction would be most helpful? Urge the application of moisture sealants. Instruct the use of warm sitz baths. Encourage a visit to a local ostomy support group. Advise cleansing of the perineum frequently.

Instruct the use of warm sitz baths.

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

Ketoralac (Toradol)

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

Painless 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? Instruct the client to drink more fluids at night for a full bladder in the morning. Place client on a timed voiding schedule. Immediately after voiding, perform a bladder scan. Perform straight catheterizations at specific times each day.

Place client on a timed voiding schedule

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction? The nursing assistant places the drainage bag on the lower area of the wheelchair for transport. The nursing assistant places the drainage bag on the client's abdomen for transport. The nursing assistant keeps the catheter and drainage bag together when moving the client. The nursing assistant holds the drainage bag while the client moves to the wheelchair.

The nursing assistant places the drainage bag on the client's abdomen for transport

The nurse provides care for a client who is prescribed bladder retraining following urinary catheterization. Complete the following sentence by choosing from the lists of options. The nurse should first ask the client to Select...urinate drink defecate then perform the prescribed Select...laboratory testing bladder scan urinary catheterization

urinate bladder scan

An 82-year-old client experiences urinary incontinence. Which factor should the nurse assess before beginning a bladder training program for this client? History of allergies Physical and environmental conditions Occupational history Smoking habits

Physical and environmental conditions

The nurse is encouraging the client with recurrent urinary tract infections to increase fluid intake to 8 large glasses of fluids daily. Which beverage would the nurse discourage for this client? Milk at lunch Coffee in the morning Fruit juice midmorning Ginger ale at dinner time

Coffee in the morning

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

Immunocompromise

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 patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care? Turn the patient every 2 hours around the clock. Administer pain medication every 2 hours. Clean the stoma with soap and water after the patient voids. Monitor urine output hourly and report output less than 30 mL/hr.

Monitor urine output hourly and report output less than 30 mL/hr

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

Urinary tract infection

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? It's a normal finding associated with the client's nothing-by-mouth status. It's an abnormal finding that will correct itself when the client ambulates. It's an abnormal finding that requires further assessment. It's a normal finding caused by blood loss during surgery.

It's an abnormal finding that requires further assessment

Bladder retraining following removal of an indwelling catheter begins with instructing the client to follow a 2- to 3-hour timed voiding schedule. advising the client to avoid urinating for at least 6 hours. encouraging the client to void immediately. performing straight catheterization after 4 hours.

Instructing the client to follow a 2- to 3-hour timed voiding schedule