M.5-2: Dynamic Study Module Bladder Incontinence and Retention

A patient presents to the nurse with complaints of urine leakage with constipation. Which dietary change should the nurse advise to the patient to help diminish urinary incontinence? Increasing fiber Increasing caffeine Increasing alcohol Increasing spicy food

Increasing fiber Increasing fiber will combat constipation, helping to prevent stress incontinence. Caffeine, alcohol, and spicy food all contribute to irritation of the bladder, which would promote urinary incontinence.

The nurse is teaching a patient on the use of Kegel exercises for stress incontinence. Which patient statement indicates an understanding of the teaching provided? "I am able to stop and start the urine stream." "I have practiced them and keep passing gas." "I should do these no more than once a day." "I know they are working because my butt muscles are sore."

"I am able to stop and start the urine stream." The nurse would evaluate effective patient teaching when the patient states they are able to control the stream of urine by starting and stopping the flow. When the patient states that they are passing gas or the butt muscles are sore, the patient is not tightening the correct muscles and further teaching is needed. The exercises should be done twice a day initially and increase to four times a day.

The nurse is providing discharge teaching to a patient diagnosed with urinary incontinence. Which patient statement indicates the need for further teaching regarding preventive methods for urinary incontinence? Answer "I have switched to a low-fiber diet." "I have begun a smoking-cessation program." "I drink six to eight 8-ounce glasses of water each day." "I have decreased the amount of coffee I drink each day from eight cups to two."

"I have switched to a low-fiber diet." A low-fiber diet is not indicated as a preventive method of decreasing urinary incontinence. The other patient statements indicate understanding of the teaching session.

he nurse is teaching the parents of a preschool-age child about the causes of nocturnal enuresis. Which statement is appropriate for the nurse to include in the teaching session with the parents? "Many children wet the bed due to difficulties in arousal from sleep." "Bedwetting is more common in girls than in boys." "Your child knows she can get away with this and is just being lazy." "It is common for children to develop incontinence when stressed."

"Many children wet the bed due to difficulties in arousal from sleep." Nocturnal enuresis is especially prevalent in children who are reported to be deep sleepers, although it can occur at any stage of sleep, and occurs more often in boys. It can also be the result of overproduction of urine at night, and constipation. There is no indication that nocturnal enuresis is caused by the child being too lazy to get out of bed at night to urinate. Stress may play a role in incontinence in pregnant and older adults but not in preschool-aged children. Secondary nocturnal enuresis can be related to stress.

A patient with urinary incontinence is scheduled for urodynamic testing. The patient's family asks the nurse, "What is this test for?" Which response by the nurse is accurate? "This test will measure bladder strength and urinary sphincter health." "This test will determine how completely the bladder empties with voiding." "This test will identify structural disorders contributing to incontinence." "This test will evaluate detrusor muscle function."

"This test will measure bladder strength and urinary sphincter health." Urodynamic testing measures bladder strength and urinary sphincter health. Cystometrography is a diagnostic test done to evaluate detrusor muscle function. A cystoscopy identifies structural disorders contributing to incontinence. Postvoiding residual volume determines how completely the bladder empties with voiding.

The nurse is caring for an older adult patient in a long-term care setting. The patient's family states, "With our mother's recent memory lapses, we are concerned about her recent urinary accidents." Which statement by the nurse best addresses the patient's risk for urinary incontinence? "We can institute scheduled toileting for your mother." "We can insert a urinary catheter." "There are medications we can give your mother." "We can get your mother a wheeled walker to help in getting to the bathroom."

"We can institute scheduled toileting for your mother." Dementia is a risk factor for urinary incontinence, because the patient may not have the cognitive ability to reach the bathroom in time. Therefore, timed voiding would be the least invasive and best way to prevent incontinent episodes. An internal catheter would increase the risk for infection. Medications may increase confusion. A person with dementia may not have impaired ambulation; this would be best for a patient with functional incontinence due to impaired mobility.

The nurse is assigned to care for four patients today. Which patient is at highest risk for developing acute urinary retention? A 28-year-old female one day postpartum A 20-year-old female with infertility A 50-year-old female with ovarian cancer A 60-year-old female with mastitis

A 28-year-old female one day postpartum The patient who is one day postpartum is at highest risk for urinary retention, secondary to inflammation in the perineal area after delivery. The patients with infertility, ovarian cancer, and mastitis do not have any risk factors for urinary retention.

Which patient with urinary incontinence would benefit most from using a bedpan and elevating the head of the bed? A patient who is bedridden A patient with a wheeled walker A patient who is pregnant A patient with multiple sclerosis

A patient who is bedridden Elevating the head of the bed and using a bedpan would be most beneficial for a patient who is bedridden. A patient with mobility issues such as using a wheeled walker and a pregnant patient would benefit from timed voiding. A patient with multiple sclerosis would benefit from catheterization.

The nurse is providing care to older adult clients at a​ long-term care facility. Which factor places these clients at risk for urinary​ incontinence? (Select all that​ apply.) A. Age B. Stroke C. Depression D. Pelvic floor muscle exercises​ (Kegel exercises) E. More than two urinary tract infections​ (UTIs) in a year​

A. Age B. Stroke C. Depression E. More than two urinary tract infections​ (UTIs) in a year​ ​Rationale: Risk factors for urinary incontinence include​ age, gender​ (women are more susceptible than are​ men), obesity,​ smoking, diabetes,​ inactivity, pregnancy,​ depression, neurologic disorders​ (e.g., stroke), two or more UTIs per​ year, and medications​ (medications affecting the adrenergic​ system, diuretics, and calcium channel​ blockers). Kegel exercises decrease the risk of urinary incontinence.

The nurse is completing an assessment on a client. Which assessment finding supports the suspicion of urinary​ incontinence? (Select all that​ apply.) A. Odor of urine B. Soiled clothing C. Irritated perineal tissue D. Strong pelvic muscle tone E. Frequent bathroom breaks

A. Odor of urine B. Soiled clothing C. Irritated perineal tissue E. Frequent bathroom breaks Rationale: The odor of​ urine, soiled​ clothing, irritated perineal​ tissue, and frequent bathroom breaks all support suspicion of leakage of urine from urinary incontinence.​ Weak, not​ strong, pelvic floor muscles would be a concern for urinary incontinence.

The nurse caring for a client with stress incontinence should identify which condition as a​ cause? A. Pelvic muscle​ relaxation, a weak​ urethra, and surrounding tissues cause decreased urethral resistance. B. There is an inability to respond to the need to urinate. C. An overactive detrusor muscle increases bladder pressure. D. The lack of normal detrusor muscle function causes bladder overfilling and increased bladder pressure.

A. Pelvic muscle​ relaxation, a weak​ urethra, and surrounding tissues cause decreased urethral resistance. Rationale: Stress incontinence occurs when the pelvic muscle relaxes and a weak urethra and surrounding tissues cause decreased urethral resistance. Urge incontinence is when an overactive detrusor muscle increases bladder pressure. Overflow incontinence is when the lack of normal detrusor muscle function causes bladder overfilling and increased bladder pressure. Functional incontinence occurs when the client is unable to respond to the need to urinate.

A patient reports the persistent urgency to urinate. Which classification of drug should the nurse anticipate being ordered for this patient? Anticholinergic agent Cholinergic agent Diuretic Antiflatulence agent

Anticholinergic agent Anticholinergic agents are used to reduce urgency and frequency by inhibiting bladder contractions and increasing bladder capacity. Cholinergic agents are used to stimulate bladder contractions and facilitate voiding. Diuretics are used to increase fluid excretion and prevent fluid reabsorption. Antiflatulence agents are used to coalesce gas bubbles and facilitate the passage of gas.

An 82-year-old female patient is admitted to a long-term care facility because the family found it too difficult to perform care in the home to meet toileting needs. Which nursing action is appropriate when providing care for the patient? Assessing the patient for physical and mental abilities and limitations, usual voiding pattern, and ability to assist with toileting Limiting the patient's fluid intake to less than 1.5 L per day to reduce the number of times she will need to void Performing intermittent catheterization on a schedule to keep the patient's clothing and skin dry Reviewing the patient's daily medications and holding those that cause diuresis

Assessing the patient for physical and mental abilities and limitations, usual voiding pattern, and ability to assist with toileting Assessing the patient for physical and mental abilities, usual voiding pattern, and ability to assist with toileting will assist in planning their care. Holding medications that cause diuresis may cause the patient to develop additional health problems with the renal or cardiovascular systems. Performing intermittent catheterization on a routine basis increases the chance for infection. Reducing fluid intake to less than 1.5 L can cause irritation of the bladder due to urine concentration and increase incontinence.

A client who has experienced a stroke is struggling with urinary continence due to difficulty with manipulating clothing at the toilet. Which collaborative team member would benefit this​ client's management of​ incontinence? A. A radiologist B. An occupational therapist C. An infection control nurse D. An ostomy nurse

B. An occupational therapist ​Rationale: The occupational therapist can assist the client with fine motor​ skills, mobility, and adaptive devices with clothing to help prevent urinary incontinence. The ostomy nurse would assist with wound care. The infection control nurse would assist with infection prevention. The radiologist interprets imaging as a diagnostic tool.

Which assessment finding should the nurse note in a patient diagnosed with urinary incontinence? Bladder bulging Hypoactive bowel sounds Use of alternative therapies Enlarged prostate

Bladder bulging During the physical examination for a patient experiencing urinary incontinence, the nurse may find perineal redness, physical or cognitive limitations, and bladder bulging. The use of alternative therapies is assessed during the patient's health history. Bowel sounds are not assessed during a focused urinary assessment. An enlarged prostate tends to cause problems with urinary retention, not incontinence.

The nurse is caring for a patient who reports urine leakage with laughter and coughing. Which is an appropriate assessment for the nurse to perform? Bulging of the bladder into the vagina when bearing down Bilateral strength the inner thigh muscles Lung sounds Capillary refill

Bulging of the bladder into the vagina when bearing down Assessment for bulging of the bladder into the vagina when bearing down aligns with assessment for continence. The inner thigh muscles, lung sounds, and capillary refill are not items that indicate urinary incontinence.

The nurse is caring for a client with newly diagnosed urinary retention. The nurse should question a medication order that falls into which​ classification? A. Antiflatulence agent B. Diuretic C. Cholinergic agent D. Anticholinergic agent

D. Anticholinergic agent ​Rationale: An anticholinergic agent is contraindicated in the client with urinary retention. Anticholinergics affect the autonomic nervous system and interfere with the normal urination process leading to the retention of urine.​ Diuretics, cholinergic​ agents, and antiflatulence agents are not contraindicated in urinary retention.

he nurse is caring for a patient diagnosed with urinary retention. Which medication on the patient's medical administration record should the nurse question? Diphenhydramine hydrochloride Bethanechol chloride Acetaminophen Ibuprofen

Diphenhydramine hydrochloride The nurse would question the use of an antihistamine, such as diphenhydramine hydrochloride, for a patient with urinary retention. These medications can affect the autonomic nervous system and interfere with the normal urination process. Bethanechol chloride is a medication used to treat urinary retention. Acetaminophen and ibuprofen can be administered safely for a patient with urinary retention.

The nurse is providing care to a patient diagnosed with urinary urgency. The healthcare provider prescribes an anticholinergic medication to increase bladder capacity and inhibit bladder contractions for the patient. Which finding would alert the nurse to an adverse effect resulting from the anticholinergics? Dry mouth Diarrhea Increased urinary output Decrease in blood pressure

Dry mouth Anticholinergic medications often lead to dry mouth, constipation, urinary retention, or blurred vision. Diarrhea typically results from laxatives. Increased urinary output is commonly seen with diuretics. Fluid loss from diuretics may also lead to hypotension.

The nurse is caring for a bedbound female patient. Which intervention should the nurse implement to support voiding and avoid urine retention in the female patient? Elevating the head of the bed Providing a urinal Remaining at the bedside during voiding Cooling the bedpan

Elevating the head of the bed Elevating the head of the bed allows the patient to sit in a more natural position. A urinal would be provided to the male patient. Providing privacy for the patient and warming the bedpan help to promote voiding.

The nurse is caring for a patient who performs self-catheterization for urinary retention. Which assessment finding indicates a potential complication related to the care of this patient? Answer Fever Intake of 3 L of fluids per day Complete emptying of bladder Increased intake of caffeine

Fever Fever is an indication that there may be a urinary tract infection from urinary catheterization. Fluid intake of 2.5 to 3 L per day promotes normal urine production and voiding. Self-catheterization should result in complete bladder emptying. Caffeine intake may lead to bladder irritation but is not a complication of self-catheterization.

The nurse is assessing a patient with a history of urinary retention who is diagnosed with a urinary tract infection. When reviewing the patient's health history, which finding would most likely be the causative agent? Intermittent self-catheterization Lack of performing Kegel exercises Decreased functional mobility Alzheimer disease

Intermittent self-catheterization A patient performing intermittent self-catheterization would be at high risk for the development of a urinary tract infection due to the introduction of a foreign object into the sterile urinary tract. Lack of performing Kegel exercises, difficulty ambulating, and Alzheimer disease cause urinary incontinence, not retention and infection.

During a checkup, a pregnant patient reports urinary incontinence. Which instruction is appropriate for the nurse to provide for this patient? Performing Kegel exercises Increasing fluid intake Consuming more fiber Avoiding alcohol

Performing Kegel exercises Kegel exercises may help pregnant women maintain urinary muscle strength and prevent incontinence. Alcohol should be avoided during pregnancy, but abstinence will not address the concern of incontinence. Consuming fiber is an appropriate topic for a patient experiencing constipation. Increasing fluid intake will not help a patient with urinary incontinence

A patient reports urine leakage. The nurse notes the following medical history: obesity, ambulation difficulty, smoking, and hypertension treated with diuretics. Which lifestyle intervention should the nurse suggest to the patient to reduce urinary incontinence? Reducing physical barriers to toileting Decreasing activity Switching from cigarette smoking to chewing tobacco Stopping all diuretics

Reducing physical barriers to toileting Reducing physical barriers to toileting promotes a safe path to the bathroom for use of the toilet. Regular exercise supports weight loss. Tobacco cessation would be indicated. A medication review helps to identify contributing factors, but stopping medications would not be instructed without healthcare provider input.

A patient is admitted to a clinic with urinary retention caused by a mechanical obstruction. The nurse should suspect which condition as the likely cause of the patient's condition? Repeated urinary tract infections Benign prostatic hyperplasia Anticholinergic medications Fecal impaction

Repeated urinary tract infections Repeated urinary tract infections lead to scarring of structure, which is a functional problem associated with urinary retention. Either mechanical obstruction of the bladder outlet or a functional problem can cause urinary retention. Scarring caused by repeated UTIs subsequently leads to urethral stricture and produces mechanical obstruction. Benign prostatic hypertrophy and fecal impaction are the causes of an obstruction that will lead to urinary retention. Anticholinergic medications may cause retention, but this is not a functional problem. Once the medication is stopped, the urinary retention resolves.

The nurse preceptor is reviewing the plan of care for a patient with urinary incontinence created by a graduate nurse. Which dietary intervention submitted by the graduate nurse should the preceptor correct? Restricting fluid intake Altering nutrition to maintain a healthy weight Avoiding bladder irritants Promoting a diet that is high in fiber

Restricting fluid intake The care plan for the patient with urinary incontinence should include nutrition that maintains a healthy weight; a high-fiber diet to prevent constipation; avoidance of bladder irritants such as alcohol, caffeine, acidic food, and spicy food; and maintenance of adequate fluid intake. Adequate fluid intake is vital to promote hydration and urinary function. Overly concentrated urine can irritate the bladder, increasing incontinence.

The nurse is preparing a teaching session about use of a pessary device for a patient with urinary incontinence. Which type of urinary incontinence should the nurse suspect? Stress incontinence Urge incontinence Reflex incontinence Overflow incontinence

Stress incontinence Stress incontinence can be treated with use of a pessary device. Urge incontinence can benefit from pelvic floor exercises and behavioral modifications. Reflex and overflow incontinence can benefit from the use of adult briefs and absorption devices.

The nurse is caring for a patient with urinary incontinence who has been prescribed bladder-training behavior modification. Which goal of therapy should the nurse include in the teaching session with the patient? Answer To toilet at regular intervals (e.g., every 2-4 hours) To improve pelvic floor muscle strength by stopping the urine flow during voiding and holding for a few seconds To gradually increase the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times To toilet on a schedule that corresponds with the normal pattern

To gradually increase the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times Bladder training increases the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times. Habit training is toileting on a schedule that corresponds with the normal pattern. Scheduled voiding is toileting at regular intervals. Kegel exercise is a technique that is done to strengthen the pelvic floor muscles.

A patient reports feeling as if their bladder is always full, requiring frequent trips to the bathroom. The patient also reports difficulty starting their urine stream and a weak urine flow. After a postvoiding catheterization obtained 250 mL of urine, the patient was diagnosed with chronic urinary retention. Which clinical therapy should the nurse anticipate being ordered? Urethral dilation Radiation therapy Lithotripsy A vaginal device

Urethral dilation Urethral dilation is often performed to aid in complete emptying of the bladder. Radiation therapy is used to treat cancers of the urinary system. Lithotripsy is used to reduce kidney stones. Vaginal devices are used to prevent the involuntary leakage of urine.

The nurse notes in the medical record that the patient's incontinence is related to an overactive detrusor muscle. Which type of urinary incontinence should the nurse suspect the patient is experiencing? Urge Stress Overflow Functional

Urge Urge incontinence is related to an overactive detrusor muscle, which increases bladder pressure. Stress incontinence is related to pelvic muscle relaxation and a weak urethra and surrounding tissues, which cause decreased urethral resistance. Overflow incontinence is related to a lack of normal detrusor muscle function, which causes the bladder to overfill and increases bladder pressure. Functional incontinence is related to the inability to respond to the need to urinate.

The nurse is caring for a patient with urinary incontinence related to a urinary tract infection. Which diagnostic test would indicate if a urinary tract infection is contributing to urinary incontinence? Answer Urinalysis Bladder diary 24-hour urine sample Postvoid residual

Urinalysis Urinalysis is used to diagnose the presence of a urinary tract infection which contributes to the occurrence of urinary incontinence. A bladder diary helps to diagnose the patient's type of incontinence. A 24-hour urine sample provides information on kidney and bladder function. Postvoid residual reveals retention of urine for further investigation of cause

Which factor should the nurse consider as a contributing cause of urinary incontinence in older adult patients? Impaired mobility Urine concentration Internal sphincter Micturition

Urinary incontinence in the older adult may be caused by impaired mobility, impaired vision, dementia, and lack of access to toileting facilities and privacy. Urine concentration, micturition, and the internal sphincter are not causes of urinary incontinence.

The labor and delivery nurse is caring for the postpartum mother. Which risk factor places the pregnant and postpartum female at an increased risk for urinary retention? Use of analgesia Vaginal delivery Low birth weight Short course of anesthesia

Use of analgesia Use of analgesia with childbirth is a risk factor for urinary retention. A cesarean, not vaginal, delivery, places the mother at higher risk as well as higher birth weight, and a longer operative time with anesthesia.

The home health nurse is visiting an older adult client. The nurse notices the scent of urine and the client states difficulty with urinary continence. Which intervention should the nurse​ implement? A. Assess mobility and bathroom access. B. Implement fluid restriction. C. Insert a urinary catheter. D. Suggest​ around-the-clock home care.

​A. Assess mobility and bathroom access. Rationale: In older​ age, decreased mobility contributes to urinary incontinence. A urinary catheter would be indicated for urinary retention.​ Around-the-clock care and fluid restriction are not therapeutic interventions for urinary continence.

The nurse is planning care for the client with urinary incontinence. Which goal should be included in the care​ plan? (Select all that​ apply.) A. Avoiding infection B. Preventing skin breakdown C. Exhibiting solid​ self-esteem D. Restoring a normal voiding pattern E. Performing toileting without assistive devices

​A. Avoiding infection B. Preventing skin breakdown C. Exhibiting solid​ self-esteem D. Restoring a normal voiding pattern Rationale: Avoiding​ infection, preventing skin​ breakdown, maintaining​ self-esteem, and establishing a normal voiding pattern are all goals in the care of the client with urinary incontinence. Assistive devices may be necessary to help​ voiding, particularly with​ mobility, so toileting with a device may not be a goal of care in all scenarios.

The nurse case manager is preparing a client for discharge. The client has been successfully taught​ self-catheterization for urinary retention related to neurogenic bladder. Which other collaborative partner does the nurse​ involve? (Select all that​ apply.) A. Family B. Ostomy nurse C. Home health aides D. Infection control nurse E. Home health medical device delivery

​A. Family D. Infection control nurse E. Home health medical device delivery Rationale: The client who is performing​ self-catheterization at home could use the support of​ family, education from an infection control nurse to prevent​ UTI, and home health delivery of catheter devices. An ostomy nurse is not​ needed, because there is no​ wound, and there is no indication of need for a home health aide.

Which risk factor should the nurse assess in a client with bladder​ incontinence? (Select all that​ apply.) A. Obesity B. Depression C. Eating a​ high-fiber diet D. Medications that affect the adrenergic system E. Two or more urinary tract infections​ (UTIs) per year

​A. Obesity B. Depression D. Medications that affect the adrenergic system E. Two or more urinary tract infections​ (UTIs) per year Rationale: Risk factors for urinary incontinence include two or more UTIs per​ year, medications that affect the adrenergic​ systems, depression, and obesity. Clients should eat a​ high-fiber diet to prevent​ constipation, which is a risk factor for incontinence.

The acute care nurse is caring for a client with urine retention requiring urinary catheterization. Which is the purpose of including the collaborative partner of the infection control nurse in the care of this​ client? A. To prevent infection that is related to the urinary catheter B. To assist with mobility with the catheter in place C. To address wound care D. To interpret diagnostic testing

​A. To prevent infection that is related to the urinary catheter Rationale: The infection control nurse would assist with infection prevention related to placement and care of the urinary catheter. The ostomy nurse would assist with wound care. The occupational therapist can assist the client with mobility. The radiologist interprets imaging as a diagnostic tool.

The nurse is caring for a client with urinary retention. Which action should the nurse include to promote normal​ voiding? (Select all that​ apply.) A. Using a sitz bath B. Providing privacy C. Turning the sink on to run water D. Running cool water over the perineum E. Lying the client in bed flat to use the bedpan

​A. Using a sitz bath B. Providing privacy C. Turning the sink on to run water Rationale: A sitz​ bath, privacy, and running water all promote normal voiding. Running warm​ water, not cool​ water, over the perineum promotes voiding. Lying flat is not a normal position for​ voiding, so it does not promote voiding.

Study Plan 5-2.4.1 The nurse is caring for a client diagnosed with urinary incontinence. Which client statement supports the nursing diagnosis of Social Isolation​? ​(Select all that​ apply.) (NANDA-I​ © 2014) A. ​"When I leave​ home, I worry that I​ can't find a bathroom in​ time." B. ​"I have discovered a brand of absorbent undergarments that fit​ well." C. ​"I have found ways to disguise the smell of urine while I am out of the​ house." D. ​"I am so embarrassed when I wet myself. Even when I use absorbent​ pads, I feel like I smell of​ urine." E. ​"I time my diuretic for early in the​ day, so I can leave home later in the day and not have to visit the bathroom as​ often."

​A. ​"When I leave​ home, I worry that I​ can't find a bathroom in​ time." D. ​"I am so embarrassed when I wet myself. Even when I use absorbent​ pads, I feel like I smell of​ urine." Rationale: Embarrassment and odor and the fear of not being able to find a bathroom in time can lead to social isolation. Seeking out and using absorbent​ products, use of odor​ eliminators, and scheduling diuretics to provide adequate time to make frequent trips to the bathroom are coping strategies that a client may use to continue to participate in normal social activities.

The nurse notices that the urine output of a client is low during the​ 8-hour shift, and the client complains of lower abdominal discomfort. A bladder scan confirms urinary retention. Which collaborative member of the healthcare team should the nurse include to investigate the cause of this urinary​ retention? A. An occupational therapist B. A pharmacist C. An infection control nurse D. An ostomy nurse

​B. A pharmacist Rationale: The pharmacist and nurse can collaborate on medication review to determine if medication is contributing to changes in the urinary system. The ostomy nurse would be helpful with wound​ care, and the infection control nurse would assist with infection prevention. Occupational therapy can assist with adaptive techniques for mobility and daily living.

The mother of a​ 3-year-old child is concerned about continued urinary incontinence of the child at night and asks the nurse what she should do. Which information should the nurse include in teaching this​ mother? A. Control of the bladder during the night should have been accomplished by now. B. Control of the bladder during the night will follow control of the bladder during the day. C. Control of the bladder during the night will not occur until after the age of 5. D. Control of the bladder during the night is related to fluid intake during the day.

​B. Control of the bladder during the night will follow control of the bladder during the day. Rationale: Control of the bladder during the night will follow control of the bladder during the day between the ages of 2 and 5. Control of the bladder during the night is related to maturation of the muscles.

The nurse is caring for a female client who complains of urine leakage when lifting moderate to heavy items at home. Which intervention should the nurse recommend to the​ client? A. Yoga B. Pelvic floor exercises C. Walking around the block daily D. Abdominal crunches

​B. Pelvic floor exercises Rationale: This client is experiencing urinary incontinence that may be reduced through the strengthening of the pelvic floor muscles with pelvic floor exercises.​ Yoga, abdominal​ exercises, and walking are all good for general health but do not directly help reduce incontinence.

Which nursing intervention would be appropriate for a client with urinary​ retention? (Select all that​ apply.) A. Increasing fluid intake B. Reviewing medications C. Inserting a vaginal device D. Using the Credé maneuver E. Inserting a urinary catheter

​B. Reviewing medications D. Using the Credé maneuver E. Inserting a urinary catheter Rationale: A review of medications for those that may cause urinary retention and use of the Credémaneuver or a urinary catheter all contribute to treatment of urinary retention. Increasing fluid intake would be indicated for a urinary tract infection. Insertion of a vaginal device is indicated for urinary​ incontinence, not urinary retention.

The nurse is assessing a client who complains of urine leakage when laughing or coughing. Which urinary disorder should the nurse​ suspect? A. Retention B. Polyuria C. Incontinence D. Oliguria

​C. Incontinence Rationale: The clinical manifestation of urinary incontinence is uncontrolled leakage of urine. Oliguria is a decrease in urine​ production, and polyuria is an increase in urine production. Urinary retention is the failure to empty the bladder.

The nurse caring for a client with incontinence should consider the client at risk for low​ self-esteem and social isolation for which​ reason? A. It is the result of​ self-care deficits in toileting. B. It results in institutionalization. C. It is considered socially unacceptable. D. It requires new​ self-care skills to manage.

​C. It is considered socially unacceptable. Rationale: Urinary incontinence is considered socially unacceptable.​ Therefore, it can be physically and emotionally distressing.​ Oftentimes, the client is embarrassed about dribbling or having an accident and may therefore restrict normal activities.

The nurse is preparing health education for men about urinary retention and urinary incontinence. Which statement should the nurse​ include? A. ​"Urinary incontinence and retention are indications of kidney​ failure." B. ​"Urinary retention in more common in women than it is in​ men." C. ​"Urinary incontinence is often associated with treatment for prostate​ enlargement." D. ​"Urinary incontinence is less common than is urinary​ retention."

​C. ​"Urinary incontinence is often associated with treatment for prostate​ enlargement." Rationale: More than half of men over 60 report urinary incontinence with treatment of prostate enlargement. Urinary retention is more common in men than it is in women and less common than is urinary incontinence. Urinary retention and incontinence are often associated with prostate issues in the​ male, not kidney​ failure, which may manifest as oliguria or anuria.

A client who has experienced a stroke is struggling with urinary continence due to difficulty with manipulating clothing at the toilet. Which collaborative team member would benefit this​ client's management of​ incontinence? A. An ostomy nurse B. A radiologist C. An infection control nurse D. An occupational therapist

​D. An occupational therapist Rationale: The occupational therapist can assist the client with fine motor​ skills, mobility, and adaptive devices with clothing to help prevent urinary incontinence. The ostomy nurse would assist with wound care. The infection control nurse would assist with infection prevention. The radiologist interprets imaging as a diagnostic tool.

The nurse is caring for a newborn infant who has not yet voided in the first 48 hours of life. Which action should the nurse​ take? A. Wait another 24 hours. B. Initiate IV fluid therapy. C. Insert a urinary catheter. D. Assess for bladder distention.

​D. Assess for bladder distention. Rationale: Bladder distention should be assessed in the newborn who has not yet voided in the first 48 hours of life. Actions should also include notifying the healthcare provider and assessing fluid​ status, not waiting another 24 hours. IV fluid and urinary catheterization would not be initiated without healthcare provider orders.