nur 116 - Davis Advantage / Edge - Bladder Incontinence

A patient with urge incontinence is treated with high doses of antispasmodics. Which action of the nurse is beneficial to the patient? Administer pessaries. Advise the patient to perform reflex voiding. Provide intermittent catheterization. Instruct the patient to avoid fluid intake 1 hour before sleep.

Provide intermittent catheterization. Rationale: Antispasmodics may cause a paralysis of the detrusor muscles. Because of this condition, urinary retention may occur. In such situations an intermittent catheter is helpful to the patient. Test Taking Tips: Understand treatments that can be used besides medications.

Which diagnostic test is most appropriate to determine the presence of urinary incontinence in pregnant women? Ultrasound testing Intravenous pyelogram Voiding cystourethrogram Kidney ureter bladder X-rays

Ultrasound testing Rationale: Ultrasound testing is recommended for pregnant women because of the lack of exposure to radiation. Test Taking Tips: Understand safety risks.

A client presents to the clinic after experiencing a strong need to urinate followed by uncontrolled leakage of urine. The nurse suspects the client will be diagnosed with which type of urinary incontinence? Stress incontinence Urge incontinence Functional incontinence Overflow incontinence

Urge incontinence

An older female client tells the nurse she has been experiencing new onset urinary incontinence. What is the nurse's best response? "That is not a part of the aging process." "Underpads are available to protect your clothing." "Please tell me about your symptoms." "There are surgical repair options available to help."

"Please tell me about your symptoms."

A client has suffered a spinal cord injury. Which urinary incontinence does the nurse anticipate the client will experience? Stress Urge Overflow Functional Submit

Overflow

A female with incontinence has this device placed. What is this device? Clean intermittent catheter Pessary Artificial sphincter Containment device

Pessary Rationale: A pessary is a device that fits into the vagina to support the bladder in an attempt to control incontinence and support bladder emptying. Test Taking Tips: Look closely at images.

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Stress Incontinence Childbirth Postmenopausal smoking Caffeine Artificial sweeteners Occurs with coughing Treated by teaching Kegel exercises Treated by fluid control

Childbirth Postmenopausal smoking Occurs with coughing Treated by teaching Kegel exercises CORRECT. Three primary risk factors for stress incontinence include childbirth, which causes stretching and relaxing of the pelvic floor muscles, ligaments, and urethra; postmenopausal smoking; and obesity. This type of incontinence occurs when abdominal pressure increases with laughing, coughing, lifting, or exercise. Nonsurgical treatment measures for stress incontinence include Kegel exercises. Caffeine and artificial sweeteners are bladder irritants associated with urge incontinence. Fluid control is a nonsurgical treatment measure for urge incontinence.

Which drug is used to treat mixed urge and stress incontinence? Ditropan Doxazosin Imipramine Topical estrogen

Imipramine Rationale: Imipramine is used to treat mixed stress and urge incontinence. Test Taking Tips: Differentiate medications to incontinence types.

The nurse is discharging a client with incontinence who will be performing clean intermittent catheterization. What is the best way for the nurse to confirm the client understands the discharge instructions? Have him or her verbalize back what is taught Have the client write out each step of the process Have him or her teach a family member what needs to occur Have him or her provide a return demonstration

Have him or her verbalize back what is taught

When teaching a client about irritants that may aggravate urinary incontinence, the nurse should include which substances? Select all that apply. Caffeine Alcohol Gluten Acidic foods Carbonated beverages

Caffeine Alcohol Acidic foods Carbonated beverages

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Functional Incontinence Causes frequent urination Causes a loss of urine in inappropriate places Caused by an inability to communicate toileting needs Caused by neurological conditions Caused by an enlarged prostate Implement timed toileting in the plan of care Administer prescribed alpha-adrenergic medications

Causes a loss of urine in inappropriate places Caused by an inability to communicate toileting needs Implement timed toileting in the plan of care CORRECT. A patient who is diagnosed with functional incontinence has an inability to get to the toilet independently or to communicate his or her need to use the toilet. This leads to a loss of urine in inappropriate places. You should include timed toileting in the patient's plan of care. Overflow incontinence is caused by neurological conditions or an enlarged prostate and causes frequent urination. Alpha-adrenergic medications are not used to treat functional incontinence.

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Urge Incontinence Nicotine Postmenopausal obesity Strong urge to urinate Uncontrolled leakage of urine More common in women Treated with systemic estrogen Teach patient to eliminate bladder irritants

Nicotine Strong urge to urinate Uncontrolled leakage of urine Teach patient to eliminate bladder irritants CORRECT. Urge incontinence is characterized by a strong urge to urinate followed by uncontrolled leakage of urine. This type of incontinence is often caused by bladder irritants such as nicotine, caffeine, and artificial sweeteners. Eliminating these irritants is the primary treatment modality. Postmenopausal obesity is a cause or risk factor for stress incontinence, which is more common in women and treated with systemic estrogen.

A client presents to the clinic with new onset urinary incontinence. While determining treatment options, which of the following is priority? Making sure the client gets to the bathroom Educating about the increasing incidence of incontinence with age Preventing skin breakdown and controlling odor Educating about pelvic floor exercises

Preventing skin breakdown and controlling odor

The nurse is preparing to teach a client about interventions to help with functional incontinence. Which intervention should be included in the teaching? Timed toileting Take alpha adrenergic medication Clean intermittent catheterization Fluid restriction

Timed toileting

The nurse is reviewing the results of a urinalysis on a client presenting for urinary incontinence. Which findings on the urinalysis may indicate infection? Select all that apply. Glucose White blood cells Nitrates Ketones Hematuria

White blood cells Nitrates Hematuria

A patient is undergoing treatment for stress incontinence. Which instruction provided by the nurse is most appropriate to manage this condition? "Avoid coffee and cigarettes." "Use diapers while traveling." "Practice pelvic floor exercises regularly." "Avoid taking large amount of fluids at once."

"Practice pelvic floor exercises regularly." Rationale: Pelvic floor exercises such as Kegel exercises should be practiced to manage stress incontinence because they help to improve the strength of the pelvic floor muscles. Test Taking Tips: Understanding the types of incontinence can help to determine the best answer.

A patient is diagnosed with urinary urge incontinence from an overactive bladder. Which treatment strategies are most likely to be beneficial to the patient? Select all that apply. Anticholinergics Systemic estrogen Bladder neck suspension Augmentation cystoplasty Alpha-adrenergic blocking agents

Anticholinergics Augmentation cystoplasty Rationale: Anticholinergics or antispasmodics are used to treat urinary incontinence. They act by blocking nervous stimulation from the parasympathetic nervous system in order to control bladder muscle contractions. Rationale: Augmentation cystoplasty is a surgical intervention used to treat urinary urge incontinence from bladder contractions. Test Taking Tips: Differentiate types of urinary incontinence.

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Overflow Incontinence Caused by spinal cord injury (SCI) Caused by an inability to get to a toilet Causes frequent urination Causes a strong urge to urinate followed by leakage of urine Causes a loss of urine in inappropriate places Treatment includes the use of alpha-adrenergic medications Treatment includes the use of antispasmodic medications

Caused by spinal cord injury (SCI) Causes frequent urination Treatment includes the use of alpha-adrenergic medications CORRECT. Overflow incontinence is triggered by a flaccid bladder caused by SCI. Other causes include stroke, diabetes, and neurological diseases. The primary clinical manifestation associated with overflow incontinence is frequent urination. Overflow incontinence is treated with alpha-adrenergic medications. Functional incontinence is caused by an inability to get to a toilet and may lead to loss of urine in inappropriate places. Urge incontinence is associated with a strong urge to urinate followed by the leakage of urine and is treated with antispasmodic medications.

A mother of three states she experiences urinary leakage when coughing or sneezing. Which intervention is most appropriate for the nurse to suggest first? Clean intermittent catheterization Anticholinergic medication Restrict oral fluid intake Kegel exercises

Kegel exercises

Which describes the action of antispasmodics in treating urinary incontinence? Select all that apply. Promote urethral relaxation Promote bladder relaxation Restore moisture of the urethra Promote the action of anticholinergics Block impulses from the parasympathetic nervous system

Promote bladder relaxation Block impulses from the parasympathetic nervous system Rationale: Antispasmodics help in relaxing and controlling the bladder. Rationale: Antispasmodics block impulses from the parasympathetic nervous system. Test Taking Tips: Understand medications.

A patient with a urinary tract infection also has a history of incontinence. The provider orders a cystourethrogram, which notes the presence of the backflow of urine. Which treatment strategy is most likely to benefit the patient? Administer antispasmodics. Advise to administer a pessary. Advise to perform Kegel exercises. Provide clean intermittent catheterization

Provide clean intermittent catheterization Rationale: Because the patient has a backflow of urine, intermittent catheterization should be used to provide complete emptying of the bladder and prevent the infection from spreading into the upper urinary system. Test Taking Tips: Know the differences in treatment plans.

Which patient's condition can be treated with artificial urinary sphincter surgery? Total incontinence Stress incontinence Reflex incontinence Instability incontinence

Stress incontinence Rationale: Artificial urinary sphincter surgery is indicated in a patient with stress incontinence. Test Taking Tips: Surgical management is sometimes needed.

Can you differentiate the causes, risk factors, clinical manifestations, and treatment options for types of bladder incontinence? Mixed Incontinence Associated with a flaccid, enlarged bladder caused by an enlarged prostate Strong urge to urinate followed by uncontrolled leakage of urine Occurs with laughing or coughing Causes frequent urination Caused by postmenopausal smoking and obesity Include timed toileting in care plan

Strong urge to urinate followed by uncontrolled leakage of urine Occurs with laughing or coughing Caused by postmenopausal smoking and obesity CORRECT. Mixed incontinence is a combination of stress and urge incontinence. Clinical manifestations include a strong urge to urinate followed by uncontrolled leakage of urine, along with incontinence that occurs with activities that increase abdominal pressure, such as laughing or coughing. Mixed incontinence has the same causes as stress and urge incontinence, including postmenopausal smoking and obesity. Overflow incontinence is associated with a flaccid, enlarged bladder. Timed toileting is an appropriate intervention for the patient diagnosed with functional incontinence.

A perimenopausal female patient reports urine leakage while laughing and coughing. Which medication is most likely to benefit the patient? Trospium Oxybutynin Darifenacin Systemic estrogen

Systemic estrogen Rationale: Stress incontinence is more common in women; it occurs when abdominal pressure increases, especially during laughing, coughing, or exercising. Patients with this type of incontinence are prescribed systemic estrogen to restore moisture and flexibility of the urethra. Test Taking Tips: Determine the type of incontinence the patient has based on the conditions mentioned. This may help you answer the question.

Topical estrogen has been prescribed for a client experiencing urinary incontinence. The nurse should tell the client that the medication has been prescribed for which purpose? To block impulses in the nervous system to control the bladder To promote anti-cholinergic actions inhibiting parasympathetic activity To promote urethral relaxation to aid with urinary retention To help restore tone of the urethra and vaginal areas

To help restore tone of the urethra and vaginal areas