Prep U Chapter 59
The nurse is caring for a client recently diagnosed with renal calculi. The nurse should instruct the client to increase fluid intake to a level where the client produces at least how much urine each day?
2,000 mL
Which medication may be ordered to relieve discomfort associated with a UTI?
Phenazopyridine
Which medication may be ordered to relieve discomfort associated with a urinary tract infection?
Phenazopyridine
A client being treated in the hospital has been experiencing occasional urinary retention. What is the best nursing action?
Provide privacy for the client.
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
The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?
Change the wafer and pouch.
A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?
Cipro
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?
Assessing present voiding patterns
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."
A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report?
"When did you last urinate?"
A client who was involved in an MVA which resulted in paraplegia is working toward living at home. The client is currently developing an individualized CIC schedule, preferring not to wear a leg bag. What is the maximum amount of urine the client should allow to collect before catheterization?
350 mL
A nurse on a busy medical unit provides care for many clients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which client?
A client who has Alzheimer disease and who is acutely agitated
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?
Maintain skin and stoma integrity
The nurse is caring for the client following surgery for a urinary diversion. The client refuses to look at the stoma or participate in its care. The nurse formulates a nursing diagnosis of:
Disturbed body image
A client has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this client's high risk for urinary retention and should implement what intervention in the client's plan of care?
Double voiding
Which instruction would be included in a teaching plan for a client diagnosed with a UTI?
Drink liberal amount of fluids.
A female client has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this client?
Drink liberal amounts of fluids.
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.
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 has just undergone a urinary diversion procedure. What management issues related specifically to urinary diversion would be included in this client's care plan? Select all that apply.
Maintain renal function. Observe for leakage of urine or stool from the anastomosis. Assess for signs and symptoms of peritonitis.
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.
A client with a recent history of nephrolithiasis has presented to the ED. After determining that the client's cardiopulmonary status is stable, what aspect of care should the nurse prioritize?
Pain management
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?
Perform meticulous perineal care daily with soap and water
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Pyridium
A client with a sacral pressure ulcer has had a urinary catheter inserted. As a result of this new intervention, the nurse should prioritize what nursing diagnosis in the client's plan of care?
Risk for infection related to presence of an indwelling urinary catheter
A client has just been diagnosed with acute pyelonephritis. What education would the nurse offer this client regarding fluids?
Significantly increase fluid intake.
The nurse who is leading a wellness workshop has been asked about actions to reduce the risk of bladder cancer. What health promotion action most directly addresses a major risk factor for bladder cancer?
Smoking cessation
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
Stress
A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?
Stress incontinence
A patient informs the nurse that every time she sneezes or coughs, she urinates in her pants. What type of incontinence does the nurse recognize the patient is experiencing?
Stress incontinence
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 who has recently undergone ESWL for the treatment of renal calculi has phoned the urology unit where he was treated, telling the nurse that he has a temperature of 101.1ºF (38.4ºC). How should the nurse best respond to the client?
Tell the client to report to the ED for further assessment.
A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic?
The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy
A client regularly recognizes the sensation of needing to void but cannot control voiding in time to reach a toilet. How would the nurse document this type of incontinence?
Urge
A nurse's colleague has applied an incontinence pad to an older adult client who has experienced occasional episodes of functional incontinence. What principle should guide the nurse's management of urinary incontinence in older adults?
Urinary incontinence is not considered a normal consequence of aging.
Which statement describing urinary incontinence in an older adult client is true?
Urinary incontinence isn't a disease.
A client has a history of neurogenic bladder and uses a permanent, indwelling catheter to facilitate urine elimination. What contributes to the likelihood of developing urinary tract or bladder infections? Select all that apply.
indwelling catheter decreased fluid intake
A client has a suspected bladder tumor. What is the most common first symptom of a malignant tumor of the bladder?
painless hematuria
A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is:
placement of small amounts of collagen in urethral walls to aid the closing pressure.
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
Nursing management of the client with a urinary tract infection should include:
Discouraging caffeine intake
An adult client has been hospitalized with pyelonephritis. The nurse's review of the client's intake and output records reveals that the client has been consuming between 3 L and 3.5 L of oral fluid each day since admission. How should the nurse best respond to this finding?
Encourage the client to continue this pattern of fluid intake.
The nurse is caring for a client who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurse's assessment reveals that the stoma is a dark purplish color. What is the nurse's most appropriate response?
Inform the primary provider that the vascular supply may be compromised.
The nurse and urologist have both been unsuccessful in catheterizing a client with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the health care provider to use to drain the client's bladder?
Insertion of a suprapubic catheter
A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?
Painless, gross hematuria
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. Assist the patients with frequent toileting. Provide careful perineal care.
The nurse is working with a client whose health history includes occasional episodes of urinary retention. What assessment finding would suggest that the client is currently retaining urine?
The client's suprapubic region is dull on percussion.
A nurse is caring for a female client whose urinary retention has not responded to conservative treatment. When educating this client about self-catheterization, the nurse should encourage what practice?
Using clean technique at home to catheterize
A client who has had a urinary diversion procedure is going to be discharged. What information would the nurse include when instructing the client on care of the stoma and collection pouch? Select all that apply.
When changing the adhesive wafer (to which the urostomy collection bag is attached), remove all remaining adhesive before applying a new wafer. Wash the urinary collection pouch thoroughly after changing. Drain the continent urostomy four times a day or as directed by the physician.
The nurse needs to assess the fluid volume status of a client with chronic glomerulonephritis. To accurately assess the client's fluid volume status, the nurse should weigh the client daily:
at the same time, on the same scale, with similar clothing.
A client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. The catheter would be clamped and unclamped to:
promote normal bladder function.
