Prep U's - Chapter 37 - Urinary Elimination
Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? A. 24-hour specimen B. random specimen C. clean-catch specimen D. intermittent specimen
Answer: A Rationale: A 24-hour urine specimen is required for accurate measurement of the kidney's excretion of substances that the kidney does not excrete at the same rate throughout the day. A clean-catch or midstream-voided specimen is used when a specimen relatively free from microorganisms is required. Random urine specimen collection is used when sterile urine is not required.
The nurse is choosing a collection device to collect urine from a Non ambulatory male client. What would be the nurse's best choice? A. urinal B. specimen hat C. large urine collection bag D. bedpan
Answer: A Rationale: A urinal is the best choice to collect urine from a nonambulatory male client. If the client is on strict bed rest or confined to bed due to weakness or disability. the client must be positioned in bed in as close to an upright position as feasible. In most instances, the client is able to place and hold the urinal himself. If he is unable to do so, the nurse should hold the urinal in place while the client urinates or place the urinal and leave the client alone for a few moments. A bedpan is not the best choice for a male client who tend to prefer the bottle-like shape of the urinal, although female clients tend to prefer the shape of a bedpan. A specimen hat is for a commode. A large urine collection bag would be used with an indwelling catheter.
A nurse is preparing a discharge teaching plan for a client being sent home with a peritoneal dialysis catheter in place. Which guideline should be included in the instructions? A. The client should avoid wearing tight clothes or belts near the site. B. The client may bathe rather than shower, provided the site is covered with gauze. C. A dressing should always be worn over the site to avoid leaking. D. Sterile technique must be observed by the client in the home setting.
Answer: A Rationale: Clients should avoid baths and public pools as well as wearing tight clothes and belts around the exit site. Once the site is healed, some health care providers do not require clients to wear a dressing unless the site is leaking. Clean technique is sometimes allowed in the home.
A client reports frequently experiencing urine loss when moving from the wheelchair to bed. Which type of incontinence does the nurse anticipate? A. functional B. urge C. reflex D. total
Answer: A Rationale: Functional incontinence takes place when attempting to overcome obstacles, such as transferring from the wheelchair to the bed. Urge incontinence takes place when there is a delay in accessing a toilet. Reflex incontinence takes place when a client automatically releases urine and cannot control it. Total incontinence takes place without a pattern or warning, and without client control.
A nurse is performing a client's intermittent closed catheter irrigation and realizes that the tubing was not clamped before introducing the irrigation solution. What would be the nurse's best response to this situation? A. Repeat the irrigation. B. Prepare to change the catheter. C. Wait 1 hour and repeat the irrigation. D. Notify the primary care provider promptly.
Answer: A Rationale: If the tubing was not clamped before introducing the irrigation solution, the nurse should repeat the irrigation. If the tubing is not clamped, the irrigation solution will drain into the urinary drainage bag and not enter the catheter. There is no immediate need to contact the primary care provider or to change the catheter.
The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle exercises (Kegel exercises) will the nurse include? A. Keep muscles contracted for at least 10 seconds. B. Relax muscles for at least 5 minutes between Kegels. C. Perform these exercises two times daily for a week. D. Loosen the internal muscles used to prevent or interrupt urination.
Answer: A Rationale: Kegel exercises should be performed by tightening the internal muscles used to prevent or interrupt urination for 10 seconds, followed by a period of 10 seconds of relaxation. The client should be instructed to perform this regimen 3-4 times daily for 2 weeks to 1 month.
A client's BUN test results are significantly elevated. When reviewing the client's history, which finding is consistent with BUN elevation other than renal compromise? A. The client is dehydrated. B. The client is on a low protein diet. C. The client is lactose intolerant. D. The client has a history of osteoarthritis.
Answer: A Rationale: The BUN test measures the amount of urea nitrogen in the blood. Urea, the major nitrogenous end-waste product of metabolism, is formed in the liver. The bloodstream carries urea from the liver to the kidneys for excretion. When the kidneys are diseased, they are unable to excrete urea adequately, and urea begins to accumulate in the blood, causing BUN to rise. Normal BUN is 8 to 25 mg/100 mL. Because other factors, such as high dietary intake of protein, fluid deficit, infection, gout, or excessive breakdown of protein stores, can also elevate BUN, it is not a highly sensitive indicator of impaired renal function.
The nurse is caring for a client who has dark amber, strongly aromatic urine with nausea and vomiting. Which condition does the nurse anticipate? A. balanced fluids B. kidney injury C. hypovolemia D. dehydration
Answer: A Rationale: The nurse anticipates that the client may be dehydrated, which is characterized by strongly aromatic, dark amber urine. The symptoms are not associated with hypovolemia, balanced fluids, nor kidney injury.
The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately? A. Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well. B. Cleansed access port with warm soap and water, syringe attached and aspirated 10 mL of urine and placed in specimen container. C. Obtained urine specimen from urinary drainage bag using a syringe, client expressed no discomfort during or after the procedure, verified prescription and cleansed access port. D. Gathered supplies, checked prescription, collected urine from access port and notified health care provider at the completion of the procedure.
Answer: A Rationale: The nurse would ensure prescription is obtained, explain procedure to the client, use an antiseptic swab to cleanse the access port, then attach syringe and aspirate urine into the syringe. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. Always observe sterile technique while collecting a urine specimen from an indwelling catheter. Gather equipment, including a syringe, an antiseptic swab, a sterile specimen container, nonsterile gloves, and only tube tubing if needed; remember to unclamp the catheter after obtaining specimen to avoid reflux of urine into bladder.
While providing care to a client admitted to the health care facility, the client states that she has "a burning sensation when urinating." After further questioning, the nurse inspects the client's perineal area. Which sign/symptom would the nurse document as an abnormal finding? A. Reddened perineal skin. B. Presence of smegma. C. Moist perineal skin. D. Absence of discharge.
Answer: A Rationale: The presence of reddened perineal skin is an abnormal finding. The healthy skin should be moist and noninflamed with no discharge present. Smegma (an accumulation of white, odorous secretions from sebaceous glands found under the labia minora in women and under the foreskin in men) is considered a normal finding.
A nurse is assessing the freshly voided urine of a client. What characteristics of the urine would indicate a urinary problem? Select all that apply. A. The urine is cloudy. B. The urine is translucent. C. There is pus in the urine. D. The urine pH is 6.0. E. The urine smells like ammonia. F. The urine is amber colored.
Answer: A, C, E Rationale: The urine specimen that would indicate a urinary problem would possibly smell like ammonia, have pus visible in the sample, and be cloudy in nature. A normal urine sample would be amber colored, translucent, and have a pH around 6.0.
A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance? A. Foley catheter. B. intermittent urethral catheter. C. indwelling urethral catheter. D. retention catheter.
Answer: B Rationale: An intermittent urethral catheter (straight catheter) is a catheter inserted through the urethra into the bladder to drain urine for a short period of time (5 to 10 minutes). With an indwelling urethral catheter (retention or Foley catheters), a catheter (tube) is inserted through the urethra into the bladder for continuous drainage of urine; a balloon is then inflated to ensure that the catheter remains in the bladder once it is inserted.
A client in a long-term care facility becomes confused and disoriented at night and is incontinent during these periods of confusion due to the inability to find the commode. During the day, the client does not experience confusion and is continent. What type of incontinence is this client experiencing during the nighttime hours? A. transient incontinence B. functional incontinence C. reflex incontinence D. stress incontinence
Answer: B Rationale: Functional incontinence is urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, or loss of memory or disorientation. Stress incontinence occurs when there is an involuntary loss of urine related to an increase in intra-abdominal pressure. Reflex incontinence is an emptying of the bladder without the sensation to void. Transient incontinence appears suddenly and lasts for 6 months or less.
The nurse is caring for a client with a history of renal insufficiency and type 2 diabetes. Which prescription, if noted in the client's chart, would alert the nurse to discuss with the health care practitioner? A. Urine dipstick four times a day. B. Gentamicin 70 mg intramuscular (IM) every 8 hours. C. Blueberry juice 10 oz by mouth (PO) daily. D. Encourage fluids intake - 2 to 3 L per day.
Answer: B Rationale: Gentamicin is known to be nephrotoxic, so the nurse will check with the health care practitioner before administering it. Because glucose acts as an excellent medium for bacteria to grow, a client with diabetes would be monitored for spillage of glucose using a dipstick. Blueberry juice is given to inhibit bacteria from adhering to the urinary bladder. Fluids are encouraged to help flush the renal system.
The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate? A. Ask the client to bear down until the catheter is expelled. B. Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter. C. Remove the catheter from the vagina and attempt to insert it into the bladder. D. Immediately remove the catheter from the vagina, contact the health care provider, and anticipate a prescription for prophylactic antibiotics.
Answer: B Rationale: Leaving the catheter in place as a marker assists in the correct placement of the second catheter into the bladder. It is not necessary to contact the health care provider. The vagina is not sterile, so insertion of a sterile catheter poses little risk for infection. Asking the client to bear down is not necessary because the catheter is not typically completely inserted. Removing the catheter from the vagina and attempting to insert it into the bladder will cause cross-contamination.
A nurse is the guest speaker at a women's club. Most of the women are older than 40 years of age and have asked the nurse to speak about health promotion topics. The nurse states that exercises may help with urinary urgency. Which exercise instruction will the nurse provide to the women? A. Lie on the floor, raise, then lower your legs 20 times per day. B. Contract the pubic muscles for 3 seconds, then relax. C. Squat down and then jump up to a standing position. D. Contract abdominal muscles 10 times per day.
Answer: B Rationale: Pelvic floor exercises, or Kegel exercises, strengthen the pubococcygeal muscles and effectively promote urinary control. The nurse should inform the women to locate the muscles used to start and stop urinating. Then contract those muscles and relax them repeatedly. Strengthening the abdominal muscles will not help with urinary control. Squatting, jumping, and performing leg lifts will help to strengthen the quadriceps and hamstrings.
A 70-year-old client who has four children and six grandchildren states that she "wets" herself when she sneezes or laughs. She reports that sometimes this also occurs when rising from a sitting to standing position. Which type of incontinence does the nurse anticipate? A. total B. stress C. reflect D. urge
Answer: B Rationale: Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Other types of incontinence have different causative factors.
The nurse is caring for a client who reports burning upon urination, and an ongoing sense of needing to urinate. Which urine characteristics does the nurse anticipate? A. light yellow, clear B. cloudy, foul odor C. clear, dark amber D. strongly aromatic, amber
Answer: B Rationale: The nurse anticipates that the client has an infection, which is characterized by cloudy, foul-smelling urine. Urine is normally light yellow and clear. Dark amber urine that is strongly aromatic could indicate dehydration but would not create the symptoms noted.
A 70-year-old client confides to the nurse that she is "terribly embarrassed" that she has developed urinary incontinence over the past year. Which nursing response supports the client's self-esteem? A. "Let me refer you to a urologist who can help you." B. "Let's explore structuring activities and toileting breaks." C. "Don't worry, this is a normal condition for older adults." D. "It would be best just to get some adult diapers."
Answer: B Rationale: The nurse will promote the client's self-esteem by exploring ways in which the client can verbalize feelings, maintain dignity, and become empowered to participate in self-care. Telling the client to get adult undergarments (referring to these as "diapers" is not therapeutic), sending her to a urologist, and telling her not to worry discounts the client's concern.
The novice nurse is assessing the urinary bladder of a client with transient urinary incontinence. The nurse mentor would intervene if which action by the novice nurse is noted? A. The novice nurse measures the height of the edge of the bladder above the symphysis pubis. B. The novice nurse asks the client to urinate before palpating the bladder. C. The novice nurse observes the lower abdominal wall for any swelling. D. The novice nurse asks the client when the last time was, he voided before palpating the bladder.
Answer: B Rationale: The urinary bladder cannot be palpated when empty, so the client should not urinate before the nurse palpates or percusses it. During data collection, the client should be asked—before the bladder is palpated—when the last voiding occurred. The height of the edge of the bladder should be measured above the symphysis pubis. The lower abdominal wall during an urinary bladder assessment is observed for any swelling.
A 57-year-old man is suffering from polyuria. What can cause polyuria? A. renal disease B. diabetes insipidus C. urinary tract infection D. renal calculi
Answer: B Rationale: Untreated diabetes insipidus can cause an increase in the formation and excretion of urine without a concurrent increase in fluid intake. Renal disease often leads to oliguria and even anuria, a decrease in urine outputs. Urinary tract infections cause an increase in frequency but not necessarily an increase in the amount of urine that is produced. Renal calculi can cause hematuria.
A client reports an episode of losing control of urination when a bathroom was not close by. The client states, "I am worried this means that I am starting to lose control of my bladder." What is the appropriate nursing response? A. "I agree; please make an appointment with your health care provider." B. "Let's review your medication history and whether you consume bladder irritants." C. "I suggest that you invest in incontinence undergarments." D. "This only happened one time, so it's nothing to worry about."
Answer: B Rationale: Urge incontinence can be aggravated by bladder irritants, such as caffeine or alcohol, and can take place if diuretics are taken in the morning. The nurse will start by reviewing these factors. The nurse should not discount this as an isolated event without further assessment. It is too soon to refer the client to the health care provider or to recommend incontinence undergarments.
A female client is diagnosed with recurrent urinary tract infections (UTIs) and the nurse is providing education about preventative methods. What information is important for the nurse to give to the client to prevent another UTI? Select all that apply. A. Dry the perineal area after urination or defecation from the back to the front. B. Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse. C. Avoid clothing that is tight and restrictive on the lower half of the body. D. Wear underwear with a cotton crotch. E. Take baths instead of showers.
Answer: B, C, D Rationale: Client education can help prevent UTI recurrence. Teaching the client about measures that promote health and decrease the severity and incidence of UTIs is a major nursing responsibility. The nurse should instruct the client to drink eight to ten 8-oz glasses (1,920 to 2,400 mL) of water daily, drink two 8-oz glasses (480 mL) of water before and after sexual intercourse, void immediately after sexual intercourse, wear underwear with a cotton crotch, and avoid clothing that is tight and restrictive on the lower half of the body. Instruction should include drying the perineal area after urination or defecation from the front to the back, or from the urethra toward the rectum, as well as taking showers instead of baths.
When collecting a urine sample from a client for examination, the nurse notes that the sample appears reddish-brown in color. What could cause this variation in color of the urine? A. infection B. dehydration C. blood D. stasis
Answer: C Rationale: A reddish-brown urine sample is indicative of the presence of blood. The urine appears dark amber in color due to dehydration. Infection and stasis would cause the urine to appear cloudy.
Which statement should the nurse convey to the mother of a 3-year-old son who has not achieved urinary continence? A. Boys may walk by 1 year and should be continent by 3 years. B. Incontinence after the age of 3 years is not normal. C. Boys may take longer for daytime continence than girls. D. Daytime continence is usually not achieved by boys until age 5.
Answer: C Rationale: Children in North American cultures usually achieve daytime urinary continence by 3 years of age; boys may take longer than girls. Nighttime continence may not occur until 4 or 5 years of age.
Which urinary care teaching will the nurse provide to a young adult female client? A. If you do not feel like voiding, still strain to make sure the bladder is empty. B. Wipe from the back to the front. C. Refrain from douching unless ordered by a health care provider. D. Drink water more frequently in the morning and evening to facilitate hydration.
Answer: C Rationale: Douching is not recommended unless ordered by the health care provider. Female clients should be taught to wipe from the urinary area towards the rectum to decrease the risk for introducing pathogens into the urethra. Straining is not appropriate. Water should be consumed throughout the day, not just in the morning and evening.
The health care provider requests an indwelling urinary catheter to be inserted into a woman who has had a total hip replacement and is on strict bed rest. When inserting the catheter, the nurse would place the client in which position? A. Dorsal recumbent B. Semi-Fowler C. Sims D. Supine
Answer: C Rationale: The Sims, or side-lying, position is especially used for clients who have limited hip mobility because it permits excellent visualization of the urinary meatus. Usually, female clients are placed in a dorsal recumbent position for catheterization, and male clients are put in a supine or semi-Fowler position.
A nurse is caring for a client with a hemodialysis access site. Which action should the nurse take? A. Measure the client's blood pressure on the arm above the access site. B. Perform venipuncture below the access site to obtain a blood sample for laboratory testing. C. Auscultate over the access site with the bell of a stethoscope, listening for a bruit or vibration. D. Administer an IV on the arm high above the access site.
Answer: C Rationale: The nurse should auscultate over the hemodialysis access site with the bell of a stethoscope, listening for a bruit or vibration, to assess the patency of the access. The nurse should not measure the client's blood pressure, perform a venipuncture, or start an IV on the access arm, as doing so could lead to infection or clotting of the graft or fistula.
A nurse who is right-handed is inserting a woman's indwelling urinary catheter. The nurse will use cotton balls and antiseptic solution to cleanse the woman's meatus and perineum. Which of the nurse's actions is most appropriate? A. Perform hand hygiene between cleansing the woman's labia and inserting the catheter. B. Insert the catheter with her left hand while supporting the woman with her right hand. C. Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted. D. Grasp a cotton ball with forceps in her left hand and spread the woman's labia with her right hand.
Answer: C Rationale: Using the thumb and one finger of the nondominant hand, the nurse should spread the client's labia and identify the meatus. The nurse should be prepared to maintain separation of labia with one hand until the catheter is inserted and urine is flowing well and continuously. The nurse does not let go of the labia to perform hand hygiene after cleansing. The catheter is inserted with the dominant hand.
The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order. A. Inflate the balloon with the correct amount of sterile saline. B. Insert the lubricated catheter into the urethra. C. Clean each labial fold, then the area directly over the meatus. D. Discard used supplies. E. Advance the catheter until there is a return of urine.
Answer: C, B, E, A, D
A nurse is preparing to measure a client's urine output. Which interventions would be of highest priority? A. Measuring the urine container at eye level. B. Using an appropriate measuring container. C. Noting the color and clarity of the urine. D. Wearing gloves when handling the urine.
Answer: D Rationale: All of these interventions would be important to ensure safety in handling the client's urine and obtaining an accurate output. However, safety with handling body fluids would be a priority for the nurse to decrease risk of exposure to pathogens or blood that may be in the client's urine.
A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance? A. retention catheter B. indwelling urethral catheter C. Foley catheter D. intermittent urethral catheter
Answer: D Rationale: An intermittent urethral catheter (straight catheter) is a catheter inserted through the urethra into the bladder to drain urine for a short period of time (5 to 10 minutes). With an indwelling urethral catheter (retention or Foley catheters), a catheter (tube) is inserted through the urethra into the bladder for continuous drainage of urine; a balloon is then inflated to ensure that the catheter remains in the bladder once it is inserted.
A client could experience increased urination when using which classification of medication? A. Analgesic medications B. Stool softeners C. Central nervous system depressants D. Cholinergic agents
Answer: D Rationale: Cholinergic agents stimulate the detrusor muscle, which causes more frequent urination. Analgesics act to relieve pain. Central nervous system depressants are medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders. Stool softeners makes bowel movements softer and easier to pass.
A client reports to the nurse that after delivering an infant, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate? A. total B. reflex C. urge D. stress
Answer: D Rationale: Stress incontinence is associated with a raise in intra-abdominal pressure related to activities such as sneezing, coughing, or laughing. Urge incontinence takes place when there is a delay in accessing a toilet. Reflex incontinence takes place when a client automatically releases urine and cannot control it. Total incontinence takes place without a pattern or warning, and without client control.
The nurse is teaching an older adult female client who must provide a urine specimen. Which is the proper method to instruct the client to use to obtain a clean-catch urine specimen? A. Catch the urine while holding the labia apart, after cleansing. Fill the specimen cup. B. Catch the urine in the cup after cleansing the perineum. C. Catch the urine while holding the labia apart, then cleanse each side of the labia with prepared aseptic swabs. D. Catch the urine while holding the labia apart, after allowing the first urine to flow into the toilet.
Answer: D Rationale: The client should first perform hand hygiene, then separate the labia minora and cleanse the perineum with commercially prepared aseptic swabs, starting in front of the urethral meatus and moving the swab toward the rectum. The client should repeat this cleansing process three times with different cotton balls or swabs, then begin to urinate while continuing to hold the labia apart. Next, the client should allow the first urine to flow into the toilet, followed by holding the specimen container under the urine stream. Then, the client should remove the specimen container, release the hand from the labia, seal the container tightly, and finish voiding. The client then performs hand hygiene again.
A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain? A. reddish-brown, clear B. clear, light yellow C. aromatic, green D. dark brown, cloudy
Answer: D Rationale: The client with advanced liver disease is expected to have dark brown or dark amber urine; infection may be represented by cloudy urine. Other answers are incorrect.
The nurse is preparing a client for a cystoscopy procedure. Which intervention would be part of the preparation for this? A. Explaining to the client that the procedure will be painful. B. Inserting a Foley catheter, the morning of the procedure. C. Maintaining the client without liquids before the procedure. D. Having the client sign a consent form for the procedure.
Answer: D Rationale: The client would sign a consent form for the procedure since it is invasive. This would be completed after the procedural health care provider had explained the purpose, risks, and benefits of the procedure. The client would not be maintained NPO (nothing by mouth) or have a catheter inserted for this procedure. The procedure is usually painless, so the client would not be told to expect pain as a normal part of the procedure.
The nurse is preparing to irrigate a Foley catheter. What is the nurse's initial action? A. Explain the procedure to the client. B. Gather equipment and supplies. C. Assess urine characteristics. D. Check electronic health record for medical order.
Answer: D Rationale: The nurse will first check for an order to irrigate the Foley catheter. The other steps can be taken after it has been confirmed that an order for irrigation exists.
A client has burning upon urination. The urinalysis indicates pyuria. Which is the next action the nurse will take? A. Instruct on proper wiping technique. B. Encourage fluids. C. Monitor vital signs. D. Contact the health care provider.
Answer: D Rationale: The term pyuria refers to the presence of pus in the urine. The nurse should first contact the health care provider, as antibiotic therapy may be necessary. Encouraging fluids, instruction on wiping technique and monitoring vital signs will follow.
The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client? A. A neurogenic bladder results from local anesthesia. B. Catheterization is necessary for 1 week. C. A urinary tract infection results from the birth process. D. The birth can cause perineal swelling.
Answer: D Rationale: Trauma from vaginal birth causes swelling in the perineal area, which can obstruct the flow of urine and cause urinary retention during the early postpartum period.
A client has been NPO. after midnight for surgery. It is 11 a.m. and the nurse has asked her to void before being transferred to the surgical suite. The nurse should expect her urine to be what color? A. tea colored B. pale yellow C. colorless D. dark amber
Answer: D Rationale: Urine may be dark amber or orange-brown if it is very concentrated secondary to a decreased fluid intake. Urine is lighter than normal if it is diluted. Foods or drugs can also alter the color of urine. Tea-colored or very dark urine is a sign of dehydration.
Which is true regarding the normal urination? A. In adults, the amount of urine voided typically does not depend on fluid intake and losses. B. In adults, the average amount of urine per void is 500 mL. C. Urinary output does not vary all that much between adults and children. D. Catheterized clients should drain a minimum of 30 mL of urine per hour.
Answer: D Rationale: Urine output of less than 30 mL per hour may indicate inadequate blood flow to the kidneys. In adults, the average amount of urine per void is approximately 200 to 400 mL. Adults generally have a urine output of 1500 mL per day, while children, depending on age, have a urine output between 500 and 1500 mL per day. Urine output can vary greatly, depending on intake and fluid losses.
A urinalysis has been ordered for a client. When is the best time for the client to provide a urine sample? A. evening B. afternoon C. before bedtime D. first thing in the morning
Answer: D Rationale: While the specimen can be collected at any time during the day, the first urine voided in the morning is preferred. The first urine is usually more concentrated because the client does not usually consume fluid during the night and the effects of diet and activity are minimized.
Use of an indwelling urinary catheter leads to the loss of bladder tone. False True
Answer: True Rationale: People with indwelling urinary catheters lose bladder tone because the bladder muscle is not being stretched by the bladder filling with urine. During prolonged periods of immobility, decreased bladder and sphincter tone can result in poor urinary control and urinary stasis. Other causes of decreased muscle tone include childbearing, muscle atrophy due to decreased estrogen levels as seen with menopause, and damage to muscles from trauma.
