PrepU Elimination

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 woman in her late 30s has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further enquiry, she reveals that she also has postcoital pain and bleeding. To which diagnosis will the investigation most likely lead?

Cervical cancer The client's symptoms are those of cervical cancer. Symptoms of cervical cancer include abnormal vaginal bleeding and persistent yellowish, blood-tinged, or foul-smelling discharge. Clients may complain of postcoital pain and bleeding, bleeding between menstrual periods, and unusually heavy menstrual periods. If the cancer has progressed into the pelvic wall, the Clients may experience pain in the flank regions of the body.

The nurse examining an infant forms the following diagnosis: "Risk for impaired skin integrity related to effects of diarrhea." This diagnosis would be most appropriate for which disease states? Select all that apply.

Inflammatory bowel disease Crohn disease Ulcerative colitis

The nurse is providing preoperative instructions to a client who is having a transurethral resection of the prostate. The nurse should tell the client:

"Expect blood in your urine in the first couple of days following the procedure." Transurethral resection of the prostate (TURP) is a common surgical procedure used to treat male clients with benign prostate enlargement. The surgery commonly results in blood from the surgery in the urine for the first few days, and the client should not be concerned; the urine will become clear within 2 to 3 days. Central venous access is not expected for this type of surgery. Peripheral IV access can be expected. Clients are instructed to anticipate hospitalization for 1 to 3 days. Because the procedure is performed transurethrally (via the urethra), there is no outward incision.

The nurse is providing discharge education for a new mother regarding constipation. Which statement by the mother indicates that she understands what the nurse explained to her?

"I will increase my intake of fruits and vegetables in my diet. I love to eat them anyhow."

A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?

"I've had trouble getting started when I urinate, often straining to do so." Symptoms that might alert the nurse to BPH include difficulty initiating urination and abdominal straining with urination. Although fever, urinary frequency, nocturia, pelvic pain, nausea, vomiting, and fatigue may be noted, they also may suggest other conditions such as urinary tract infection. Fever, nausea, vomiting, and fatigue are general symptoms that can accompany many conditions.

A 7-month-old female infant is admitted to the hospital with a tentative diagnosis of Hirschsprung's disease. When obtaining the infant's initial health history from the parents, which statement made by the mother would be most important?

"She gets constipated often."

A nurse is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the care plan to reduce ICP?

Administer stool softeners.

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate]) The elevated potassium levels may be reduced by administering cation-exchange resins (sodium polystyrene sulfonate [Kayexalate]) orally or by retention enema. Kayexalate works by exchanging sodium ions for potassium ions in the intestinal tract.

The nurse assists and educates clients about the structure and function of the digestive system. The nurse is reviewing the processes involved during digestion. What is the best explanation the nurse can give the client about the process of peristalsis?

Alternate contraction and relaxation of muscles that sends food down through the digestive tube

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?

Angiography

Which objective symptom of a UTI is most common in older adults, especially those with dementia?

Change in cognitive functioning

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

Control blood glucose levels.

Gastrin has which of the following effects on gastrointestinal (GI) motility?

Increased motility of the stomach

An elderly patient has come in to the clinic for her yearly physical. The patient tells the nurse that she is having difficulty with bowel movements. What intervention could the nurse suggest?

Increasing intake of water

A client informs the nurse that he is taking a stimulant laxative in order to be able to have a bowel movement daily. What should the nurse inform the client about taking a stimulant laxative?

They can be habit forming and will require increasing doses to be effective. The nurse should discourage self-treatment with daily or frequent enemas or laxatives. Chronic use of such products causes natural bowel function to be sluggish. In addition, laxatives continuing stimulants can be habit forming, requiring continued use in increasing doses. Although the nurse should encourage the client to have adequate fluid intake, laxative use should not be encouraged. The laxative may interact with other medications the client is taking and may cause a decrease in absorption. A fiber supplement may be taken alone but should not be taken with a stimulant laxative.

Which of the following is the most accurate indicator of fluid loss or gain?

Weight The most accurate indicator of fluid loss or gain in an acutely ill patient is weight, as accurate intake and output and assessment of insensible losses may be difficult. Urine output, caloric intake, and body temperature would not be the most reliable indicator of fluid loss or gain.

The actual concentration that a drug reaches in the body involves which processes? (Select all that apply.)

absorption from the site of entry distribution to the active site biotransformation in the liver excretion from the body

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes:

high-fiber diet. A high-fiber diet is prescribed to help control diarrhea and constipation. Foods that are possible irritants, such as caffeine, spicy foods, lactose, beans, fried foods, corn, wheat, and alcohol, should be avoided. Fluids should not be taken with meals because they cause abdominal distention.

A client who has skeletal traction to stabilize a fractured femur has not had a bowel movement for 2 days. The nurse should:

increase the client's fluid intake to 3,000 mL/day.