Urinary elimination chapter 19

An older adult client reports urinary frequency with burning when urinating. The client's temperature is 100.4°F (37.8°C). Which action will the nurse take first?

Ask the client to provide a clean-catch urine sample

The nurse develops a plan of care for a family with a experiencing caregiver fatigue related to the client's overnight urinary incontinence. Which intervention will the nurse include?

Assist the client to the bathroom prior to bedtime.

What action should the nurse prioritize when trying to prevent an older adult client's risk for urosepsis?

Avoid the use of urinary catheters whenever possible. Urosepsis is a common complication in older adults using indwelling urinary catheters so selective use of catheters is important.

The nurse is assisting an older adult client with changing the client's sanitary briefs, which revealed that the client was incontinent of urine. Which statement by the client requires further follow up by the nurse?

"I have found this is something that happens from time to time at my age." Incontinence of urine is not normal.

The nurse is providing education to an older adult client who is experiencing nocturia. Which statement(s) will the nurse include in the teaching about this condition? Select all that apply.

"It is common to have the need to urinate at least one time per night." "The need to void at night may indicate there is a urinary tract disorder present." "Medications like diuretics can contribute to the need to urinate during the night." "Urinating at night is considered a change in health that occurs more with advanced

An older adult client is discouraged that urinary incontinence continues despite performing Kegel exercises for a week. How will the nurse respond?

"It takes several months to see an improvement."

An older adult client is embarrassed because of an episode of urinary incontinence associated with a fecal impaction. What should the nurse explain to the client about this type of incontinence?

"It was probably because of your bowel problem."

A nurse administers medications to an older adult client. Which statement, if made by the client, indicates proper use of tamsulosin?

"My urine flow starts much faster now."

An older adult client has a history of an enlarged prostate, urinary retention, and recurrent urinary tract infections. Which information is appropriate for the nurse to teach this client?

"You should add cranberry juice capsules to your daily routine."

the findings that are normal age-related changes.

-urinary frequency, urgency, nocturia. -difficulty manipulating buttons and zippers. -incontinence of urine at times.

The nurse is assessing an older adult client's overall urinary wellness. Which assessment or clinical finding(s) is a risk factor for decreased urinary wellness for this client?

1.history of Parkinson disease 2.history of 1 to 2 glasses of wine per night with dinner 3.last reported bowel movement 3 days ago 4.reported body mass index (BMI) of 36.0

An older adult client was admitted to the medical-surgical unit with a urinary tract infection after being febrile and confused but is now ready for discharge. Which intervention will the nurse teach the client to help prevent future urinary tract infections?

Increase fluid intake

The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older adult clients. Which unit-based protocol likely contributed to this outcome?

Cranberry juice has long been promoted as a means to reduce urinary tract infections. Research now supports this belief. A study conducted at the Harvard Medical School demonstrated a reduction in the frequency of bacteria and white blood cells in the urine of women who regularly consumed cranberry juice.

An older adult client has a history of diabetes and arteriosclerosis. The client has been febrile and tachycardic since the morning and tested positive for a urinary tract infection. Which intervention is appropriate for this client?

Document intake and output. Treatment of urinary tract infections (UTIs) aims to establish adequate urinary drainage and control the infection through antibiotic therapy. The nurse should carefully note the client's fluid intake and output.

While the nurse is performing a urinary assessment on an older adult client with benign prostatic hyperplasia (BPH), the client states that they do not want to have treatment. Which intervention(s) is appropriate to teach the client to prevent the possible risks of untreated BPH? Select all that apply.

Increase fluid intake. Rock back and forth while voiding. Practice good hygiene.

When asked to cough with a full bladder, an older adult female client experiences urinary incontinence. Which action should the nurse take to help this client?

Instruct the client to keep a log of all episodes of incontinence.

The nurse cares for an older adult client experiencing urinary retention. Which intervention should the nurse add to this client's plan of care?

Instruct to massage bladder area.

An older adult client reports painful hematuria to the health care provider. Which action is appropriate for the nurse to teach the client to perform?

Pain and hematuria are associated with renal calculi. The nurse will instruct the client to drink ample fluids.

The nurse performs a urinary assessment on an older adult male client and starts by interviewing the client. The client reports urinary frequency, urgency, and retention. Which nursing assessment(s) is appropriate based on this report?

Palpate the bladder. Percuss the bladder. Ask the client to provide a urine sample.

An older adult client has been taking hydrocodone for the last week and has been very lethargic and weak. Knowing that the filtration efficiency of the kidneys decreases with age, which action will the nurse take?

Recommend the medication dose be lowered.

Which older female reproductive system problem is associated with the nursing diagnosis anxiety?

Sexual dysfunction

An 88-year-old client presents to the emergency room with a family member who states that the client became acutely confused, has a fever of 98.6°F (37°C), and has not voided in 10 hours. Which action does the nurse expect to take next based on the client's symptoms?

Straight catheterize the client to obtain a urine culture.

Which older adult client likely has the highest risk for urinary tract infections?

The client who has uncontrolled diabetes is at highest risk for developing urinary tract infections (UTIs)

The nurse educates an older adult client with stress incontinence. Which statement will the nurse include in the education?

The statement, "Your condition is a result of increased intra-abdominal pressure" is an accurate description of stress incontinence, and will be included by the nurse in the education. The nurse will include situations that may increase the intra-abdominal pressure, such as coughing, lifting, sneezing, laughing, or exercising.

A male client recovering from a radical prostatectomy is experiencing dry, hard bowel movements. Which intervention is appropriate for the nurse to teach this client?

To prevent injury and infection after prostate surgery, the client should avoid constipation. Stool softeners may be prescribed if bowel movements are strained or irregular, and the nurse should advise the client to ask the health care provider whether they should be taken.

A client asks what can be done to reduce the incidence of vaginitis. What should the nurse instruct this client?

Wear cotton underwear. Use lubricants with intercourse. Avoid sprays to the genital area. Keep the genital area clean and dry.

Urosepsis

can be serious in older adult clients and can manifest as delirium, fever, urinary retention, incontinence, and hematuria. The nurse should anticipate "straight catheterizing" this client to obtain a urine culture.

The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older adult clients. Which unit-based protocol likely contributed to this outcome?

cranberry juice with breakfast

Transient incontinence is acute and reversible and can be caused by

fecal impaction.

The nurse prepares to assess an older adult client's urinary status. Because of the client's age, which concern will the nurse focus on during this assessment?

frequency

An older adult client receiving pain medication after surgery is experiencing urinary incontinence. For which type of incontinence will the nurse plan care for this client?

functional

The nurse notes that an older adult client's biopsy of vaginal tissue is positive for cancer. What care will the nurse expect to be prescribed for this client next?

identification of a primary site. Cancer of the vagina is rare in older adult women; it results more frequently from metastasis than from the vaginal area as a primary site.

vulvitis

inflammation of the vulva. Possible causes include fungal or bacterial infections, chafing, skin conditions, or allergies to products such as soaps and bubble bath

Urge urinary incontinence

is characterized by involuntary urinary leakage due to the inability to hold urine long enough to reach a toilet after perceiving the urge to void

Functional incontinence

is urination due to inability to reach an appropriate toileting facility.

The nurse notes that an older client has experienced signs of benign prostatic hypertrophy "for years." What additional diagnostic testing may be prescribed for this client?

kidney function evaluation

Stress Incontinence examples

leaking urine when coughing. leaking of urine when lifting a heavy object.

Urge Incontinence examples

loss of urine after perceiving the need to urinate. loss of urine with a urinary tract infection.

Overflow Incontinence example

loss of urine due to an overdistended bladder.

A client with benign prostatic hypertrophy is being treated with medication. The expresses concern that the medication is causing weight loss. What should the nurse suspect is occurring with this client?

metastatic prostate cancer

A nurse assesses an older adult client who has high blood pressure and chronic obstructive pulmonary disease. The client has been prescribed nicardipine and an ipratropium inhaler. This medication regimen combines a calcium-channel blocker and an anticholinergic. For which urinary effect will the nurse teach the client to monitor?

nocturia

A registered nurse assesses an older adult client 24 hours after a retropubic suspension surgical procedure. The client is confused, exhibits muscle twitching, and reports being nauseated. Which laboratory data should the nurse assess?

sodium

An older adult client receives a recommendation for weight reduction as an approach to help with urinary incontinence. For which type of incontinence is this intervention appropriate to recommend?

stress

An older adult client has developed urinary incontinence. The client states, "When I have to go, I go. I cannot make it to the bathroom before it leaks out." For which type of incontinence should the nurse develop a plan of care?

urge incontinence

A nurse instructs a class of older adult women about pelvic floor muscle exercises (PFMEs). In which urinary condition(s) will PFME be effective? Select all that apply.

urge incontinence stress incontinence pelvic organ prolapse functional incontinence

The nurse notes that an older adult female client has urinary incontinence. For which health problem should the nurse assess this client?

vulvitis