CHAPTER 32 - URINARY ELIMINATION, PrepU ch37, PrepU CH 36 urinary elimination, PrepU Chapter 36: Urinary Elimination, Nursing Chapter 37 (urinary Elimination), Ch. 37 Urinary Elimination, PrepU Ch 37 Urination, Chapter 37: Urinary Elimination. Rated A+

Document Content and Description Below

Which terms is most closely associated with an acute urinary tract infection? - pyuria - glycosuria - proteinuria - anuria -✔✔- pyuria p. 1021 Rationale: Pyuria, or the presence of pus... in urine, is highly suggestive of a urinary tract infection (UTI). UTIs do not typically result in glycosuria (sugar in the urine) or proteinuria (protein in the urine). Similarly, a complete cessation of urine production (anuria) is not associated with uncomplicated UTI. A sterile urine specimen for culture and sensitivity has been ordered for a client who has an indwelling urinary catheter. How should the nurse obtain this specimen? - Discontinue the indwelling catheter and insert an intermittent catheter to obtain the sterile specimen - Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle - Collect a urine specimen from the collection bag first thing in the morning, or a few hours after the client receives a diuretic - Empty the collection bag, wait 30 minutes, and then collect the contents of the collection bag -✔✔- Withdraw several milliliters of urine from the port on the collection tubing, using a syringe and needle p. 1027 Rationale: When it is necessary to collect a urine specimen from a client with an indwelling catheter, it should be obtained from the catheter itself using the special port for specimens. A specimen from the collecting receptacle (drainage bag) may not be fresh urine and could result in an inaccurate analysis. A client's catheter would not be removed for the sole purpose of obtaining a urine specimen. During his stay in the hospital, a male client has established a pattern of maintaining urinary continence during the day, but he is experiencing incontinence at night. What intervention should the nurse implement in this client's care? - indwelling catheter - toileting the client every 2 hours - intermittent catheterization at bedtime - condom catheter -✔✔- condom catheter p. 1034 Rationale: A condom catheter may be used in the care of male clients who lack voluntary control of urination. This is preferable to invasive catheterization (which presents an infection risk). Frequent toileting may prevent episodes of incontinence but would significantly disrupt the client's sleep quality. Which of the following describes the term micturition? - experiencing total incontinence - emptying the bladder - collecting a urine specimen - catheterizing the bladder -✔✔- emptying the bladder p. 1014 Rationale: The process of emptying the bladder is known as urination, micturition, or voiding. A nurse working in a community pediatric clinic explains the process of toilet training to mothers of toddlers. What is a recommended guideline for initiating this training? - The child should be able to hold urine for 4 hours - The child should be able to communicate the need to void - The child should be between 18 and 24 months old - The child does not need the desire to gain control of voiding -✔✔- The child should be able to communicate the need to void p. 1014, 1015 Rationale: Voluntary control of the urethral sphincters occurs between 18 and 24 months of age. However, many other factors are required to achieve conscious control of bladder function, and toilet training usually begins at about 2 to 3 years of age. Toilet training should not begin until the child is able to hold urine for 2 hours, recognize the feeling of bladder fullness, communicate the need to void, and control urination until seated on the toilet. The child's desire to gain control is also important. A nurse is assessing the urine on a newborn's diaper. What would be a normal assessment finding? - highly concentrated urine - dark in color and odorous - scanty to no urine - light in color and odorless -✔✔- light in color and odorless p. 1015 Rationale: Infants are born with little ability to concentrate urine. An infant's urine is usually very light in color and without odor until about 6 weeks of age, when the nephrons are able to control reabsorption of fluids and effectively concentrate urine. Infants do not normally have scanty, highly concentrated, or dark and odorous urine. A student is collecting a sterile urine specimen from an indwelling catheter. How will the student correctly obtain the specimen? - Aspirate urine from the collecting bag - Remove the catheter and ask the client to void - Pour urine from the collecting bag - Aspirate urine from the collection port -✔✔- Aspirate urine from the collection port p. 1027 Rationale: When it is necessary to collect a urine specimen from a client with an indwelling catheter, it should always be obtained from the catheter itself using the special collection port An older adult woman has constant dribbling of urine. The associated discomfort, odor, and embarrassment may support which nursing diagnosis? - Social Isolation - Impaired Adjustment - Defensive Coping - Impaired Memory -✔✔- Social Isolation p. 1022 Rationale: Urinary incontinence is a special problem for older adults who may have decreasing control over micturition, or find it more difficult to reach the toilet in time. The discomfort, odor, and embarrassment of urine-soaked clothing can greatly diminish a person's self-concept, causing him to feel like a social outcast. 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? - Stasis - Infection - Dehydration - Blood -✔✔- Blood p. 1021 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. A nurse uses a catheter to collect a sterile urine specimen from a client at a health care facility. If a catheter is required temporarily, which type of catheter should the nurse use? - condom catheter - retention catheter - urinary bag - straight catheter -✔✔- straight catheter p. 1034-1035 Rationale: The nurse should use a straight catheter to collect a sterile urine specimen from the client. A straight catheter is a urine drainage tube inserted but not left in place. It drains urine temporarily or provides a sterile urine specimen. Condom catheters are helpful for clients with urinary incontinence receiving care at home, because they are easy to apply. A urinary bag is more often used to collect urine specimens from infants. A retention catheter, also called an indwelling catheter, is left in place for a period of time A nurse caring for a client with a nephrostomy tube finds that the urine output from the tube has decreased and notifies the physician. The physician writes an order for the tube to be irrigated. Which would be most appropriate for the nurse to do when irrigating a nephrostomy tube? - Use clean technique - Instill 50 mL of solution - Clamp the nephrostomy tube - Irrigate with sterile saline -✔✔- Irrigate with sterile saline p. 1040 Rationale: The nurse should use sterile saline for irrigation, as tap water may damage the kidneys. Irrigation of a nephrostomy must be done using strict asepsis, not a clean technique, and no more than 10 mL of sterile saline should be instilled. It is important never to clamp a nephrostomy tube because doing so would cause the backup of urine that could result in renal damage 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. What would would the nurse document as an abnormal finding? - moist perineal skin - presence of smegma - absence of discharge - reddened meatal skin -✔✔- reddened meatal skin p. 1026 Rationale: The presence of reddened meatal 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 normal and is not a discharge from the urinary meatus. Urinary catheterization is the most common cause of healthcare-associated infection (HAI) True False -✔✔- True p. 1018 Rationale: The catheter is not in the bladder, so urine in the tubing is not sterile A nurse is using a bladder scanner to assess the bladder volume of a client with urinary frequency. In which position would the nurse place the client? - High Fowler's - Dorsal recumbent - Supine - Sims' -✔✔- Supine p. 1045 Rationale: Portable bladder ultrasound devices are accurate, reliable, and noninvasive devices used to assess bladder volume. Results are most accurate when the client is in the supine position during the scanning. The nurse is assessing a female client who states that she notices an involuntary loss of urine following a coughing episode. What would be the nurse's best reply? - "You are experiencing total incontinence. Have you had any surgeries or trauma that may be causing this?" - "You are experiencing transient incontinence. Have you been administered diuretics or IV fluids lately?" - "You are experiencing reflex incontinence. Have you had a spinal cord injury in the past?" - "You are experiencing stress incontinence. Do you know how to do Kegel exercises?" -✔✔- "You are experiencing stress incontinence. Do you know how to do Kegel exercises?" p. 1022, including table 32-2 Rationale: Stress incontinence occurs when there is an involuntary loss of urine related to an increase in intra-abdominal pressure. This commonly occurs during coughing, sneezing, laughing, or other physical activities. Childbirth, menopause, obesity, or straining from chronic constipation can also result in urine loss. Pelvic floor muscle training (PFMT) can improve voluntary control of urination and significantly reduce or eliminate problems with stress incontinence by strengthening perineal and abdominal muscle tone (Huebner et al., 2011). PFMT, more commonly called Kegel exercises, targets the inner muscles that lie under and support the bladder. These muscles can be toned, strengthened, and actually made larger by a regular routine of tightening and relaxing. Transient incontinence appears suddenly and lasts for 6 months or less. It is usually caused by treatable factors, such as confusion secondary to acute illness, infection, and as a result of medical treatment (e.g., use of diuretics, IV fluid administration). Total incontinence is a continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation. Urination cannot be controlled due to an anatomic abnormality The nurse measures a client's residual urine by catheterization after the client voids. Which condition would this test verify? - urinary retention - urinary incontinence - urinary tract infection (UTI) - urinary suppression -✔✔- urinary retention p. 1021 Rationale: Urinary retention occurs when urine is produced normally but is not excreted completely from the bladder. Factors associated with urinary retention include medications, an enlarged prostate, or vaginal prolapse. Urinary incontinence is the inability for the client to control his urine. There are many different causes for urinary incontinence. Urinary tract infections are a leading cause of morbidity and health care expenditures in persons of all ages, accounting for up to 40% of infections reported by acute care hospitals. These infections can be of the upper or lower urinary system. Urinary retention is the inability to urinate. The causes of urinary retention are numerous Which catheter would the nurse use to drain a client's bladder for short periods (5 to 10 minutes)? - straight catheter - suprapubic catheter - indwelling urethral catheter - Foley catheter -✔✔- straight catheter p. 1035, including fig. 32-4 Rationale: Intermittent urethral catheters, or straight catheters, are used to drain the bladder for shorter periods. If a catheter is to remain in place for continuous drainage, an indwelling urethral catheter is used. Indwelling catheters are also called retention or Foley catheters. A suprapubic catheter is used for long-term continuous drainage. This type of catheter is inserted surgically through a small incision above the pubic area The nurse is assessing a client's bladder volume using an ultrasound bladder scanner. Which nursing actions are performed correctly? Select all that apply. - The nurse presses and holds the END button until it beeps 3 times and then reads the volume measurement on the screen - The nurse adjusts the scanner head to center the bladder image on the crossbars - The nurse places a generous amount of ultrasound gel or gel pad midline on the client's abdomen, about 1 to 1.5 inches above the symphysis pubis - The nurse places the scanner head on the gel or gel pad, with the directional icon on the scanner head pointed away from the client's head. - The nurse gently palpates the client's symphysis pubis - The nurse aims the scanner head toward the bladder (points the scanner head slightly downward toward the coccyx). -✔✔- - The nurse adjusts the scanner head to center the bladder image on the crossbars - The nurse places a generous amount of ultrasound gel or gel pad midline on the client's abdomen, about 1 to 1.5 inches above the symphysis pubis - The nurse gently palpates the client's symphysis pubis - The nurse aims the scanner head toward the bladder (points the scanner head slightly downward toward the coccyx). p. 1045-1047 Rationale: To correctly use the ultrasound bladder scanner, the nurse would gently palpate the client's symphysis pubis. Palpation identifies the proper location and allows for correct placement of scanner head over the client's bladder. The nurse would place a generous amount of ultrasound gel midline on the client's abdomen. The gel is necessary to conduct the ultrasound waves for an accurate reading. The nurse would aim the scanner head toward the bladder. Failure to point the scanner in this direction will give erroneous results. The nurse would adjust the scanner head to center the bladder image on the crossbars. This step is necessary to record the most accurate results Which is the test that would provide an accurate measurement of the kidney's excretion of creatinine? - Random specimen - 24-hour specimen - Intermittent specimen - Clean-catch specimen -✔✔- 24-hour specimen p. 1026 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 A client reports an episode of losing control of urination when a bathroom wasn't close by. The client states, "I'm worried this means that I'm starting to lose control of my bladder." What is the appropriate nursing response? - "Let's review your medication history and whether you consume bladder irritants." - "I suggest that you invest in incontinence undergarments." - "This only happened one time, so it is nothing to worry about." [Show More]

Last updated: 2 years ago

Preview 1 out of 75 pages