Ch 89 Urinary Disorder Flashcards
______ refers to the procedure of crushing the kidney stones.
Lithotripsy
_____ are epithelial, fatty, or waxy tissue abnormally forced out of the renal tubules.
Casts
A ______ is performed to measure bladder pressure during filling.
Cystometrogram
A primary cancer of the kidney is referred to as a/an _____
Hypernephroma
A _____ pouch is a type of continent diversion in which the middle portion of the ileum is folded and opened onto itself to create a pouch.
Kock
Almost continuous; commonly caused by prostatectomy
True Incontinence
A sudden increase in intraabdominal pressure
Stress incontinence
Irritation of the bladder wall by urine components
Urge incontinence
Bladder instability as a result of upper motor lesions
Reflex incontinence
Write the correct sequence of the steps performed during a cystoscopy.
- Instill Xylocaine jelly into the urethra.
- Encourage the client to drink fluids.
- Obtain a urinalysis and a urine culture.
- Pass the cystoscope into the client’s bladder.
Obtain a urinalysis and a urine culture.
Instill Xylocaine jelly into the urethra.
Pass the cystoscope into the client’s bladder.
Encourage the client to drink fluids.
What are the specialized imaging studies used to study the urinary tract?
The specialized imaging studies used to study the urinary tract include the following: intravenous
pyelogram, radioactive renogram, bone scan, nephrotomogram, renal arteriogram, cystogram and voiding cystourethrogram, and retrograde pyelogram.
What are urodynamic tests?
Urodynamic testing is a series of tests that determine the actual function of the detrusor muscle of
the bladder, which pushes the urine out; the external sphincter muscle; and the pelvic (pubococcygeal) muscles.
What are the factors that cause transient incontinence?
Factors that cause transient incontinence include reversible contributing factors such as changes in
mental status, infections, medications, fluid intake, mobility problems, and stool impaction.
Which factors make a person more susceptible to urinary tract infection (UTI)?
Factors that may make a person more susceptible to UTI include catheterization, which can advance
bacteria into the bladder; systemic diseases, such as diabetes; and changes in the vaginal pH in women.
What is glomerulonephritis?
Glomerulonephritis is a group of diseases in which the kidneys are damaged and partly destroyed by inflammation of the glomeruli. It may be a result of an acute infection, as with poststreptococcal glomerulonephritis. This type of inflammation may result in an antigen and antibody reaction.
Who is considered a good candidate for kidney donation?
The client’s living relatives who have compatible tissue matches are considered good candidates as
kidney donors. The donor must have two well functioning kidneys and no underlying disease.
A client comes to the healthcare facility with complaints of increased urinary frequency, especially during the night, for about the past week. The client also reports a painful, burning sensation felt when passing urine.
a. Which nursing diagnoses may be established for a client with a urinary disorder?
• Risk for infection related to dehydration, excess wastes in the body, or tissue breakdown
and damage.
• Risk for deficient or excess fluid volume related to the kidney’s inability to effectively concentrate urine, fluid restrictions, or electrolyte imbalance.
• Stress urinary incontinence, reflex urinary incontinence, functional urinary incontinence related to sphincter incompetence, neurologic disorders, impaired mental status, medications, fistula, cancer, surgery, trauma, or obstruction.
• Urinary retention related to obstruction, sphincter incompetence, cancer, or trauma.
• Impaired tissue integrity related to dehydration, mucous membrane friability and break-down, or general malaise.
• Social isolation related to incontinence, presence of ureterostomy, or presence of a
urinary diversion appliance.
• Ineffective sexuality patterns related to indwelling catheter, dialysis, or urinary diversion.
• Pain related to surgery, invasive diagnostic tests, urinary tract infections, pyelonephritis, or calculi.
A client comes to the healthcare facility with complaints of increased urinary frequency, especially during the night, for about the past week. The client also reports a painful, burning sensation felt when passing urine.
• Obtaining frequent vital signs, especially blood pressure.
• Managing related symptoms such as diarrhea, nausea, vomiting, headache, anemia, and pain.
• Administering prescribed diuretics, mineral supplements, and antibiotics.
• Providing skin and mouth care.
• Observing and documenting skin condition, tissue turgor, and presence of edema or dehydration.
• Measuring and recording fluid intake and output (I&O), color and clarity of urine, and urine specific gravity.
• Taking daily weights and encouraging fluid intake.
• Assisting with voiding and continence training.
• Providing medications and emotional support for dysuria and painful intercourse.
• Managing and caring for an indwelling catheter or suprapubic Cystocath.
• Giving sitz baths and warm moist packs to offset pain.
• Assisting with movement and activity to prevent disorders of immobility, such as deep-vein thrombosis, pneumonia, and urinary tract infections
What are the general nursing considerations undertaken when caring for clients with urinary disorders?
- Teach the client to take ample time in the bathroom.
• Encourage the client with “shy bladder syndrome” to find a private, quiet bathroom.
• Encourage the client to listen to the sound of running water, which helps the bladder that
has difficulty starting to urinate.
• Encourage the client to start a bladder training program.
• Tap above the pubic bone, tap the clitoris, or tickle the base of the bladder to initiate a stream.
• Push on the belly above the pubic bone during the stream to empty the bladder completely.
• Use the double-void technique to empty the bladder completely
A client complains of urinary leakage when coughing or sneezing. The client has been experiencing these incidences since childbirth 6 months ago. The client is diagnosed with stress incontinence.
a. Which tips should the nurse provide the client to help empty the bladder completely?
Use an incontinent pad on the bed and wheel-
chair to prevent soiling.
• Teach principles of bladder retraining, including the Credé maneuver, if necessary.
• Self-catheterization may be required for long-term management.
• Wear an appliance, condom catheter, or incontinent briefs or pads.
• Wash appliances regularly.
• Ensure regular skin care to maintain good skin integrity.
• Wash hands after using the bathroom
A client complains of urinary leakage when coughing or sneezing. The client has been experiencing these incidences since childbirth 6 months ago. The client is diagnosed with stress incontinence.
Which client education is provided for the management of stress incontinence?
• Use an incontinent pad on the bed and wheelchair to prevent soiling.
• Teach principles of bladder retraining, including the Credé maneuver, if necessary.
• Self-catheterization may be required for long-term management.
• Wear an appliance, condom catheter, or incontinent briefs or pads.
• Wash appliances regularly.
• Ensure regular skin care to maintain good skin integrity.
• Wash hands after using the bathroom.
A nurse is caring for a client who is experiencing a flare-up of chronic glomerulonephritis. Which measure should the nurse employ when caring for this client?
a. Encourage the client to drink plenty of fluids.
B. Place the client in the orthopneic position.
c. Provide the client with a protein-rich diet.
d. Encourage the client to remain ambulatory.
B. Place the client in the orthopneic position.
A nurse is caring for a client who is receiving peritoneal dialysis. Which measure should the nurse take after the procedure?
a. Ask the client to avoid breathing deeply.
b. Place the client flat for 24 hr.
C. Assess the client for constipation.
d. Encourage increased fluid intake for 24 hr.
C. Assess the client for constipation.
A female client is required to provide a urine sample for a culture and sensitivity test. Which intervention should the nurse perform?
a. Ask the client to insert a container and start voiding.
b. Send the urine sample to the laboratory within 24 hr.
C. Instruct the client to clean the perineal area before voiding.
d. Give the client nothing by mouth (NPO) for 8-10 hr before the test.
C. Instruct the client to clean the perineal area before voiding.
