Fund 45 Urinary questions Flashcards
A female patient reports that she is experiencing burning on urination, frequency, and urgency. The nurse notes that a clean-voided urine specimen is markedly cloudy. The probable cause of these symptoms and findings is:
a) Cystitis. b) Hematuria. c) Pyelonephritis. d) Dysuria.
A
Urine is cloudy in cystitis because of bacterial and white cells.
A male patient returned from the operating room 6 hours ago with a cast on his right arm. He has not yet voided. Which action would be the most beneficial in assisting the patient to void?
A) Suggest he stand at the bedside
B) Stay with the patient
C) Give him the urinal to use in bed
D) Tell him that, if he doesn’t urinate, he will be catheterized
A
A man voids more easily in the standing position.
Elimination changes that result from inability of the bladder to empty properly may cause which of the following? (Select all that apply.)
A) Incontinence B) Frequency C) Urgency D) Urinary retention E) Urinary tract infection
ABCDE
Any condition resulting in urinary retention increases the risk for urinary tract infection. As retention progresses, retention with overflow develops. Pressure in the bladder builds to a point at which the external urethral sphincter is unable to hold back urine. With retention the patient may void small amounts of urine 2 to 3 times an hour and have urgency. He or she may continually dribble urine. Urinary retention results from inability of the bladder to empty.
An older male patient states that he is having problems starting and stopping his stream of urine and he feels the urgency to void. The best way to assist this patient is to:
A) Help him stand to void. B) Place a condom catheter. C) Have him practice Credé’s method. D) Initiate Kegel exercises.
D
Kegel exercises strengthen pelvic floor muscles and are effective in urine control in patients with urge incontinence and difficulty starting and stopping urination.
Since removal of the patient’s Foley catheter, the patient has voided 50 to 100 mL every 2 to 3 hours. Which action should the nurse take first?
A) Check for bladder distention B) Encourage fluid intake C) Obtain an order to recatheterize the patient D) Document the amount of each voiding for 24 hours
A
The patient may experience urinary retention after catheter removal. If amounts voided are small, checking for bladder distention is necessary.
To minimize the patient experiencing nocturia, the nurse would teach him or her to:
A) Perform perineal hygiene after urinating. B) Set up a toileting schedule. C) Double void. D) Limit fluids before bedtime.
D
With nocturia the patient has to get up during the night to urinate. Limiting fluids 2 hours before bedtime minimizes nocturia.
A patient with a Foley catheter carries the collection bag at waist level when ambulating. The nurse tells the patient that he or she is at risk for: (Select all that apply.)
A) Infection. B) Retention. C) Stagnant urine. D) Reflux of urine.
A&D
Urine in the bag and tubing becomes a medium for bacteria, and infection is likely to develop if urine flows back into the bladder.
The patient is incontinent, and a condom catheter is placed. The nurse should take which action?
A) Secure the condom with adhesive tape B) Change the condom every 48 hours C) Assess the patient for skin irritation D) Use sterile technique for placement
C
Skin irritation can occur when the condom is twisted at the drainage tube attachment and obstructs urine drainage.
After a transurethral prostatectomy a patient returns to his room with a triple-lumen indwelling catheter and continuous bladder irrigation. The irrigation is normal saline at 150 mL/hr. The nurse empties the drainage bag for a total of 2520 mL after an 8-hour period. How much of the total is urine output?
__________________________________
The correct response is “1320 mL”
The nurse directs the NAP to remove a Foley catheter at 1300. The nurse would check if the patient has voided by:
A) 1400. B) 1600 C) 1700. D)2300.
C
The patient may experience urinary retention after removal of the catheter. If 4 hours after Foley removal have elapsed without voiding, it may be necessary to reinsert the Foley.
The postoperative patient has difficulty voiding after surgery and is feeling “uncomfortable” in the lower abdomen. Which action should the nurse implement first?
A) Encourage fluid intake B) Administer pain medication C) Catheterize the patient D) Turn on the bathroom faucet as he tries to void
D
The sound of running water helps many patients to void through the power of suggestion.
The patient is to have an intravenous pyelogram (IVP). Which of the following apply to this procedure? (Select all that apply.)
A) Note any allergies.
B) Monitor intake and output.
C) Provide for perineal hygiene.
D) Assess vital signs.
E) Encourage fluids after the procedure.
A &E
The dye used in the procedure is iodine based. Assessing for history of any allergies can predict allergy to the dye used. Fluid intake dilutes and flushes the dye from the patient.
The nurse assesses that the patient has a full bladder, and the patient states that he or she is having difficulty voiding. The nurse would teach the patient to:
A) Use the double-voiding technique. B) Perform Kegel exercises. C) Use Credé’s method. D) Keep a voiding diary.
C
With this method pressure is put on the suprapubic area with each attempted void. The maneuver promotes bladder emptying by relaxing the urethral sphincter.
The patient states that she “loses urine” every time she laughs or coughs. The nurse teaches the patient measures to regain urinary control. The nurse recognizes the need for further teaching when the patient states:
A) “I will perform my Kegel exercises every day.”
B) “I joined weight watchers.”
C)“I drink two glasses of wine with dinner.”
D)“I have tried urinating every 3 hours.”
C
Alcohol is a bladder irritant. It increases urine production and causes uncontrolled bladder contractions.
The nurse notes that the patient’s Foley catheter bag has been empty for 4 hours. The priority action would be to:
A) Irrigate the Foley. B) Check for kinks in the tubing. C) Notify the health care provider. D) Assess the patient’s intake.
B
Kinks in tubing prevent flow of urine. To keep the drainage system patent, check for kinks or bends in the tubing.
