Urinary and Bowel Prep U Q's Flashcards
A nurse is performing an abdominal assessment of a client before administering a large-volume cleansing enema. Which assessment technique would be performed last
Palpation
After data collection on a client, the nurse suspects that the client has diarrhea. Which data collection finding, if observed by the nurse, would confirm the nurse’s suspicion?
Hyperactive bowel sounds
The nursing student is performing a focused gastrointestinal assessment. Which action performed by the student would indicate to nurse faculty that further instruction is needed?
The student sequenced from auscultation to inspection, and percussion to palpation.
A cleansing enema has been ordered for the client to draw water into the bowel. Which type of solution does the nurse gather?
hypertonic saline
A nurse is caring for a client with constipation. The incidence of constipation tends to be high among clients that follow which diet?
a diet lacking in fruits and vegetables
A nurse is assessing the stoma of a client with an ostomy. Which intervention should the nurse perform when providing peristomal care to the client to preserve skin integrity?
Wash it with a mild cleanser and water
The nurse is caring for a client with a stoma placed before the terminal ileum. Which vitamin does the nurse anticipate will be ordered?
vitamin B12
The nurse is administering a cleansing enema when the client reports cramping. What is the appropriate nursing action?
Clamp the tube for a brief period.
The nurse is preparing to administer a large-volume enema to an adult client. How far should the nurse insert the tubing?
3 inches (7.5 cm)
The proliferation of Clostridium difficile causes:
antibiotic-associated diarrhea.
The nurse is administering a large-volume cleansing enema to a client who reports severe cramping upon introduction of the enema solution. What would be the nurse’s next action?
Lower solution container and check temperature and flow rate
The nurse is caring for a client with a Foley catheter in place who has a prescription for a sterile urine specimen for culture and sensitivity. The nurse implements which techniques to obtain the prescribed urine specimen?
- The nurse uses a syringe to withdraw urine from the port.
* The nurse dons clean gloves and cleanses the port with aseptic solution.
A nurse drains the bladder of a client by inserting a catheter for 5 minutes. What type of catheter would the nurse use in this instance?
intermittent urethral catheter
To promote drainage of a client’s Foley catheter, which intervention would be most important for the nurse to implement?
Confirming the catheter tubing is not lying under the client
Types of incontinence
stress incontinence: following weakening of perineal and sphincter muscle tone secondary to giving birth. Reflex incontinence is caused by damage to motor and sensory tracts in the lower spinal cord secondary to trauma. Urge incontinence is caused by bladder irritation secondary to infection. Functional incontinence is caused by impaired mobility, impaired cognition, or an inability to communicate.