Urinary Elimination Flashcards
Which component of the urination system would cause peristaltic waves
Ureters
Rationale: uterers drain urine from the kidneys into the bladder. The kidney, bladder, and urethra do not produce peristaltic waves
A patient requests the nurse assistance to the bedside commode and becomes frustrated when unable to void in front of the nurse. The nurse understand that patients inability to void because
Anxiety can make it difficult for abdominal and perineal muscles to relax enough to void
The nurse knows that in dwelling catheters are placed before a cesarean because
Spinal anesthetics can temporarily disable urethral sphincters
Rationale: spinal anesthetics may cause urinary retention due to the inability to sense or carry out the need to void.
The nurse knows that UTI is the most common health care associated infection because
E. coli pathogens are transmitted during surgical of catherization
Rationale: E. coli is the leading pathogen causing UTI; this pathogen enters during procedures. Sterile technique is imperative to prevent the spread of infection
A 86 year old patient tells the nurse that she is experiencing uncontrollable leakage of urine. Which nursing diagnosis should the nurse include in the patients plan of care
Urinary incontinence
Rationale: age related changes such as loss of pelvic muscle tone can cause involuntary loss of urine
When caring for a patient with urinary retention, the nurse would anticipate an order for
Urinary Catheter
Rationale: a catheter would relieve urinary retention. Reducing fluids would reduce the amount of urine produced but would not alleviate the urine retention
Upon palpation, the nurse notices that the bladder is firm and distended; the patient expresses an urge to urinate. The nurse should follow up by asking
“ when was the last time your voided”
Rationale: the nurse should first determine the source of discomfort.
Which of the following is the primary function of the kidney
Maintaining fluid and electrolyte balance
Rationale: the main purpose of the kidney is to maintain fluid and electrolyte balance by filtering waste products and regulating pressures
While receiving a shift report on a patient, the nurse is informed that the patient has urinary incontinence. Upon assessment, the nurse would expect to find
Reddened irritated skin on the buttocks
Rationale: if the urine has prolonged contact with the skin, skin breakdown can occur. Urinary incontinence is uncontrolled urinary elimination
Which nursing diagnosis repeated to alternations in urinary function in an older adult should be a nurses first priority
Risk of infection
Rationale: older adults experience poor muscle tone, which leads to an inability of the bladder to fully empty. Residual greatly increases the risk of infection.
A patient asks about treatment for urge urinary incontinence. The nurses best repose is to advise the patient to
Perform pelvic floor exercise
Rationale: poor muscle tone leads to an inability to control urine flow. The nurse should recommend pelvic muscle strengthening exercises
The nurse suspects that a urinary tract infection has progressed to cystitis when the patient complains of which symptom
Frequency
Rationale: cystitis is inflammation of the bladder; associated symptoms include hematuria(blood in urine) and urgency
Which assessment question should the nurse ask if stress incontinence is suspected
“ do you experience urine leakage when you cough or sneeze”
Rationale: stress incontinence can be related to intra-abdominal pressure causing urine leakage
When establishing a diagnosis of altered urinary elimination, the nurse should first
Discuss causes and solution to problems related to micturition(urination)
To obtain a clean voided urine specimen for a female patient, the nurse should teach the patient to
Hold the labia apart while voiding into the specimen cup
Rationale: this reduce bacteria levels in the specimen. Should be cleansed from the area least contaminated to the greatest (front to back)
When viewing a urine specimen under a microscope, what would the nurse expect to see in a patient with a UTI
Bacteria
The nurse would expect the urine of a patient with uncontrolled diabetes mellitus to be
Sweet smelling
Rationale: incomplete fat metabolism and buildup ketones give urine a sweet or fruity odor.
What signs and symptoms would the nurse expect to observe in a patient with excessive white blood cells present in the urine
Fever and chills
Rationale: the presence of white blood cells indicates a UTI
The nurse would anticipate an order for which diagnostic test for a patient who has severe flank pain and calcium phosphate crystals
Intravenous pyelogram
Rationale: flank pain and calcium phosphate crystals are associated with rank calculi. An intravenous pyelogram allows the provider to observe pathological problems such as obstruction to the ureter.
A nurse is caring for a patient who just underwent intravenous pyelography that reveled a renal calculus obstructing the left ureter. What is the nurses first priority in caring for this patient
Monitor the patient for fever, rash, and difficulty breathing
Rationale: intravenous pyelography is performed by administering iodine based dye to view functionality of the urinary system. Many individuals are allergic to shellfish, therefore, the first nursing priority is to assess the patient for an allergic reaction
The nurse anticipates preparing a patient who is allergic to shellfish for an arteriogram by
Administering an antihistamine medication to the patient
Rationale: the nurse should asses the patient for food and other allergies and should administer an antihistamine, because a contrast iodine based dye is used for the procedure
A nurse anticipates urodynamic testing for a patient with which symptom
Involuntary urine leakage
Rationale: urodynamic testing evaluates the muscle function of the bladder and is used to look for the cause of urinary incontinence.
The nurse would anticipate inserting a coude catheter for which patient
A 56 year old male admitted for bladder irrigation
Rationale: a coude catheter has a curved top that is used for patients with enlarged prostates.
The nurse knows that which indwelling catheter procedure places that patient at greatest risk for acquiring a UTI
Placing the drainage bag on the side rail of the patients bed
Rationale: placing the drainage bag on the side rail of the bed could allow the bag to be raised above the level of the bladder and urine to flow back into the bladder. Allowing it to re enter the bladder can cause infection.
A nurse notifies the provider immediately if a patient with an indwelling catheter
Has not collected any urine in the drainage bag for 2 hours
Rationale: physician needs to be notified immediately because this could indicate renal failure.
The nurse would question an order to insert a urinary catheter on which patient
A 30 year old patient requiring drug screening for employment
Rationale: this should only be performed if necessary because the patient is at risk for infection due to catherization
When caring got a hospitalized patient with a urinary catheter, which nursing action best prevents the patient from acquiring an infection
Performing hand hygiene before and after providing perineal care
Rationale: hand hygiene helps prevent infection in patients with a urinary catheter. Should be inserted using sterile technique
A nurse is providing education to a patient being treated for a UTI. Which of the following statements by the patient indicated an understanding
My medication may discolor my urine, this should resolve once the medication is stopped
Rationale: some anti-infective medications turn urine colors
To reduce patient discomfort during closed catheter irrigation, the nurse should
Use room temperature irrigation solution
Rationale: using cold solutions, instilling solutions too quickly, and prolonging filling of the bladder can cause discomfort and cramping
Which observation by the nurse best indicated that bladder irrigation for urinary retention has been effective
Recording an output that is larger then the amount instilled
Rationale: recording an output that is greater then what was irrigated into the bladder shouts proceed that the bladder is draining urine.
The nurse anticipates urinary diversion from the kidneys to a site other than the bladder for which patient
A 12 year old female with severe abdominal trauma
Rationale:urinary diversion is a surgical procedure to reroute urine flow from its normal pathway. This would be needed in a patient with abdominal trauma who might have injury to the urinary system
Which nursing actions are acceptable when collecting a urine specimen
Labeling all specimens with date, time, initials
Allowing the patient adequate time and privacy to void
Transporting specimens to the laboratory in a timely fashion
Placing a plastic bag over the child’s urethra to catch urine- children may have difficulty voiding so attaching a plastic bag gives the child more time and freedom to void
The nurse properly obtains a 24 hour urine specimen collection by
Asking a patient to void and to discard the first sample
Keeping the urine collection container on ice
Rationale: when obtaining 24 hour urine specimen, it is important to keep the urine in cool condition.
Which of the following are indicators for irrigating a urinary catheter
Sediment occluding within the tubing
Blood clots in the bladder following surgery
Bladder infection
Rationale: catheter irrigation is used to flush and remove blockage that may be impending the catheter from properly draining the bladder. Irrigation is used to remove blood clots in the bladder following surgery
Which of the following symptoms are most closely associated with uremic syndrome
Nausea and vomiting
Headache
Altered mental status
Rationale: uremic syndrome is associated with end stage renal disease. Signs and symptoms include headache, altered mental status, coma, seizures, nausea, vomiting, and pericarditis
The nurse understand that peritoneal dialysis and hemodialysis use which processes to clean that patients blood
Osmosis
Diffusion
Rationale: osmosis and diffusion are two processes used to clean the patients blood in both types of dialysis.
