Quiz and Flashcards for Chapter 49: Urinary Disorders

Questions and Answers

What should be encouraged regarding fluids for a patient with an urinary diversion?

Fluids should be encouraged, not limited.

The collection bag should not be allowed to become more than ______ full.

one-third

How can the nurse best address the effects of an Indiana pouch on the patient's body image?

Emphasize that the diversion is an integral part of successful cancer treatment.

Allow the patient to initiate the process of providing care for the diversion.

Provide the patient with detailed written materials about the diversion at the time of discharge.

Encourage the patient to speak openly and frankly about the diversion. (correct)

Providing educational materials is sufficient to address changes in body image for a patient with a urinary diversion.

False Signup and view all the answers

During the admission assessment, what parameters would be priorities for the nurse to address? (Select all that apply)

Dietary history Signup and view all the answers

What action has the greatest potential to prevent urinary tract infections (UTIs) in older adults?

Limit the use of indwelling urinary catheters Signup and view all the answers

What assessment findings should prompt the nurse to suspect a UTI? (Select all that apply)

Uncharacteristic fatigue Signup and view all the answers

What topic should a nurse address while providing health education for a patient prescribed antibiotics for a UTI?

The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy Signup and view all the answers

How should the nurse respond to a patient with pyelonephritis who has been consuming between 3 L and 3.5 L of oral fluid each day?

Encourage the patient to continue this pattern of fluid intake Signup and view all the answers

What assessment should the nurse prioritize when assessing an older adult with new onset of urinary incontinence?

Reviewing the patient's medication administration record for recent changes Signup and view all the answers

What is the best way to promote successful treatment for a patient prescribed pelvic floor muscle exercises for urinary incontinence?

Arrange for biofeedback when the patient is learning to perform the exercises Signup and view all the answers

What intervention should be implemented for a patient with a flaccid bladder due to a spinal cord injury?

Double voiding Signup and view all the answers

What nursing diagnosis should be prioritized for a patient with a urinary catheter due to a sacral pressure ulcer?

Risk for infection related to presence of an indwelling urinary catheter Signup and view all the answers

What should a nurse communicate to a patient who experiences urinary urgency after having an indwelling catheter removed?

Inform the patient that this is not unexpected in the short term and scan the patient's bladder following each void Signup and view all the answers

Which patient may have a heightened risk of injury associated with indwelling catheter use?

A patient who has Alzheimer's disease and who is acutely agitated Signup and view all the answers

What signs and symptoms are characteristic of ureteral colic secondary to urolithiasis? (Select all that apply)

Acute pain Signup and view all the answers

Following stabilization of a patient with nephrolithiasis, what aspect of care should the nurse prioritize?

Pain management Signup and view all the answers

What preventative measure should the nurse encourage a patient, successfully treated for kidney stones, to adopt?

Increasing fluid intake Signup and view all the answers

How should the nurse respond to a patient indicating a temperature of 101.1F (38.4C) after undergoing ESWL for renal calculi?

Tell the patient to report to the ED for further assessment Signup and view all the answers

What health promotion action most directly addresses a major risk factor for bladder cancer?

Smoking cessation Signup and view all the answers

What should a patient receiving topical chemotherapy for a bladder tumor be instructed to do?

Hold the solution in the bladder for 2 hours before voiding Signup and view all the answers

What is the best response to a urine pH of 6.8 from a patient with a newly created ileal conduit?

Obtain an order to increase the patient's dose of ascorbic acid Signup and view all the answers

What is the most appropriate response to a patient concerned about the mucus in urine after an ileal conduit procedure?

Reassure the patient that this is an expected phenomenon Signup and view all the answers

To prevent leakage or skin breakdown in a patient with an ileal conduit, which practice should the nurse encourage?

Avoid using moisturizing soaps and body washes when cleaning the peristomal area Signup and view all the answers

What health education should the nurse provide to a female patient experiencing recurrent urinary tract infections?

Drink liberal amounts of fluids. Signup and view all the answers

A 42-year-old woman complains of occasional urinary incontinence when she sneezes. What type of incontinence should the clinic nurse recognize?

Stress incontinence Signup and view all the answers

When educating a female patient about self-catheterization, what practice should the nurse encourage?

Using clean technique at home to catheterize Signup and view all the answers

What is the most plausible nursing diagnosis to address for a patient scheduled to undergo ileal conduit surgery?

Deficient knowledge related to care of the ileal conduit Signup and view all the answers

What nutritional guideline should the nurse provide to a patient diagnosed with oxalate renal calculi?

Restrict protein intake as ordered. Signup and view all the answers

What instruction should the nurse give to a patient who underwent percutaneous lithotripsy earlier in the day?

Notify the physician about cloudy or foul-smelling urine. Signup and view all the answers

What principle should inform the nurse's data analysis when assessing a patient with bacteriuria?

Urine samples are frequently contaminated by bacteria normally present in the urethral area. Signup and view all the answers

In implementing a behavioral therapy approach for a patient with stress incontinence, what role will the nurse have?

Teach the patient to perform pelvic floor muscle exercises. Signup and view all the answers

What approach should the nurse anticipate the physician using to drain a patient's bladder with prostatic obstruction?

Insertion of a suprapubic catheter Signup and view all the answers

What would be the nurse's best response if an older adult patient has approximately 50 mL of urine remaining in her bladder after voiding?

Avoid further interventions at this time, as this is an acceptable finding. Signup and view all the answers

How much urine should a patient with renal calculi increase fluid intake to produce each day?

2,000 mL Signup and view all the answers

What hourly urine output should a nurse notify the physician about for a patient who has just undergone surgery to create an ileal conduit?

30 mL Signup and view all the answers

What nursing action helps prevent infection in a patient with an indwelling urinary catheter?

Empty the drainage bag at least every 8 hours. Signup and view all the answers

What characteristic of UTIs in older adults should be cited by the nurse in a health class?

The prevalence of UTIs in men older than 50 years of age approaches that of women in the same age group. Signup and view all the answers

What should the nurse measure to determine the size of the appliance needed for a stoma?

The widest part of the stoma Signup and view all the answers

What nursing action should the nurse take to encourage a patient experiencing occasional urinary retention?

Provide privacy for the patient. Signup and view all the answers

What principle should guide the nurse's management of urinary incontinence in older adults?

Urinary incontinence is not considered a normal consequence of aging. Signup and view all the answers

What assessment finding would suggest that a patient is experiencing urinary retention?

The patient's suprapubic region is dull on percussion. Signup and view all the answers

What should the nurse include in the patient's post-procedure care after extracorporeal shock wave lithotripsy (ESWL)?

Strain the patient's urine following the procedure. Signup and view all the answers

What is the nurse's most appropriate response to a dark purplish color of a stoma 48 hours after a urinary diversion surgery?

Inform the primary care provider that the vascular supply may be compromised. Signup and view all the answers

Completing diagnostic testing for a suspected urinary obstruction, what can incomplete emptying due to bladder outlet obstruction cause?

Hydronephrosis Signup and view all the answers

Study Notes

Urinary Disorders Management

Educating patients with recurrent urinary tract infections emphasizes increasing fluid intake to aid urine production and flush bacteria.
Stress incontinence, characterized by involuntary urine loss during activities that increase abdominal pressure (e.g., sneezing), is common in women.
For patients with urinary retention requiring self-catheterization, using clean technique at home is essential for safety.
Discharge education for patients post-ileal conduit surgery needs to focus on the care and maintenance of the urinary diversion.
Patients with oxalate renal calculi should have protein intake restricted to prevent further stone formation.
Following percutaneous lithotripsy, patients should report any cloudy or foul-smelling urine as potential indicators of a urinary tract infection.
Bacteriuria diagnoses reflect the importance of considering urine sample contamination by urethral bacteria, not necessarily needing three positive results for confirmation.
Pelvic floor muscle exercises are fundamental in the behavioral therapy approach to managing stress incontinence in patients.
Suprapubic catheters are utilized for bladder drainage when traditional catheterization fails due to obstructions.
Residual urine volumes of 50 mL are acceptable in older adults; further intervention is often unnecessary unless complications arise.
Advise patients with renal stones to maintain a daily urine output of at least 2,000 mL to dilute urine and decrease stone formation.
Monitor patients post-ileal conduit for urine output, alerting physicians if it drops below 30 mL/hr to rule out obstructions or dehydration.
Emptying the drainage bag of indwelling urinary catheters at least every eight hours is a crucial infection prevention strategy.
The likelihood of UTIs in older men rises post-50, nearing the rates seen in women due to decreased prostatic antibacterial activity.
When measuring for stoma appliance sizing post-surgery, the stoma's widest part is critical to ensure proper fit and prevent skin irritation.
Encouraging privacy can significantly facilitate normal voiding patterns in hospitalized patients experiencing urinary retention.
Urinary incontinence is not an inevitable consequence of aging; it is often treatable and reversible.
Dullness upon percussion of the suprapubic region often suggests urinary retention in patients.
Following ESWL, nurses should strain urine to collect stone fragments, without routine IV fluids or catheterization.
A dark purplish stoma following a urinary diversion surgery indicates potential vascular compromise and should prompt immediate physician notification.
Hydronephrosis can develop from chronic incomplete bladder emptying due to bladder outlet obstruction, necessitating assessment during diagnostics.
Assessing dietary history, family history of stones, and medication history is crucial in the management of renal stones, while surgical history is less relevant.
Limiting indwelling urinary catheters is vital in long-term care settings to reduce UTIs among older adults, who are at higher risk.
In older patients, symptoms of UTI, like fatigue and confusion, may present atypically, warranting careful assessment for proper diagnosis.### Cognitive Changes and UTI
A significant indicator of a possible UTI is a notable change in cognitive function.
Symptoms like food cravings, increased thirst, and upper abdominal pain may require evaluation, but they are not definitive indicators of a UTI.

Antibiotic Education for UTI

The most important topic to discuss with patients on antibiotics for UTI is the risk of developing a vaginal yeast infection.
Up to 25% of patients may develop yeast vaginitis post-antibiotic treatment, which can be more challenging to manage than the original UTI.

Fluid Intake in Pyelonephritis

Encourage patients hospitalized with pyelonephritis to maintain high fluid intake (3-4 L daily) to help dilute urine and reduce discomfort.
No need for a high-calorie or high-sodium diet supplements; focus on hydration instead.

Assessing Urinary Incontinence in Older Adults

Prioritize reviewing medication administration records when assessing newly developed urinary incontinence in older adults, as medications are commonly a causative factor.
Other factors such as dietary changes and psychosocial stress can also contribute, but medications are more frequently involved.

Promoting Pelvic Floor Muscle Exercises

For patients with stress urinary incontinence, arrange for biofeedback during pelvic floor muscle exercise training to improve effectiveness.
Educating patients about the benefits of exercises is key, but guidance through biofeedback is superior for ensuring proper technique.

Flaccid Bladder Management

Teaching patients with flaccid bladders to practice double voiding enhances bladder emptying and reduces retention.

Nursing Diagnosis for Indwelling Catheters

The priority nursing diagnosis for patients with an indwelling urinary catheter is the risk for infection due to the higher susceptibility of UTIs associated with catheters.

Post-Catheter Removal Urgency

Inform patients experiencing urgency after catheter removal that this is typical in the immediate aftermath and monitor bladder fullness.

High-Risk Patients for Catheter Use

Patients with cognitive impairments, like Alzheimer's, are at an increased risk of trauma or injury from indwelling catheters.

Signs of Ureteral Colic

The classic signs and symptoms of ureteral colic include hematuria, urinary frequency, and acute, pain radiating to the thigh and genitalia.

Pain Management in Nephrolithiasis

Pain management is the priority for patients presenting with kidney stones, exceeding the need for IV fluids or catheter insertion.

Preventing Recurrence of Kidney Stones

Post-treatment education for patients should include increasing fluid intake to prevent recurrence of kidney stones.

Response to Fever after ESWL

A fever post-Extracorporeal Shock Wave Lithotripsy (ESWL) is abnormal and may indicate a UTI, necessitating immediate medical attention.

Bladder Cancer Risk Reduction

Smoking cessation is a crucial action to reduce the risk of bladder cancer, as smokers have double the risk compared to non-smokers.

Topical Chemotherapy Administration

Patients receiving intravesical chemotherapy should be instructed to retain the solution in the bladder for two hours before voiding for optimal effectiveness.

Urine pH Management in Ileal Conduit

Administering ascorbic acid helps maintain a urine pH below 6.5 to prevent alkaline encrustation in patients with an ileal conduit.

Mucus Presence in Ileal Conduit

Reassure patients after an ileal conduit procedure that mucus in the urine is expected due to the use of mucous membrane during surgery.

Managing Ileal Conduit Care

Instruct patients to avoid moisturizing soaps near the stoma to ensure proper adhesion of pouches and maintain skin integrity.

Addressing Body Image Concerns Post-Diversion

Encourage open dialogue about urinary diversions to help patients address body image concerns, enabling them to express feelings and anxieties effectively.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the management of patients with urinary disorders through these flashcards. The focus is on health education, prevention, and management strategies to address urinary tract infections and related conditions. Perfect for nursing students and healthcare professionals.

Chapter 49: Management of Urinary Disorders