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Questions and Answers
What should be encouraged regarding fluids for a patient with an urinary diversion?
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.
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?
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.
Providing educational materials is sufficient to address changes in body image for a patient with a urinary diversion.
During the admission assessment, what parameters would be priorities for the nurse to address? (Select all that apply)
During the admission assessment, what parameters would be priorities for the nurse to address? (Select all that apply)
What action has the greatest potential to prevent urinary tract infections (UTIs) in older adults?
What action has the greatest potential to prevent urinary tract infections (UTIs) in older adults?
What assessment findings should prompt the nurse to suspect a UTI? (Select all that apply)
What assessment findings should prompt the nurse to suspect a UTI? (Select all that apply)
What topic should a nurse address while providing health education for a patient prescribed antibiotics for a UTI?
What topic should a nurse address while providing health education for a patient prescribed antibiotics for a UTI?
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?
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?
What assessment should the nurse prioritize when assessing an older adult with new onset of urinary incontinence?
What assessment should the nurse prioritize when assessing an older adult with new onset of urinary incontinence?
What is the best way to promote successful treatment for a patient prescribed pelvic floor muscle exercises for urinary incontinence?
What is the best way to promote successful treatment for a patient prescribed pelvic floor muscle exercises for urinary incontinence?
What intervention should be implemented for a patient with a flaccid bladder due to a spinal cord injury?
What intervention should be implemented for a patient with a flaccid bladder due to a spinal cord injury?
What nursing diagnosis should be prioritized for a patient with a urinary catheter due to a sacral pressure ulcer?
What nursing diagnosis should be prioritized for a patient with a urinary catheter due to a sacral pressure ulcer?
What should a nurse communicate to a patient who experiences urinary urgency after having an indwelling catheter removed?
What should a nurse communicate to a patient who experiences urinary urgency after having an indwelling catheter removed?
Which patient may have a heightened risk of injury associated with indwelling catheter use?
Which patient may have a heightened risk of injury associated with indwelling catheter use?
What signs and symptoms are characteristic of ureteral colic secondary to urolithiasis? (Select all that apply)
What signs and symptoms are characteristic of ureteral colic secondary to urolithiasis? (Select all that apply)
Following stabilization of a patient with nephrolithiasis, what aspect of care should the nurse prioritize?
Following stabilization of a patient with nephrolithiasis, what aspect of care should the nurse prioritize?
What preventative measure should the nurse encourage a patient, successfully treated for kidney stones, to adopt?
What preventative measure should the nurse encourage a patient, successfully treated for kidney stones, to adopt?
How should the nurse respond to a patient indicating a temperature of 101.1F (38.4C) after undergoing ESWL for renal calculi?
How should the nurse respond to a patient indicating a temperature of 101.1F (38.4C) after undergoing ESWL for renal calculi?
What health promotion action most directly addresses a major risk factor for bladder cancer?
What health promotion action most directly addresses a major risk factor for bladder cancer?
What should a patient receiving topical chemotherapy for a bladder tumor be instructed to do?
What should a patient receiving topical chemotherapy for a bladder tumor be instructed to do?
What is the best response to a urine pH of 6.8 from a patient with a newly created ileal conduit?
What is the best response to a urine pH of 6.8 from a patient with a newly created ileal conduit?
What is the most appropriate response to a patient concerned about the mucus in urine after an ileal conduit procedure?
What is the most appropriate response to a patient concerned about the mucus in urine after an ileal conduit procedure?
To prevent leakage or skin breakdown in a patient with an ileal conduit, which practice should the nurse encourage?
To prevent leakage or skin breakdown in a patient with an ileal conduit, which practice should the nurse encourage?
What health education should the nurse provide to a female patient experiencing recurrent urinary tract infections?
What health education should the nurse provide to a female patient experiencing recurrent urinary tract infections?
A 42-year-old woman complains of occasional urinary incontinence when she sneezes. What type of incontinence should the clinic nurse recognize?
A 42-year-old woman complains of occasional urinary incontinence when she sneezes. What type of incontinence should the clinic nurse recognize?
When educating a female patient about self-catheterization, what practice should the nurse encourage?
When educating a female patient about self-catheterization, what practice should the nurse encourage?
What is the most plausible nursing diagnosis to address for a patient scheduled to undergo ileal conduit surgery?
What is the most plausible nursing diagnosis to address for a patient scheduled to undergo ileal conduit surgery?
What nutritional guideline should the nurse provide to a patient diagnosed with oxalate renal calculi?
What nutritional guideline should the nurse provide to a patient diagnosed with oxalate renal calculi?
What instruction should the nurse give to a patient who underwent percutaneous lithotripsy earlier in the day?
What instruction should the nurse give to a patient who underwent percutaneous lithotripsy earlier in the day?
What principle should inform the nurse's data analysis when assessing a patient with bacteriuria?
What principle should inform the nurse's data analysis when assessing a patient with bacteriuria?
In implementing a behavioral therapy approach for a patient with stress incontinence, what role will the nurse have?
In implementing a behavioral therapy approach for a patient with stress incontinence, what role will the nurse have?
What approach should the nurse anticipate the physician using to drain a patient's bladder with prostatic obstruction?
What approach should the nurse anticipate the physician using to drain a patient's bladder with prostatic obstruction?
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?
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?
How much urine should a patient with renal calculi increase fluid intake to produce each day?
How much urine should a patient with renal calculi increase fluid intake to produce each day?
What hourly urine output should a nurse notify the physician about for a patient who has just undergone surgery to create an ileal conduit?
What hourly urine output should a nurse notify the physician about for a patient who has just undergone surgery to create an ileal conduit?
What nursing action helps prevent infection in a patient with an indwelling urinary catheter?
What nursing action helps prevent infection in a patient with an indwelling urinary catheter?
What characteristic of UTIs in older adults should be cited by the nurse in a health class?
What characteristic of UTIs in older adults should be cited by the nurse in a health class?
What should the nurse measure to determine the size of the appliance needed for a stoma?
What should the nurse measure to determine the size of the appliance needed for a stoma?
What nursing action should the nurse take to encourage a patient experiencing occasional urinary retention?
What nursing action should the nurse take to encourage a patient experiencing occasional urinary retention?
What principle should guide the nurse's management of urinary incontinence in older adults?
What principle should guide the nurse's management of urinary incontinence in older adults?
What assessment finding would suggest that a patient is experiencing urinary retention?
What assessment finding would suggest that a patient is experiencing urinary retention?
What should the nurse include in the patient's post-procedure care after extracorporeal shock wave lithotripsy (ESWL)?
What should the nurse include in the patient's post-procedure care after extracorporeal shock wave lithotripsy (ESWL)?
What is the nurse's most appropriate response to a dark purplish color of a stoma 48 hours after a urinary diversion surgery?
What is the nurse's most appropriate response to a dark purplish color of a stoma 48 hours after a urinary diversion surgery?
Completing diagnostic testing for a suspected urinary obstruction, what can incomplete emptying due to bladder outlet obstruction cause?
Completing diagnostic testing for a suspected urinary obstruction, what can incomplete emptying due to bladder outlet obstruction cause?
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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.
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