Questions :Urinary Elimination – Flashcards

How many mL's of urine does the bladder usually hold?

Within a 24 hr day, how many ml's can an individual void?

Since men's prostate enlarges as they age what type of complications are associtated with the enlargement?

What kind of effect does anxiety have on the urinary system? It over stimulates the individuals nervous system and clamps the sphincter shut.Concerning muscle tone, what can cause poor control of voiding?

How can prolonged use of indwelling catheter cause urinary problems?

What is Oliguria? Can occur from losses of what?

What happens to pt's who become extremely diaphoretic (sweating) loses a large amnt of fluids through insensible water loss, will this increase or decrease urine production?

How does anesthesia and narcotic analgesics alter urine formation?

A urinalysis is a general examination of urine to establish baseline information or provide data to establish a _______ diagnosis?

What is important when obtaining a urine culture (what is required of the specimen)?

During bladder distention the bladder cannot be percussable until it contains how much fluid?

What is stress incontinenece and the etiogology behind it? Stress incontinence is leakage of small amnt of urine caused by sudden increase in intra-abdominal pressure. Etiology: coughing, laughing and exercise, weak pelvic musculature, incompetent bladder outlet, and obesity.

A client in the hospital has an indwelling urinary catheter, and the nurse is instructing the nursing assistant in the appropriate care to provide. The nurse teaches the assistant to: A) Empty the drainage bag at least q8h B) Cleanse up the length of the catheter to the perineum C) Use clean technique to obtain a specimen for culture and sensitivity D) Place the drainage bag on the client's lap while transporting the client to testing Correct Answer: A Explanation: The urinary drainage bag should be emptied at least every 8 hours. If large outputs are noted, more frequent emptying will be required. B. The perineum should be cleansed, and then down the catheter. C. Use sterile technique only to collect specimens from a closed drainage system. D. Avoid raising the drainage bag above the level of the bladder. The drainage bag can be attached to the wheelchair below the level of the client's bladder for transport. It should not be placed on the client's lap.

A client with an excessive alcohol intake has a reduced amount of antidiuretic hormone (ADH). The nurse anticipates the client will exhibit: A) Hematuria B) An increased blood pressure C) Dry mucous membranes D) A low serum sodium level Correct Answer: C Explanation: Alcohol inhibits the release of antidiuretic hormone (ADH), resulting in increased water loss in urine. The client may show signs of decreased fluid volume (dehydration), including dry mucous membranes.

A 6-month-old infant has severe diarrhea. The major problem associated with severe diarrhea is: A) Pain in the abdominal area B) Electrolyte and fluid loss C) Presence of excessive flatus D) Irritation of the perineal and rectal area Correct Answer: B Explanation: Diarrhea can result in serious fluid and electrolyte or acid-base imbalances. Infants and older adults are particularly susceptible to associated complications. A. Pain from abdominal cramping may occur with diarrhea, but it is not the major problem associated with severe diarrhea. C. Excessive flatus is not the major problem associated with severe diarrhea. D. Because repeated passage of diarrhea stools exposes the skin of the perineum and buttocks to irritating intestinal contents, meticulous skin care and containment of fecal drainage is needed to prevent skin breakdown. Skin care is important but it is not the major problem.

A 24 hour urine specimen collection is ordered. The test will need to be restarted if the following occurs: A) The client voids in the toilet B) The urine specimen is kept cold C) The first voided urine is discarded D) The preservative is placed in the collection container

The nurse is visiting the client who has a nursing diagnosis of "Alteration in urinary elimination; retention". On assessment, the nurse anticipates that this client will exhibit: A) Severe flank pain and hematuria B) Pain and burning on urination C) A loss of the urge to void D) A feeling of pressure and voiding of small amounts Correct Answer: D Explanation: With urinary retention, urine continues to collect in the bladder, stretching its walls and causing feelings of pressure, discomfort, tenderness over the symphysis pubis, restlessness, and diaphoresis. The sphincter temporarily opens to allow a small volume of urine (25 to 60 ml) to escape, with no real relief of discomfort. A. Severe flank pain and hematuria are supporting data for an upper UTI (pyelonephritis). B. Pain and burning on urination are symptoms of a lower UTI (such as a bladder infection). C. Supportive data for reflex incontinence would include a loss of the urge to void.

Urinary elimination may be altered with different pathophysiologic conditions. For the client with diabetes mellitus, the nurse anticipates that an initial urinary sign or symptom will be: A) Urgency B) Dysuria C) Hematuria D) Polyuria Correct Answer: D Explanation: An initial urinary symptom of diabetes mellitus is polyuria. A. Urgency is not a symptom of diabetes mellitus. Urgency may be caused by a full bladder, bladder irritation from infection, incompetent urethral sphincter, or psychological stress. B. Dysuria is not a symptom of diabetes mellitus. Dysuria may be caused by bladder inflammation, trauma, or inflammation of the urethral sphincter. C. Hematuria is not a symptom of diabetes mellitus. Hematuria may be a symptom of neoplasms of the bladder or kidney, glomerular disease, infection of the kidney or bladder, trauma to urinary structures, calculi, or bleeding disorders.

An assessment is completed by the nurse and a nursing diagnosis for the oriented adult female client is identified as "Stress incontinence related to decreased pelvic muscle tone". An appropriate nursing intervention based on this diagnosis is to: A) Apply adult diapers B) Catheterize the client C) Initiate a bladder emptying program D) Teach Kegel exercises Correct Answer: D Explanation: Pelvic floor exercises, also known as Kegel exercises, improve the strength of pelvic floor muscles and consist of repetitive contractions of muscle groups. These exercises have demonstrated effectiveness in treating stress incontinence, overactive bladders, and mixed causes of urinary continence. A. The client is oriented and therefore could be taught Kegel exercises to improve pelvic floor muscle tone. Applying adult diapers does not improve the client's problem of incontinence and places the client at risk for skin breakdown. B. Because bladder catheterization carries the risk of urinary tract infection (UTI), it is preferable to rely on other measures for management of incontinence. The nurse can support the use of Kegel exercises as an inexpensive nonpharmacologic intervention to reduce the client's stress incontinence. C. The client's condition do not require this intervention at this time.

What should the nurse monitor to best assess a patient's renal perfusion? Blood pressure every 15 minutes Urinary output every hour Body weight every day I&O every 24 hours

When assessing for the presence of dysuria, the nurse should ask, "Do you: Feel that you are able to empty your bladder fully each time you void?" Have a problem stopping or starting the flow of urine?" Pass a little urine when you cough or sneeze?" Experience any pain or burning on urination?"

Which adaptation would indicate urinary retention? Wet bed and undergarments Burning and pain on voiding Sudden, Overwhelming need to void Bladder fullness in the absence of voiding

An additional nursing diagnosis appropriate for a patient with the nursing diagnoses Bowel Incontinence and Total Incontinence would be Risk for: Disuse Syndrome Deficient Fluid Volume Impaired Skin Integrity Imbalanced Nutrition Less Than Body Requirements

When the nurse documents that the patient has polyuria the nurse is communicating that the patient is: Excreting excessive amounts of urine Experiencing pain or urination Retaining urine in the bladder Passing blood in the urine

What is the most common adaptation associated with excessive production of the hormone ADH? Diuresis Oliguria Retention Incontinence

Which is a major contributing factor to overflow incontinence? Coughing Mobility deficits Prostate enlargement Urinary tract infection

Which nursing diagnosis would be the most appropriate for the patient who states, "I can't hold my water once I feel like I have to go." Reflex Incontinence Stress Incontinence Total Incontinence Urge Incontinence

Which action is most important when caring for a patient with a condom catheter? Providing perineal care every shift Avoiding kinks in the collection tubing Ensuring that the Velcro strap is snug, not tight Retracting the foreskin before the catheter is applied

When caring for a patient on bed rest who has a urinary retention catheter, the nurse should: Irrigate the tubing to ensure patency Label the tubing with the date that it was inserted Ensure that the tubing is positioned over the leg Hang the collection bag on the side rail of the bed

Which should be avoided to prevent urinary diuresis? Narcotics Caffeine Activity Protein

The nurse recognizes that additional teaching about fluid intake and urinary incontinence is necessary when the patient said, "If I drink: Less, I will reduce the risk of loss of bladder control." More, it will help prevent irritation of my bladder." Less, it can contribute to a urinary tract infection." More, I am less likely to become dehydrated."

Which constituent, if found in urine, would indicate an abnormality? Electrolytes Protein Water Urea

Which would be the best question to obtain information about a patient's dysuria? "Tell me about the problems you have been having with urination?" "How would you describe your experience with incontinence?" "What are your usual bowel habits?" "What color is your urine?"

Which patient adaptation would cause the most concern? Anuria Dysuria Diuresis Enuresis

What action is most important when removing a urinary retention catheter? Deflate the balloon Wear sterile gloves Clean the meatus with soap and water before removal Dispose of the equipment in an appropriate waste container

What would be the best nursing action to facilitate bladder continence for the patient who is cognitively impaired? Offer toileting reminders every 2 hours Provide clothing that is easy to manipulate Encourage avoidance of fluid between meals Explain the need to call for the nurse for help with toileting

Which nursing intervention takes priority when caring for a bed-bound patient who has Total Incontinence? Insertion of a retention catheter Application of an incontinence device Skin care after episodes of incontinence Positioning a protective pad under the patient

Which nursing diagnosis would be most appropriate for the patient who states, "It burns and stings every time I pass urine." Urinary Retention Reflex Incontinence Stress Incontinence Impaired Urinary Elimination

The nurse should encourage an older adult to drink 8 ounces of cranberry juice daily because it: Dilutes bacterial growth Promotes an acidic urine Prevents urinary retention Stimulates hypoactive detrusor muscles