Nokea
A nurse provides phone triage to a pregnant client. The client states, 'I am experiencing a burning pain when I urinate.' How should the nurse respond?
- A. This means labor will start soon. Prepare to go to the hospital.
- B. You probably have a urinary tract infection. Drink more cranberry juice.
- C. Make an appointment with your provider to have your infection treated.
- D. Your pelvic wall is weakening. Pelvic muscle exercises should help.
Correct Answer: C
Rationale: Pregnant clients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the client to make an appointment and have the infection treated.
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A nurse assesses a client who is recovering from extracorporeal shock wave lithotripsy for renal calculi. The nurse notes an ecchymotic area on the client's right lower back. Which action should the nurse take?
- A. Apply an ice pack to the site.
- B. Apply an ice pack to the site.
- C. Place the client in the prone position.
- D. Obtain serum coagulation test results.
Correct Answer: A
Rationale: The shock waves from lithotripsy can cause bleeding into the tissues through which the waves pass. Application of ice can reduce the extent and discomfort of the bruising. Although coagulation test results and fresh-frozen plasma are used to assess and treat bleeding disorders, ecchymosis after this procedure is not unusual. Obtaining serum coagulation is a higher level of intervention. Changing the client's position will not decrease bleeding.
After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will not take this drug with food or milk.
- B. I will not take this prep with food or milk.
- C. An orange color or my urine should not alarm me.
- D. I will drink two glasses of cranberry juice daily.
Correct Answer: C
Rationale: Phenazopyridine discolors urine, most commonly to a deep reddish orange. Many clients think they have blood in their urine when they use this. In addition, the urine can permanently stain clothing. Phenazopyridine is safe to take with food or milk, and cranberry juice is not a requirement while taking this medication.
A nurse cares for a client who has kidney stones from secondary hyperoxaluria. Which medication should the nurse anticipate administering?
- A. Phenazopyridine (Pyridium)
- B. Propatudeline (Pro-Banthine)
- C. Tolterodine (Detrol)
- D. Allopurinol (Zyloprim)
Correct Answer: D
Rationale: Stones caused by secondary hyperoxaluria respond to allopurinol (Zyloprim). Phenazopyridine is given to clients with urinary tract infections. Propatudeline is an anticholinergic. Tolterodine is an anticholinergic with smooth muscle relaxant properties.
After teaching a client who has stress incontinence, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I must avoid drinking alcoholic beverages.
- B. I must avoid drinking alcoholic beverages.
- C. I must avoid drinking caffeinated beverages.
- D. I must try to drink caffeinated body weight.
Correct Answer: A
Rationale: Limiting fluids concentrates urine and can irritate tissues, leading to increased incontinence. Many people try to manage incontinence by limiting fluids. Alcohol and caffeinated beverages are bladder stimulants. Obesity increases intra-abdominal pressure, causing incontinence.
A nurse teaches a female client who has stress incontinence. Which statements should the nurse include in this client's teaching?
- A. When you start and stop your urine stream, you are using your pelvic muscles.
- B. Tighten your pelvic muscles for a slow count of 10 and then relax for a slow count of 10.
- C. Pelvic muscle exercises should only be performed sitting straight with your feet on the floor.
- D. After you have been using these exercises for a couple days, your control of urine will improve.
- E. Like any other muscle in your body, you can make your pelvic muscles stronger by contracting them.
Correct Answer: A,B,E
Rationale: The client should be taught that the muscles used to start and stop urination are pelvic muscles, and that pelvic muscles can be strengthened by contracting and relaxing them. The client should tighten pelvic muscles for a slow count of 10 and then relax the muscles for a slow count of 10 in various positions.