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A nurse teaches a client about self-care after experiencing a urinary calculus treated by lithotripsy. Which statements should the nurse include in this client's discharge teaching?
- A. Finish the prescribed antibiotic even if you are feeling better.
- B. Drink at least 3 liters of fluid daily.
- C. The bruising on your back may take several weeks to resolve.
- D. Report any blood present in your urine.
- E. It is normal to experience pain and difficulty urinating.
Correct Answer: A,B,C
Rationale: The client should be taught to finish the prescribed antibiotic to ensure that he or she does not get a urinary tract infection. The client should drink at least 3 liters of fluid daily to dilute potential stone-forming crystals, prevent dehydration, and promote urine flow. After lithotripsy, the client should expect bruising that may take several weeks to resolve.
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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.
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 cares for a client admitted from a nursing home after several recent falls. What prescription should the nurse complete first?
- A. Obtain urine sample for culture and sensitivity.
- B. Administer intravenous antibiotics.
- C. Encourage protein intake and additional fluids.
- D. Consult physical therapy for gait training.
Correct Answer: A
Rationale: Although all interventions are or might be important, obtaining a urine sample for urinalysis takes priority. Often urinary tract infection (UTI) symptoms in older adults are atypical, and a UTI may present with new onset of confusion or falling. The urine sample should be obtained before starting antibiotics.
A nurse plans care for clients with urinary incontinence. Which client is correctly paired with the appropriate intervention?
- A. A 24-year-old female post vaginal delivery: Habit training
- B. A 58-year-old postmenopausal client who is not taking estrogen therapy: Electrical stimulation
- C. A 64-year-old female with Alzheimer's-type senile dementia: Bladder training
- D. A 7-year-old female who has difficulty ambulating: Exercise therapy
Correct Answer: B
Rationale: Exercise therapy and electrical stimulation are used for clients with stress incontinence related to childbirth or low levels of estrogen after menopause. Exercise therapy increases pelvic wall strength; it does not improve ambulation. Habit training is the type of bladder training that will be most effective for cognitively impaired clients.
A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?
- A. A 60-year-old female who is confused
- B. A 65-year-old female who is confused
- C. A 65-year-old female who is confused
- D. A 62-year-old female with kidney failure
Correct Answer: A
Rationale: For a bladder training program to succeed in a client with urge incontinence, the client must be alert, aware, and able to resist the urge to urinate. Habit training will work best for a confused client. This includes going to the bathroom (or being assisted to the bathroom) at set times. The other clients may benefit from another type of bladder training.