Nokea
An older adult client is participating in a bladder retraining program as part of the treatment for urinary incontinence. The nurse advises the client to wear barrier garments such as liners and protective pants. Which suggestion would be most appropriate to help the client maintain skin integrity?
- A. Avoiding the application of moisture sealant
- B. Exposing the affected area to air
- C. Using scented sprays or perfumes
- D. Avoiding using an electric room deodoriorer
Correct Answer: B
Rationale: Exposing the affected area to air helps maintain skin integrity by reducing moisture, which can lead to skin breakdown in incontinent clients. Avoiding moisture sealant may increase irritation, and scented sprays or perfumes can cause further irritation. Electric room deodorizers do not directly impact skin integrity.
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The nurse is caring for a client with a urinary tract infection and a urethral stricture. Which complication of the condition is the primary cause of infection?
- A. The bladder mucosa attracts bacteria
- B. There is a backflow of urine causing a diverticulum
- C. Urine leakage occurs as urine passes through the stricture
- D. Urine production is limited due to the urine remaining in the bladder
Correct Answer: B
Rationale: It is common for a client with a stricture to have a urinary tract infection due to the backflow of urine and the stasis of the urine, causing an outpouching or diverticulum. Interstitial cystitis is an inflammatory disease where bacteria cling to the bladder mucosa. Urine leakage is characteristic in urinary incontinence. Urine production is impacted, urine excretion is impacted.
The nurse is caring for a client who is following a treatment plan to decrease urinary tract infections. What indicates the need to change the treatment plan?
- A. The client has history of repeated antibiotic therapy
- B. The client has improved personal hygiene methods
- C. The client exhibits continued symptoms
- D. The client has diluted urine
Correct Answer: C
Rationale: If the client exhibits continued symptoms, the treatment plan is ineffective and the plan needs to be revised. Having a history of antibiotic therapy indicates the need to establish a treatment plan. Having improved hygiene indicates that the client is following the treatment plan. Having diluted urine indicates that the client has increased fluids which are a plan of typical treatment plans.
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
- A. Anticholinergic
- B. Diuretics
- C. Anticonvulsant
- D. Cholinergic
Correct Answer: A
Rationale: Pharmacologic agents that can improve bladder retention, emptying, and control include anticholinergic drugs. In this classification are medications such as Detrol, Ditropan, and Urecholine. Diuretics eliminate fluid from the body but do not affect the muscles of urinary elimination. Anticonvulsant and cholinergic medications also do not directly help with control.
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?
- A. The nursing assistant keeps the catheter and drainage bag together when moving the client
- B. The nursing assistant places the drainage bag on the client's abdomen for transport
- C. The nursing assistant places the drainage bag on the lower area of the wheelchair for transport
- D. The nursing assistant holds the drainage bag while the client moves to the wheelchair
Correct Answer: B
Rationale: The nurse would instruct the nursing assistant to maintain the drainage bag lower than the genital region to avoid a backflow of urine into the bladder. The nursing assistant is correct to move the catheter and drainage bag with the client to not put tension on the catheter, place the drainage bag on the lower area of the wheelchair, and hold the drainage bag while the client is in the process of moving.
The licensed practical nurse is employed as a charge nurse at a long-term care facility. A resident is ordered a catheterization schedule of every 6 hours due to chronic urinary retention. The LPN reports daily catheterization amounts from the previous day ranging from 450 mL to 800 mL. Which nursing action is most correct?
- A. Continue the same order
- B. Obtain an order to decrease the frequency of the catheterizations
- C. Obtain an order to increase the frequency of the catheterizations
- D. Leave the catheterer in if obtaining a urine amount over 500 mL
Correct Answer: C
Rationale: The charge nurse realizes that if the volume of urine obtained via catheterization is more than 400 mL, the client should be catheterized more often. The LPN would call for a change in orders citing the urine volume as the rationale. Leaving the catheter in place is only completed if necessary.