Nokea
The nurse is caring for a 37-year-old female client with potential interstitial cystitis. Which question, asked by the nurse, is helpful in supporting the diagnosis?
- A. Have you noted any unusual vaginal drainage?
- B. Have you experienced hematuria with cramping?
- C. When was your last menstrual period?
- D. Do you drink alcoholic beverages on a frequent basis?
Correct Answer: C
Rationale: Although the cause of interstitial cystitis is unknown, there appears to be a connection with female hormones as a link between flare-ups prior to menstruation has been noted. Unusual vaginal drainage is a symptom of a sexually transmitted disease. Hematuria is a symptom of many urinary tract disorders and not helpful in specifically suggesting interstitial cystitis. Alcoholic beverage consumption is not an indicator.
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The nurse is completing a plan of care for a client with chronic urinary incontinence. Which of the following outcomes is a priority?
- A. The client will decrease fluid intake to 1000 mL/day
- B. The client will use the bathroom every 30 minutes while awake
- C. The client will maintain perineal skin integrity
- D. The client will express feelings of acceptance related to condition
Correct Answer: C
Rationale: The nurse planning care would identify the priority outcome being to maintain skin integrity. Due to the urinary incontinence, perineal skin breakdown may occur due to the warm, moist environment. A skin barrier or moisture sealant is suggested. The nurse would not decrease fluid intake dramatically or tell the client to use the bathroom every 30 minutes in a chronic condition. It is important to accept those things that cannot be controlled.
The nurse is caring for a client diagnosed with bladder stones. The client is scheduled for a cystolitholapaxy. Which nursing action is most important to complete prior to the procedure?
- A. Strain all urine
- B. Maintain the intake and output
- C. Maintain 12 hours of nothing by mouth
- D. Make sure that the nurse has the consent signed
Correct Answer: A
Rationale: It is most important to strain all urine up to the time of the procedure. Should the client pass the stone, the procedure may be able to be cancelled. Maintaining intake and output is important in considering fluid balance. Most clients are ordered nothing by mouth after midnight for a morning procedure. The physician is responsible for explaining the procedure and obtaining the signatures on the consent.
The nurse is encouraging the client with recurrent urinary tract infections to increase fluid intake to 8 large glasses of fluids daily. Which beverage would the nurse discourage for this client?
- A. Coffee in the morning
- B. Fruit juice midmorning
- C. Milk at lunch
- D. Ginger ale at dinner time
Correct Answer: A
Rationale: The nurse would discourage drinking coffee. Coffee, tea, alcohol, and colas are urinary tract irritants. Fruit juice, milk, and ginger ale are appropriate for drinking and counted toward the daily fluid total.
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
- A. Low oxalate
- B. Low purine
- C. High protein
- D. High sodium
Correct Answer: B
Rationale: A low-purine diet is used for uric acid stones, the benefits, however, are unknown. Clients with a history of calcium oxalate stone formation need a diet that is adequate in calcium and low in oxalate. Only clients who have type II absorptive hypercalciumâ??approximately half of the clientsâ??need to limit calcium intake. Usually, clients are told to increase their fluid intake significantly, consume a moderate protein intake, and limit sodium. Avoiding excessive protein intake is associated with lower urinary oxalate and lower uric acid levels. Reducing sodium intake can lower urinary calcium levels.
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.