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The nurse is caring for a female patient who has had a urinary tract infection (UTI). Which of the following interventions should the nurse include in the plan of care?
- A. Encourage the patient to use a diaphragm for contraception.
- B. Sitz baths
- C. Encourage the patient to drink cranberry juice.
- D. Teach the patient how to do isometric perineal exercises.
Correct Answer: B
Rationale: Sitz baths can soothe the perineal area and promote voiding in patients with a UTI. Diaphragm use increases the risk for UTI and should be avoided. While cranberry juice may help prevent UTIs, evidence is inconclusive, and it is not a priority intervention. Isometric perineal exercises (e.g., Kegel exercises) are useful for stress incontinence, not UTI management.
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The nurse is obtaining the health history for a patient who smokes two packs of cigarettes daily. Which of the following conditions should the nurse include in the teaching plan that the patient is at an increased risk for developing?
- A. Kidney stones
- B. Bladder cancer
- C. Bladder infection
- D. Interstitial cystitis
Correct Answer: B
Rationale: Cigarette smoking is a risk factor for bladder cancer. The patient's risk for developing interstitial cystitis, urinary tract infection (UTI), or kidney stones will not be reduced by quitting smoking.
The nurse is providing teaching to a patient with impaired urinary elimination related to an UTI who weighs 70 kg. Which of the following daily fluid intake amounts should the nurse include in the teaching plan?
- A. 650 mL
- B. 1250 mL
- C. 1800 mL
- D. 2450 mL
Correct Answer: C
Rationale: The recommended daily liquid intake for the ambulatory adult is approximately 30 mL/kg body weight per day. Thus, a 70-kg person would require approximately 2100 mL each day. Among the options, 1800 mL is the closest appropriate amount to promote adequate urine output and prevent UTI recurrence.
The nurse is caring for a patient following rectal surgery who voids about 50 mL of urine every 30-60 minutes. Which of the following nursing actions is best?
- A. Use a bladder scan device to check the postvoiding residual.
- B. Monitor the patient's intake and output over the next few hours.
- C. Have the patient take small amounts of fluid frequently throughout the day.
- D. Reassure the patient that this is normal after rectal surgery because of anesthesia.
Correct Answer: A
Rationale: A bladder scan device can be used to check for residual urine after the patient voids. Because the patient's history and clinical manifestations are consistent with overflow incontinence, it is not appropriate to have the patient drink small amounts. Although overflow incontinence is not unusual after surgery, the nurse should intervene to correct the physiological problem, not just reassure the patient. The patient may develop reflux into the renal pelvis as well as discomfort from a full bladder if the nurse waits to address the problem for several hours.
After receiving change-of-shift report, which of the following patients should the nurse assess first?
- A. A patient with nephrotic syndrome with massive edema and ascites
- B. A patient with stage 3 chronic kidney disease with complaints of fatigue
- C. A patient with stage 4 chronic kidney disease with complaints of dysuria
- D. A patient with urolithiasis who needs teaching about preventing recurrence
Correct Answer: A
Rationale: The patient with nephrotic syndrome with massive edema and ascites is at risk for complications such as respiratory distress or infection due to fluid overload, making this the priority for assessment. Fatigue and dysuria in chronic kidney disease and teaching needs for urolithiasis are less urgent.
The nurse is teaching a patient about avoiding the recurrence of a urinary tract infection. Which of the following information should be included in the teaching plan?
- A. Teach the patient to wipe from back to front after voiding.
- B. Suggest the use of a diaphragm during intercourse.
- C. Advise the patient to urinate every 2-4 hours during the day.
- D. Advise the patient to report cloudy urine.
- E. Educate about the effects of a bubble bath.
Correct Answer: C,D,E
Rationale: The nurse would teach about voiding every 2-4 hours during the day, avoiding bubble baths, and advising the patient to report cloudy urine, as well as pain, frequency, and urgency. The patient should be taught to wipe from front to back. Diaphragm use should be discouraged temporarily, rather than suggested as an option.