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The nurse is caring for a patient who has had an ureterolithotomy with a left ureteral catheter and a urethral catheter in place. Which of the following actions should the nurse include in the plan of care?
- A. Provide education about home care for both catheters
- B. Apply continuous steady tension to the ureteral catheter.
- C. Clamp the ureteral catheter unless output from
- D. Call the health care provider if the ureteral catheter output drops suddenly.
Correct Answer: D
Rationale: The health care provider should be notified if the ureteral catheter output decreases since obstruction of this catheter may result in an increase in pressure in the renal pelvis. Tension on the ureteral catheter should be avoided in order to prevent catheter displacement. To avoid pressure in the renal pelvis, the catheter is not clamped. Since the patient is not usually discharged with a ureteral catheter in place, patient teaching about both catheters is not needed.
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A female patient asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which of the following interventions is best to include in the care plan?
- A. Assist the patient to the bathroom q3hr.
- B. Place a commode at the patient's bedside.
- C. Demonstrate how to perform the Credé manoeuvre.
- D. Teach the patient how to perform Kegel exercises.
Correct Answer: D
Rationale: Exercises to strengthen the pelvic floor muscles will help reduce stress incontinence. The Credé manoeuvre is used to help empty the bladder for patients with overflow incontinence. Placing the commode close to the bedside and assisting the patient to the bathroom are helpful for functional incontinence.
The nurse is caring for a patient who has a history of functional urinary incontinence. Which of the following nursing actions should be included in the plan of care?
- A. Place a bedside commode near the patient's bed.
- B. Demonstrate the use of the Credé manoeuvre to the patient.
- C. Use an ultrasound scanner to check postvoiding residuals.
- D. Teach the use of Kegel exercises to strengthen the pelvic floor.
Correct Answer: A
Rationale: Modifications in the environment make it easier to avoid functional incontinence. Checking for residual urine and performing the Credé manoeuvre are interventions for overflow incontinence. Kegel exercises are useful for stress incontinence.
The nurse is admitting a patient with acute glomerulonephritis. Which of the following assessments is most important for the nurse to include?
- A. Recent sore throat and fever
- B. History of high blood pressure
- C. Frequency of bladder infections
- D. Family history of kidney stones
Correct Answer: A
Rationale: Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is not caused by hypertension, urinary tract infection (UTI), or kidney stones.
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.
The nurse is preparing a patient with bladder cancer for intravesical chemotherapy. Which of the following information should the nurse teach the patient about in preparation for the treatment?
- A. Premedicating to prevent nausea
- B. Where to obtain wigs and scarves
- C. The importance of oral care during treatment
- D. The need to empty the bladder before treatment
Correct Answer: D
Rationale: Intravesical chemotherapy is the instillation of the agent directly into the bladder, therefore the patient needs to have an empty bladder before the instillation of the chemotherapy. Systemic adverse effects are not experienced with intravesical chemotherapy.