Nokea
The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of an early stage of malignant tumor of the bladder?
- A. Incontinence
- B. Dysuria
- C. Hematuria
- D. Frequency
Correct Answer: C
Rationale: The most common first symptom of a malignant tumor is painless hematuria. Most malignant tumors are vascular, thus, abnormal bleeding can be a first sign of abnormality. The client then has symptoms of incontinence (a later sign), dysuria, and frequency.
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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.
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 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 caring for a client for whom an ileal conduit is created after a radical cystectomy. Which instructions would the nurse expect to include in the client's plan of care?
- A. Application of an ostomy pouch
- B. Intermitient catheterizations
- C. Exercises to promote sphincter control
- D. Irrigating the urinary diversion
Correct Answer: A
Rationale: An ileal conduit involves care of a urinary stoma, much like that of a fecal stoma, including the application of an ostomy pouch, skin protection, and stoma care. Intermitient catheterizations and irrigations are appropriate for a continent urinary diverse such as a Kock or Indiana pouch. Exercises to promote sphincter control are appropriate for an ureterosigmoidoscopy.
The best nursing action to remove urine from the bladder is to use a curve-tipped coud?© catheter
- A. Use a large catheter such as a 22 French
- B. Use a straight-tipped catheter
- C. Crec?º maneuver
Correct Answer: C
Rationale: The best nursing action to remove urine from the bladder is to use a curve-tipped coud?© catheter. The coud?© catheter has a curved tip to slide over the obstruction. Using a large catheter such as a 22 French would meet resistance and traumatize the urethral lining. A straight-tipped catheter also would meet the obstruction and not advance. Crec?º maneuver may eliminate a small amount of urine but does nothing to allow urine flow around the narrowing.