Nokea
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.
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Which of the following findings for a patient who has had a cystectomy with an ileal conduit the previous day is most important for the nurse to communicate to the health care provider?
- A. Cloudy appearing urine
- B. Hypotonic bowel sounds
- C. Heart rate 102 beats/minute
- D. Stoma appears pale and dry
Correct Answer: D
Rationale: A pale and dry stoma indicates poor vascularity or ischemia, which is a critical complication requiring immediate reporting to the health care provider. Cloudy urine, hypotonic bowel sounds, and a slightly elevated heart rate are common postoperative findings but are less urgent unless accompanied by other critical symptoms.
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 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.
Which of the following actions should the nurse teach to a patient to help prevent the recurrence of renal calculi?
- A. Use a filter to strain all urine.
- B. Avoid dietary sources of calcium.
- C. Drink diuretic fluids such as coffee.
- D. Have 2000-3000 ml of fluid a day.
Correct Answer: D
Rationale: A fluid intake of 2000-2200 ml daily is recommended to help flush out minerals before stones can form. Avoidance of calcium is not usually recommended for patients with renal calculi. Coffee tends to increase stone recurrence. There is no need for a patient to strain all urine routinely after a stone has passed, and this will not prevent stones.
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.