The nurse is providing patient teaching to a patient with cystitis regarding prevention of future urinary tract infections (UTIs). Which of the following patient statements indicate that teaching has been effective?
- A. I can use vaginal sprays to reduce bacteria.
- B. I will drink a litre of water or other fluids every day.
- C. I will wash with soap and water before sexual intercourse.
- D. I will empty my bladder every 2-4 hours during the day.
Correct Answer: D
Rationale: Voiding every 2-4 hours is recommended to prevent UTIs. Use of vaginal sprays is discouraged. The bladder should be emptied before and after intercourse, but cleaning with soap and water is not necessary. A litre of fluids is insufficient to provide adequate urine output to decrease risk for UTI.
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The nurse is planning teaching for a patient with benign nephrosclerosis. Which of the following information should the nurse include in the teaching plan?
- A. Monitor and record blood pressure daily.
- B. Obtain and document daily weights.
- C. Measure daily intake and output amounts.
- D. Prevent bleeding caused by anticoagulants.
Correct Answer: A
Rationale: Hypertension is the major symptom of nephrosclerosis. Measurements of intake and output and daily weights are not necessary unless the patient develops renal insufficiency. Anticoagulants are not used to treat nephrosclerosis.
The home health nurse is teaching a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying. Which of the following patient statements indicates that the teaching has been effective?
- A. I will use a sterile catheter and gloves for each time I self-catheterize.
- B. I will clean the catheter carefully before and after each catheterization.
- C. I will need to buy seven new catheters weekly and use a new one every day.
- D. I will need to take prophylactic antibiotics to prevent any urinary tract infections.
Correct Answer: B
Rationale: Patients who are at home can use a clean technique for intermittent self-catheterization and change the catheter every 7 days. There is no need to use a new catheter every day, to use sterile catheters, or to take prophylactic antibiotics.
The nurse is caring for a patient with nephrotic syndrome who develops flank pain. Which of the following medication classifications should the nurse anticipate including in the patient teaching plan?
- A. Antibiotics
- B. Anticoagulants
- C. Corticosteroids
- D. Antihypertensives
Correct Answer: B
Rationale: Flank pain in a patient with nephrosis suggests a renal vein thrombosis, and anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by pyelonephritis. Antihypertensives are used if the patient has high blood pressure. Corticosteroids may be used to treat nephrotic syndrome but will not resolve a thrombosis.
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.
Which of the following nursing actions is most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in patients admitted to the hospital?
- A. Avoid unnecessary catheterizations
- B. Encourage adequate oral fluid intake.
- C. Test urine with a dipstick daily for nitrites.
- D. Provide thorough perineal hygiene to patients.
Correct Answer: A
Rationale: Since catheterization bypasses many of the protective mechanisms that prevent urinary tract infection (UTI), avoidance of catheterization is the most effective means of reducing HAI. The other actions will also be helpful, but are not as useful as decreasing urinary catheter use.
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