Nokea
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.
You may also like to solve these questions
The nurse is caring for a patient who has had a segmental cystectomy. Which of the following information should the nurse include in the postoperative teaching for the patient?
- A. Limit fluid intake for at least 7 days.
- B. Urine should be amber and not contain blood clots.
- C. In about one week urine will have rust-coloured flecks.
- D. Avoid sitz baths for a week after surgery.
Correct Answer: C
Rationale: Approximately 7-10 days following tumour resection or ablation, the patient may observe dark red or rust-coloured flecks in the urine. These are anticipated and represent scabs from the healing tumour resection sites. Other postoperative instructions for a segmental cystectomy include to drink a large volume of fluid each day for the first week following the procedure and to avoid intake of alcoholic beverages. Urine is anticipated to be pink during the first several days after the procedure, but it should not be bright red or contain blood clots. The patient can be encouraged to take a 15-20-minute sitz bath two to three times a day to promote muscle relaxation and to reduce the risk of urinary retention.
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 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.
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim-sulfamethoxazole for 3 days. Which of the following actions should the nurse plan to take?
- A. Remind the patient about the need to drink 1000 mL of fluids daily.
- B. Obtain a midstream urine specimen for culture and sensitivity testing.
- C. Teach the patient to take the prescribed trimethoprim-sulfamethoxazole for at least 3 more days.
- D. Suggest that the patient drink cranberry juice to treat the symptoms.
Correct Answer: B
Rationale: Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy. Although daily intake of cranberry juice has been purported to assist in treating, there is currently no conclusive evidence to support advocating this treatment. The fluid intake should be increased to at least 1000 mL/day. Since the UTI has persisted after treatment with trimethoprim-sulfamethoxazole, the patient is likely to need a different antibiotic.
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.