Nokea
You are teaching an aide to perform catheter care. Which of the following represents an accurate statement?
- A. Clean the perineum and a few inches of tubing using a perineal wash and a washcloth or gauze in downward strokes away from the body.
- B. Wash the perineum with a soapy washcloth using circular motions.
- C. Wash from the tubing 3 to 4 inches from the insertion site up toward the meatus.
- D. Separate the labia if the patient is female and wash first on one side, then the other, and then down the middle.
Correct Answer: A,D
Rationale: Cleaning downward from the meatus and separating the labia to clean thoroughly prevents infection by moving away from the insertion site.
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Neuropathic incontinence
- A. Incontinence related to inability to get to the bathroom
- B. The brain does not receive a message that the bladder is full
- C. Incontinence related to bladder spasms and contractions
- D. The bladder does not empty because of an obstruction
- E. Incontinence related to weak pelvic floor muscles
- F. Loss of urine with no warning
Correct Answer: B
Rationale: Neuropathic incontinence occurs when nerve damage prevents the brain from receiving signals that the bladder is full.
Functional incontinence
- A. Incontinence related to inability to get to the bathroom
- B. The brain does not receive a message that the bladder is full
- C. Incontinence related to bladder spasms and contractions
- D. The bladder does not empty because of an obstruction
- E. Incontinence related to weak pelvic floor muscles
- F. Loss of urine with no warning
Correct Answer: A
Rationale: Functional incontinence results from physical or cognitive inability to reach the bathroom in time.
You will need to push back the foreskin before catheterizing uncircumcised males. After you catheterize the patient, you should
- A. Pull the foreskin back over the glans.
- B. Leave the foreskin retracted.
- C. Lubricate the foreskin with petroleum jelly and then replace it.
- D. Elevate the penis on a folded towel to prevent swelling of the foreskin or glans.
Correct Answer: A
Rationale: Replacing the foreskin over the glans after catheterization prevents paraphimosis, a condition where the retracted foreskin causes swelling.
You are teaching bladder retraining to the patient with incontinence. She tries the plan and reports back to you about her progress. 'I tried going to the bathroom every 2 hours like you said, but I just sit there. I'm trying now to just go when I feel the urge, which is about every 3 hours. I'm still having accidents about half the time, which is a big improvement.' Which of the following statements should you make in response to the patient's comment?
- A. That's great. Keep up that pattern. It sounds like it's working.
- B. Waiting until you feel the urge defeats the purpose of a bladder retraining program. It sounds like you haven't really implemented the program. You should go back to trying to void every 2 hours to train your bladder to empty when you want it to.
- C. It sounds like bladder retraining isn't working for you, but that paying greater attention to the urge to go is.
- D. This is good information, but waiting for the urge to go is not going to retrain your bladder. Try toileting yourself every 2½ hours. Do this for several days to a week and then let me know the results.
Correct Answer: D
Rationale: Adjusting the interval to 2½ hours may help the patient adhere to a scheduled voiding program, which is essential for bladder retraining.
Symptoms of UTI include dysuria, urinary frequency, urgency, nocturia, low abdominal pain, and incontinence.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: These are common UTI symptoms due to bladder irritation and inflammation.