Elimination

Question 1

Inability to empty the bladder partially or completely

Answer 1

Urinary Retention

Question 2

Incontinence caused by medial conditions that are treatable and reversible i.e. mobility impairment, inflammation/infection

Answer 2

Transient incontinence

Question 3

Loss of continence because of causes outside the urinary tract such as functional deficits related to altered mobility, cognitive impairment or functional barriers

Answer 3

Functional incontinence

Question 4

Involuntary loss of urine caused by an overdistended bladder often related to bladder outlet obstruction or poor bladder emptying

Answer 4

Overflow urinary incontinence

Question 5

Involuntary leakage of small volumes of urine associated with increased intra-abdominal pressure i.e. with coughing, laughing

Answer 5

Stress urinary incontinence

Question 6

Involuntary passage of urine caused by involuntary contractions of the bladder associated with a strong urge to void that causes leakage of urine

Answer 6

Urge incontinence

Question 7

Involuntary loss of urine occurring at predictable intervals when bladder reaches specific volumes, related to spinal cord damage between C1 and S2

Answer 7

Reflex urinary incontinence

Question 8

Delay in start of urinary stream when voiding

Answer 8

Hesitancy

Question 9

What is the normal colour of urine?

Answer 9

Normal urine ranges in color from a pale straw to amber, depending on its concentration.

Urine is usually more concentrated in the morning or with fluid volume deficits. As the patient drinks more fluids, urine becomes less concentrated, and the color lightens.

Question 10

What is a common cause of dark amber urine?

Answer 10

High concentration of bilirubin (urobilinogen) in patients with liver disease

Question 11

What is a common cause of cloudy urine?

Answer 11

Presence of bacteria and white blood cells

Question 12

Normal pH of urine

Answer 12

4.6 to 8.0

Question 13

Is it normal to have protein in urine?

Answer 13

Protein is normally not present in urine, and is a sensitive indicator of kidney function.

Question 14

What could be a cause of proteinuria?

Answer 14

Damage to glomerular membrane, allowing filtration of large molecules such as proteins

Question 15

True or False: Glucose is normally not present in urine.

Answer 15

True. Glucose in urine may indicate poorly controlled diabetes

Question 16

True or False: it is normal for some patients to have ketones in the urine.

Answer 16

False. Ketones are end-products of fat metabolism, which is usually an indicator of poorly controlled diabetes type 1.

Question 17

What is the normal urine specific gravity?

Answer 17

1.005 to 1.030

Question 18

What would cause presence of RBCs in urine?

Answer 18

Damaged glomeruli or tubules from trauma and renal disease

Question 19

Helping patients assume the normal position for voiding promotes bladder emptying. What is the most natural position for:
Males
Females

Answer 19

Males: standing
Females: squatting

Question 20

An exercise the can improve pelvic muscles strength and promote bladder emptying.

Answer 20

Kegel exercises

Question 21

One-time catheterisation is also called:

Answer 21

Intermittent catheterisation

Question 22

A catheter that remains in place over a period of time:

Answer 22

Indwelling catheter

Question 23

Between single, double or triple-lumen catheters, which type used for intermittent/straight catheterisation?

Answer 23

Single lumen catheter

Question 24

Between single, double or triple-lumen catheters, which type used for indwelling catheterisation?

Answer 24

Double lumen: one lumen is for urinary drainage, 2nd lumen is used to inflate the balloon that keeps the catheter in place

Question 25

Between single, double or triple-lumen catheters, which type used for continuous bladder irrigation?

Answer 25

Triple lumen

Question 26

What are the functions of each of the 3 lumens in CBI?

Answer 26

Drainage of urine, balloon inflation, delivery of irrigation fluid into bladder

Question 27

What size catheter would you use for inserting a short-term indwelling catheter for an adult?

Answer 27

Fr 14 to 16

Question 28

What size catheter would you use for inserting an indwelling catheter for an adult with hematuria or clots?

Answer 28

Fr 20 to 24 – higher number, smaller diameter

Question 29

How much fluid is normally required to inflate the balloon of an adult catheter?

Answer 29

10 ml

Question 30

When long-term catheterisation is required, how frequently will the catheter need to be changed?

Answer 30

Every 4 to 6 weeks

Question 31

If a catheter appears to be blocked, which of the following is the preferred management: Irrigation/flushing with sterile solution or changing the catheter immediately?

Answer 31

Irrigation poses risk of causing UTI. In general, if a catheter becomes occluded, it is best to CHANGE it rather than risk flushing debris into the bladder. Irrigation can be used in specific situations such as after surgery, when there is high risk for catheter occlusion from blood clots.

Question 32

What is an important nursing intervention after catheter removal?

Answer 32

Monitor patient’s voiding for at least 24 to 48 hours using a bladder diary.

Question 33

Give at leas 3 measures to prevent catheter-associated urinary tract infection? HINT: CLEAN URINE

Answer 33

Clean: routine perineal hygiene Catheter size: smallest possible Low: keep drainage bag below level of bladder Early removal: catheters should be removed as soon as possible Aseptic: maintain sterile, closed urinary drainage system, do not let spigot of bag touch drainage receptacle No obstruction: check for kinks or bends, observe for clots which may block tubing

Question 34

What is an important assessment to make before application of a condom catheter?

Answer 34

Assess for latex allergy

Question 35

What are the ideal positions for female catheterisation?

Answer 35

Dorsal recumbent Side-lying position with upper leg flexed at knee and hip

Question 36

What is the ideal position for male catheterisation?

Answer 36

Supine with legs extended and thighs slight abducted to aid in the visualisation of the penis

Question 37

Why is it important to lubricate the catheter prior to insertion?

Answer 37

Lubrication minimises trauma to the urethra and discomfort during catheter insertion

Question 38

How much of the catheter would you lubricate for a male and female catheterisation?

Answer 38

Male catheter 5-7 inches Female 1-2 inches

Question 39

What instruction to the patient would help visualise the urinary meatus and promote relaxation of the external urinary sphincter

Answer 39

Asking the patient to bear down gently

Question 40

How far would you advance the catheter in a female patient?

Answer 40

2-3 inches or until urine flows out of the catheter, and then insert another 1-2 inches

Question 41

How far would you advance the catheter INITIALLY in a male patient?

Answer 41

7-9 inches or until urine flows

Question 42

Once urine flows during male catheterisation, what action will ensure that the balloon part is not in the prostatic urethra?

Answer 42

Advancing the catheter to the bifurcation of drainage and balloon port Flow of urine indicates that tip of catheter is in bladder or urethra but the balloon part of the indwelling catheter may not necessarily be in bladder yet. Further advancement to bifurcation ensures that balloon part is not still in the prostatic urethra.

Question 43

What 5 actions would a nurse take if patient reports sudden pain during balloon inflation?

Answer 43

If patient reports sudden pain or when resistance is felt during inflation, the nurse should: 1. Stop the inflation 2. Allow the fluid from the balloon to flow back into the syringe 3. Advance catheter further – balloon may have been inflating in the urethra 4. Reinflate the balloon 5. If pain continues, notify health care provider

Question 44

Why is it important to anchor the catheter properly?

Answer 44

Anchoring catheter reduces traction on the urethra and reduces urethral injury

Question 45

What can be used to detect the chemical properties of urine such as presence of glucose, ketones, protein or blood not normally present in the urine when more detailed laboratory testing is not available?

Answer 45

Chemostrip

Question 46

What is the most common type of timed urine specimen for quantitative analysis?

Answer 46

24-hour urine collection

Question 47

Why is it important to perform perineal care prior to urine collection?

Answer 47

Prevents contamination of specimen, which is the most frequent reason for inaccurate results.

Question 48

What is the best way to perform perineal care for circumcised males?

Answer 48

Clean meatus from centre to outside using a circular motion. This should be done 3 times using three different towelettes or sponges.

Question 49

To effectively clean the meatus of an uncircumcised male and prevent stricture of the penis, the nurse must perform which step?

Answer 49

Have uncircumcised male retract foreskin, and return foreskin when done to prevent stricture.

Question 50

What is the best way to perform perineal care for females?

Answer 50

Clean from front (above urethral orifice) to back (toward anus), holding labia apart; clean 3x using fresh swab each time.

Question 51

How much urine should be collected for a mid-stream clean catch?

Answer 51

90 to 120 ml

Question 52

How long will you need to clamp the catheter before collecting specimen from a catheter?

Answer 52

10 to 15 minutes

Question 53

True or False. You cannot collect a specimen from the catheter bag.

Answer 53

True. Urine in drainage bag is not considered sterile.

Question 54

How much specimen will you collect from a patient's catheter for: a. Culture b. Routine urinalysis

Answer 54

Culture – 3 ml Routine urinalysis - 20 ml

Question 55

A urine specimen needs to be sent to the laboratory within _____ minutes.

Answer 55

20 minutes

Question 56

What measure can be done to facilitate the collection of timed urine specimen?

Answer 56

Have the patient drink two to four glasses of water 30 minutes before times of collection

Question 57

How do you prevent decomposition of urine while 24-hour collection is taking place?

Answer 57

Keep specimen bottle in specimen refrigerator or container of ice in bathroom