Unit 4: Chapter 46: Urinary Elimination Flashcards
(21 cards)
Diabetes mellitus, history of stroke, mild dementia. Currently hospitalized for urinary retention and UTI. A Foley catheter was placed 2 days ago.
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A patient reports leakage of urine with coughing and sneezing.
What type of urinary incontinence is this?
A. Stress
B. Urge
C. Reflex
D. Functional
A
Stress: Leakage with pressure indicates stress incontinence.
Which nursing action is a priority in managing a patient with urge incontinence?
A. Restrict all fluids
B. Establish toileting schedule
C. Insert indwelling catheter
D. Apply heat to the bladder
B
Toileting schedule: Urge incontinence improves with bladder training.
Which factor contributes to overflow incontinence?
A. Weak pelvic floor
B. Spinal cord injury
C. Enlarged prostate
D. Urinary tract infection
C
Enlarged prostate: Obstructs flow, leading to overflow.
What is the most helpful intervention for a patient with functional incontinence and limited mobility?
A. Bladder irrigation
B. Timed toileting
C. Foley catheter
D. Pelvic floor exercises
B
Timed toileting: Helps those with mobility limitations.
A urinalysis shows: positive nitrites, positive leukocyte esterase, pH 8.2.
What does this suggest?
A. Dehydration
B. Metabolic acidosis
C. UTI
D. Renal failure
C
UTI: Nitrites and leukocytes signal infection.
Which statements indicate understanding of catheter care? (Select all that apply.)
A. “I should keep the bag above my bladder.”
B. “I’ll clean around the catheter with soap and water daily.”
C. “I can disconnect the tubing to adjust the bag.”
D. “The drainage tubing should not be kinked.”
E. “I should hang the drainage bag from the bed rail.”
B, D
Daily cleaning and preventing kinks reduce CAUTI.
Which finding should prompt the nurse to suspect a catheter-associated urinary tract infection (CAUTI)?
A. Clear yellow urine
B. Temperature 101.1°F (38.4°C)
C. Urine output of 60 mL/hr
D. Decreased thirst
B
Fever: Indicates infection risk with catheter.
Which of the following indicates a normal adult urine output per hour?
A. 15 mL/hr
B. 30 mL/hr
C. 80 mL/hr
D. 100 mL/hr
B
30 mL/hr: Minimum acceptable adult output.
Which finding may indicate dehydration?
A. Specific gravity of 1.005
B. Pale yellow urine
C. Specific gravity of 1.030
D. pH of 6.5
C
1.030: High specific gravity = dehydration.
A bladder scan after voiding shows 180 mL of residual urine.
What is the appropriate response?
A. Document as normal
B. Insert straight catheter
C. Repeat scan in 6 hours
D. Encourage oral fluids
B
Straight catheter: Residual >100 mL may require draining.
A client has an ileal conduit.
What assessment finding is expected?
A. Patient voids via urethra
B. Drainage from a stoma into pouch
C. No urinary output
D. Intermittent catheterization
B
Stoma: Ileal conduits require external pouching.
Which teaching indicates effective learning?
A. “I will need a urostomy bag.”
B. “I can void through my urethra.”
C. “I won’t need to retrain my bladder.”
D. “I should limit fluids permanently
B
Void via urethra: Neobladder uses urethral passage
Which child is most developmentally ready for toilet training?
A. 12-month-old who crawls
B. 24-month-old who stays dry 2 hours
C. 18-month-old who hides when soiling diaper
D. 15-month-old who stands unaided
B
24 months: Physical readiness includes dry periods.
What age-related change contributes to urinary incontinence?
A. Increased bladder capacity
B. Faster response to urge
C. Decreased sphincter tone
D. Increased renal blood flow
C
Decreased tone: Weak muscles increase incontinence risk.
Which urinalysis result is considered normal?
A. Protein: 1+
B. Nitrites: positive
C. Glucose: positive
D. pH: 6.0
D
pH 6.0: Normal urinary pH is 4.6–8.0.
What is the best approach to promote independence in a patient with mild dementia and urge incontinence?
A. Insert catheter
B. Use adult briefs at all times
C. Provide scheduled bathroom trips
D. Restrict fluids after dinner
C
Scheduled toileting: Preserves dignity and function.
When should a nurse remove a Foley catheter?
A. After 3 days even if output is normal
B. If patient has fever and hematuria
C. As soon as it’s no longer medically necessary
D. Only when physician orders
C
When no longer needed: Early removal reduces infection.
Which instruction supports bladder training?
A. Go to the bathroom only when you feel the urge
B. Void every 30 minutes regardless of urge
C. Follow a schedule and gradually increase intervals
D. Increase caffeine to stimulate bladder activity
C
Gradual schedule: Encourages retraining.
Which teaching helps reduce UTI risk? (Select all that apply.)
A. Wipe front to back
B. Avoid cotton underwear
C. Void after intercourse
D. Avoid holding urine
E. Limit fluid intake
A ,C, D
Hygiene, post-intercourse voiding, and timely urination reduce UTIs.
What is a possible complication of long-term indwelling catheter use?
A. Skin turgor loss
B. Urinary retention
C. Urethral trauma
D. Polyuria
C
Urethral trauma: Long-term use increases risk.
