Question 1

When assessing the client for urinary incontinence, which client symptom best supports the nursing diagnosis of overflow incontinence?

Accepted Answer

Typically, individuals with overflow incontinence complain of frequent loss of small volumes of urine, which are commonly a result of cystoceles.

Question 2

When assessing an older client for the possible cause of his acute urinary incontinence, the nurse demonstrates an understanding of exacerbating factors when doing which of the following? Select all that apply.

Accepted Answer

Constipation and/or fecal impaction as well as an enlarged prostate gland (causing frequent nighttime urination) are commonly overlooked causes of incontinence.

Question 3

An older adult woman has a resistant strain of pneumonia.To best minimize her risk of developing acute renal failure, the nurse:

Accepted Answer

Interventions for an older adult with renal failure should focus on maintaining fluid and electrolyte balances.

Question 4

When preparing educational information regarding benign prostatic hyperplasia (BPH) for a group of older male clients, the nurse includes which of the following? Select all that apply.

Accepted Answer

Approximately 80% of men may be diagnosed with BPH by the age of 80. In early prostatic enlargement the client may be asymptomatic because the muscles may initially compensate for increased urethral resistance. As the prostate gland enlarges, the client begins to manifest symptoms of an obstructive process. The symptoms may include hesitancy, a decrease in the force of the urinary stream, terminal dribbling, a sensation of a full bladder after voiding, and urinary retention. Urethral obstruction may cause urinary stasis, UTIs, hydronephrosis, and renal calculi.

Question 5

An older client is admitted with possible chronic renal failure (CRF).The nurse notifies the attending physician with the results showing the client's:

Accepted Answer

The diagnosis of CRF is usually made based on a decrease in creatinine clearance, an elevation of BUN level, and a decrease in red blood cells.

Question 6

The nurse is completing an admission assessment on an older client who has been diagnosed with benign prostate hyperplasia.The nurse's priority questioning focuses on:

Accepted Answer

The purpose of the nursing assessment for an individual with BPH is to determine the extent of prostate enlargement and its effect on function so that appropriate nursing interventions can be planned and implemented. The primary assessment focuses on the client's current voiding patterns.

Question 7

When caring for older adults, the nurse expects to encounter the normal urinary age-related outcome of:

Accepted Answer

With age increased urine formation at night leads to nocturia.

Question 8

An 87-year-old client who does not have a history of urinary incontinence has suddenly become incontinent.In dealing with this problem, the nurse's first action should be to:

Accepted Answer

Medication is a common cause and should always be suspected as a potential cause of new incontinence.

Question 9

An older adult client is hospitalized for surgery to treat injuries he received in an automobile accident.The nurse recognizes symptoms suggestive of an upper urinary tract infection when the client:

Accepted Answer

If the UTI is in the upper urinary tract, older clients may manifest fever, chills, and flank tenderness in addition to mental status changes.

Question 10

An older cognitively impaired adult client is being prepared for discharge to be cared for by her daughter.The nurse knows that the continued success of the client's bladder training for urinary incontinence primarily rests upon the:

Accepted Answer

Treating UI in individuals with cognitive impairment requires the use of other behavioral techniques that depend on the caregiver rather than the client. The success of the techniques in large part depends on the availability and motivation of the caregiver.

Question 11

An older adult client reports "losing urine" when she bends over or gets out of a chair.In light of her symptoms, the nurse edits the client's care plan to include Altered urinary function, __________ incontinence.

Accepted Answer

Stress incontinence is commonly seen in older women who involuntarily lose urine as the result of a sudden increase in intra-abdominal pressure.

Question 12

An older adult client's urinary incontinence is being addressed by prompted voiding.The nurse instructs all ancillary staff to do which of the following? Select all that apply.

Accepted Answer

The goal is to increase a client's awareness of the need to void and, it is hoped, to increase the frequency of self-initiated toileting. Clients are approached on a regular schedule, asked if they are wet or dry, and then prompted to toilet. A client should never be forced to toilet or reprimanded for failing to toilet appropriately. Self-initiated toileting should not be discouraged. To relieve the stress that can occur due to sleep disruption for both caregiver and client, toileting protocols can be modified during the nighttime hours.

Quiz 28: Urinary Function