Chapter 27 Urinary Elimination

Chapter 27 Urinary Elimination

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)An instructor is showing a nursing student how to assess the height of the top or fundus of theuterus after a woman has delivered a baby. When the fundal height is assessed, it is found to betwo fingerbreadths below the umbilicus and in midline. One hour later the fundal height is onefingerbreadth below the umbilicus and tipped to the right. The instructor asks the student nursewhat the next nursing action should be. Based upon knowledge of anatomy and urinaryelimination, what is the most correct answer by student nurse?1)A)”The findings should be documented in the client’s chart.”B)”The client should be assisted to the bathroom to urinate.”C)”The client should be encouraged to stay in bed until the next assessment.”D)”The client should be encouraged to drink more fluids.”Answer:BExplanation:A)The urinary bladder lies anterior to the uterus. Tissue edema from the deliverymay make urination difficult. When the bladder is full, it can be palpated abovethe level of the symphysis pubis. A full bladder will push the uterus upwards andslightly off midline. Diuresis is common after delivery and emptying the bladderregularly is an important nursing assessment. Although the assessment findings aswell as the nursing actions and results of those actions must be documented in theclient’s medical record, documentation will not be the “next nursing action.”ImplementationHealth Promotion and MaintenanceAnalysisB)The urinary bladder lies anterior to the uterus. Tissue edema from the deliverymay make urination difficult. When the bladder is full, it can be palpated abovethe level of the symphysis pubis. A full bladder will push the uterus upwards andslightly off midline. Diuresis is common after delivery and emptying the bladderregularly is an important nursing assessment. Although the assessment findings aswell as the nursing actions and results of those actions must be documented in theclient’s medical record, documentation will not be the “next nursing action.”ImplementationHealth Promotion and MaintenanceAnalysisC)The urinary bladder lies anterior to the uterus. Tissue edema from the deliverymay make urination difficult. When the bladder is full, it can be palpated abovethe level of the symphysis pubis. A full bladder will push the uterus upwards andslightly off midline. Diuresis is common after delivery and emptying the bladderregularly is an important nursing assessment. Although the assessment findings aswell as the nursing actions and results of those actions must be documented in theclient’s medical record, documentation will not be the “next nursing action.”ImplementationHealth Promotion and MaintenanceAnalysis1
D)The urinary bladder lies anterior to the uterus. Tissue edema from the deliverymay make urination difficult. When the bladder is full, it can be palpated abovethe level of the symphysis pubis. A full bladder will push the uterus upwards andslightly off midline. Diuresis is common after delivery and emptying the bladderregularly is an important nursing assessment. Although the assessment findings aswell as the nursing actions and results of those actions must be documented in theclient’s medical record, documentation will not be the “next nursing action.”ImplementationHealth Promotion and MaintenanceAnalysis2)Clients who are at risk for urinary tract infections are usually encouraged to increase their fluidintake. This appropriateness of the intervention would need to be evaluated for the client with:(Select all that apply.)2)A)Congestive heart failure.B)A condom catheter.C)A concussion.D)Difficulty swallowing.E)Liver cancer with ascites.F)Diarrhea.Answer:A, C, EExplanation:A)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysisB)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysisC)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysis2
D)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysisE)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysisF)The clients with congestive heart failure and liver cancer are already havingdifficulty with the management of excess fluid. The client with a concussionshould not have increased fluids because this may lead to increased pressure onthe brain. Clients with diarrhea will need increased fluids to balance the fluid loss,regardless of risk for urinary tract infection. Increased fluids are notcontraindicated just because a client has a condom catheter in place. Difficultyswallowing is not a contraindication to increasing fluid intake.EvaluationPhysiological Integrity-Physiological AdaptationAnalysis3)A home care nurse is doing a follow-up visit for a client who had a knee replacement. During thevisit, the client tells the nurse that she has been having some incontinence of urine when she coughsor sneezes. The most helpful action by the nurse at this time is to suggest that the client:3)A)Practice Kegel exercises every hour throughout the day and when urinating to improvesphincter control.B)Call her primary physician’s office to get information about new medications available forthis kind of urinary incontinence.C)Wear cotton underwear and use a thin absorbent pad to prevent any skin breakdown.D)Rent a commode so she will not have to walk so far to the bathroom.Answer:AExplanation:A)The client is describing stress incontinence, which is related to weakening of thepelvic floor muscles and the voluntary external urinary sphincter. These musclescan be strengthened by actively contracting them just as one would strengthen anyset of muscles. Kegel exercises can be done anytime and anywhere, includingduring urination. Suggesting that the client rent a commode or wear cottonunderwear and use a thin absorbent pad does not attempt to resolve the problem.Calling her physician to get information about new medications might be a futureaction if the incontinence continues.ImplementationPhysiological Integrity-Basic Care and ComfortApplication3
B)The client is describing stress incontinence, which is related to weakening of thepelvic floor muscles and the voluntary external urinary sphincter. These musclescan be strengthened by actively contracting them just as one would strengthen anyset of muscles. Kegel exercises can be done anytime and anywhere, includingduring urination. Suggesting that the client rent a commode or wear cottonunderwear and use a thin absorbent pad does not attempt to resolve the problem.Calling her physician to get information about new medications might be a futureaction if the incontinence continues.ImplementationPhysiological Integrity-Basic Care and ComfortApplicationC)The client is describing stress incontinence, which is related to weakening of thepelvic floor muscles and the voluntary external urinary sphincter. These musclescan be strengthened by actively contracting them just as one would strengthen anyset of muscles. Kegel exercises can be done anytime and anywhere, includingduring urination. Suggesting that the client rent a commode or wear cottonunderwear and use a thin absorbent pad does not attempt to resolve the problem.Calling her physician to get information about new medications might be a futureaction if the incontinence continues.ImplementationPhysiological Integrity-Basic Care and ComfortApplicationD)The client is describing stress incontinence, which is related to weakening of thepelvic floor muscles and the voluntary external urinary sphincter. These musclescan be strengthened by actively contracting them just as one would strengthen anyset of muscles. Kegel exercises can be done anytime and anywhere, includingduring urination. Suggesting that the client rent a commode or wear cottonunderwear and use a thin absorbent pad does not attempt to resolve the problem.Calling her physician to get information about new medications might be a futureaction if the incontinence continues.ImplementationPhysiological Integrity-Basic Care and ComfortApplication