GU Quiz

GU Quiz

SI Leader: Meg

Multiple Select

What should the nurse do to prevent catheter-associated urinary tract infection (CAUTI)? Select all that apply.

• a. Change the catheter daily

• b. Provide perineal care several times a day

• c. Monitor the temperature as an indicator of the infection

• d. Encourage the client to drink 3,000 mL fluid daily

• e. Recommend the HCP prescribe antibiotics

B, C, D

Catheter-associated urinary tract infection is the most frequent type of healthcare acquired infection and represents as much as 80% of healthcare acquired infections in hospitals. The nurse should provide meticulous perineal care, encourage the client to obtain an adequate fluid intake, and assess the client for signs of infection such as an elevated temperature. It is not necessary to change the catheter daily. It is recommended that long-term use of an indwelling urinary catheter be evaluated carefully and other methods considered if catheter will be in place for longer than 2 weeks. It is not necessary to request a prescription for antibiotics as the client does not currently have an infection. 

Multiple Choice

A 24-year-old female client comes to an ambulatory care clinic in moderate distress with probable diagnosis of acute cystitis. When obtaining the client’s history, the nurse should ask the client if she has had:

• a. Fever and chills

• b. Frequency and burning on urination

• c. Flank pain and nausea

• d. Hematuria

B

The classic symptoms of cystitis are severe burning on urination, urgency, and frequent urination. Systemic symptoms, such as fever and nausea and vomiting, are more likely to accompany pyelonephritis than cystitis. Hematuria may occur, but it is not as common as frequency and burning. 

Multiple Choice

What should the nurse teach the client to do to prevent stress incontinence? Select all that apply.

• a. Use techniques to strengthen the sphincter and structural supports of the bladder, such as Kegel exercises

• b. Avoid natural diuretics such as caffeine or alcoholic beverages

• c. Carry an extra incontinence pad when away from home

• d. Maintain a fluid intake of 500 ml/day

A,B

Kegel exercises strengthen the sphincter and supportive structural supports the bladder. Establishing a voiding schedule is more effective than carrying incontinence pad to prevent stress incontinence. In non-restricted clients, a fluid intake of at least 2 to 3L/day is encouraged clients with stress incontinence may reduce their fluid intake to avoid incontinence at the risk of developing dehydration and urinary tract infections. Natural diuretics- such as caffeine and alcoholic beverages may worsen stress incontinence. 

Multiple Choice

Which nursing action is MOST appropriate for a client who has urge incontinence?

• a. Have the client urinate on a timed schedule

• b. Provide a bedside commode

• c. Administer prophylactic antibiotics

• d. Teach the client intermittent self-catheterization techniques

A

Instructing the client to avoid at regularly schedule intervals can help decrease the frequency of incontinence episodes. Providing a bedside commode does not decrease the number of incontinent episodes and does not help the client who leads an active lifestyle. Infections are not a common cause of urge incontinence, so antibiotics are not an appropriate treatment. Intermittent self-catheterization is appropriate for overflow or reflux incontinence but not urge incontinence, because it does not treat the underlying cause. 

Multiple Select

When teaching the client with a urinary tract infection about taking a prescribed antibiotic for 7 days, the nurse should tell the client to report which symptoms to the HCP? Select all that apply.

• a. Cloudy urine for the first few days

• b. Blood in the urine

• c. Rash

• d. Mild nausea

• e. Fever above 100 F

B, C, E

The nurse should instruct the client to report signs of adverse reactions to the antibiotic or indications that the urinary tract infection is not clearing. Blood is urine is not an expected outcome, rash is an adverse response to the antibiotic, and an elevated temperature indicates a persistent infection. These signs should be reported to the HCP. Cloudy urine can be expected the first few days of antibiotic therapy, but it can be managed with eating small, frequent meals. Urinating every 3 to 4 hours or more is expected, particularly if the client is increasing the fluid intake as directed. 

Multiple Choice

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?

• a. Nocturia

• b. Scrotal edema

• c. Occasional constipation

• d. Decreased force in the stream of urine

D

Decreased force in the stream of urine is an early symptom of benign prostatic hyperplasia. The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur. Constipation or scrotal edema is not associated with benign prostatic hyperplasia.