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Ch. 48: Urinary Disorders

Terms in this set (15)

A 25-year-old female patient reports urinary frequency with pain on urination, flank pain, fever, and chills. The nurse recognizes these symptoms as characteristic of which condition?
a. Cystitis
b. Dysuria
c. Pyelonephritis
d. Urethritis
c. Pyelonephritis
Rationale: These are symptoms of pyelonephritis, characterized by fever, dysuria, flank pain, and urinary frequency.
A male patient reports urinary urgency and pain with burning on urination. The nurse understands that this patient will be treated for which condition?
a. Cystitis
b. Prostatitis
c. Pyelonephritis
d. Urethritis
b. Prostatitis
Rationale: In a male patient, a lower urinary tract infection is most likely prostatitis with symptoms similar to cystitis.
The nurse is caring for a patient who is diagnosed with a urinary tract infection. The patient reports always having difficulty remembering to take medications. Which drug will the nurse expect the provider to select when treating this patient?
A. Fosfomycin tromethamine (Monurol)
B. Ciprofloxacin (Cipro)
C. Nitrofurantoin (Macrodantin)
D. Trimethoprim-sulfamethoxazole (Bactrim)
A. Fosfomycin tromethamine (Monurol)
Rationale: Fosfomycin is given as a one-time, single dose. Ciprofloxacin is given daily or twice a day. Nitrofurantoin is given four times daily. Trimethoprim-sulfamethoxazole is given twice daily.
The nurse is caring for a hospitalized patient who has symptoms characteristic of pyelonephritis. Before administering the first dose of the intravenous antibiotic, the nurse will ensure that which action is performed?
A. An antipyretic is administered.
B. A dose of oral antibiotic is given.
C. A urinary analgesic is given.
D. A urine culture is obtained.
D. A urine culture is obtained.
Rationale: A urinalysis, as well as a culture and sensitivity, is usually performed before initiating drug therapy. An antipyretic is indicated for fever but does not need to be timed before the antibiotic. An oral antibiotic is not indicated. A urinary analgesic is given as needed.
The nurse provides teaching for a patient who will begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. Which statement by the patient indicates understanding of the teaching?
A. "If I experience gastrointestinal upset, I may take an antacid."
B. "I should notify my provider immediately if my urine is brown."
C. "I should take the drug with food and increase my fluid intake."
D. "Tingling of my fingers is a harmless side effect of this drug."
C. "I should take the drug with food and increase my fluid intake."
Rationale: Patients taking nitrofurantoin should take the drug with foods and increase fluid intake. The drug should not be taken with antacids. Brown urine is a harmless side effect. Tingling of extremities can indicate neuropathy.
The nurse is preparing to administer methenamine (Hiprex) to a patient who is diagnosed with a urinary tract infection. The nurse reviews the patient's chart and notes a urinary pH of 6.0. Which action will the nurse take?
A. Administer the drug as ordered.
B. Obtain an order for 8 ounces of cranberry juice three times daily.
C. Request an order for an increased dose.
D. Restrict fluids to concentrate the patient's urine.
B. Obtain an order for 8 ounces of cranberry juice three times daily.
Rationale: Methenamine produces a bactericidal effect when the urine pH is less than 5.5. Cranberry juice will help to acidify the urine.
Which side effects are common to most urinary antiseptics?
A. Dyspnea and chest pain
B. Nausea and vomiting
C. Peripheral neuritis
D. Visual disturbances
B. Nausea and vomiting
Rationale: Nausea and vomiting are common side effects with most urinary antiseptics.
The nurse is preparing to administer a phenazopyridine HCl (Pyridium) dose to a patient who has diabetes. The nurse notes that the patient has a positive Clinitest. What will the nurse do next?
A. Encourage the patient to increase oral fluid intake.
B. Hold the dose until the patient's Clinitest is negative.
C. Notify the provider of the patient's hyperglycemia.
D. Request an order for serum blood glucose.
D. Request an order for serum blood glucose.
Rationale: Phenazopyridine can alter the glucose urine test (Clinitest), so a blood test should be done to monitor glucose levels.
A patient who has pain with urination associated with cystitis will be discharged home with a prescription for phenazopyridine (Pyridium). What instruction will the nurse include when teaching the patient about this drug?
A. "Do not take this drug concurrently with an antibiotic."
B. "Report reddish-brown urine to the provider immediately."
C. "This drug has antiseptic and analgesic properties."
D. "The drug provides symptomatic relief of pain."
D. "The drug provides symptomatic relief of pain."
Rationale: Phenazopyridine is used to provide symptomatic pain relief. It may be taken with antibiotics. Reddish-brown urine is a harmless side effect. It does not have antiseptic properties.
The nurse is preparing to administer bethanechol chloride (Urecholine) to a patient. The nurse understands that this drug acts to
A. block parasympathetic nerve impulses.
B. increase the tone of the urinary detrusor muscle.
C. relax smooth muscles in the urinary tract.
D. relieve urinary pain and burning.
B. increase the tone of the urinary detrusor muscle.
Rationale: Bethanechol is used to increase the tone of the detrusor muscle and increase the bladder tone to stimulate urination. It stimulates the parasympathetic nerves. It tones the smooth muscles of the urinary tract. It does not alleviate dysuria.
An older woman has urgent urinary incontinence related to an overactive bladder. Which medication does the nurse expect the provider to order?
A. Dimethylsulfoxide (DMSO)
B. Flavoxate (Urispas)
C. Phenazopyridine HCl (Pyridium)
D. Tolterodine tartrate (Detrol)
D. Tolterodine tartrate (Detrol)
Rationale: Detrol is used to treat an overactive bladder. Dimethylsulfoxide (DMSO) and flavoxate (Urispas) are used to relax uterine smooth muscle. Phenazopyridine HCl (Pyridium) is used to alleviate the pain and burning sensation during urination that is experienced with chronic cystitis.
The nurse assumes care for a patient who is experiencing urinary tract spasms and is ordered to receive flavoxate HCl (Urispas). When reviewing this patient's history, which condition would cause the nurse to notify the provider?
A. Chronic obstructive pulmonary disorder
B. Diabetes
C. Glaucoma
D. Hypotension
C. Glaucoma
Rationale: Urispas should not be used for patient who has gastrointestinal or urinary tract obstruction or if the patient has glaucoma.
The nurse is preparing to administer methenamine (Hiprex) to a patient who has pyelonephritis. Which action will the nurse perform?
A. Increase fluid intake to 2000 mL/day.
B. Monitor the patient's urine for dark brown color.
C. Order alkaline foods three times daily.
D. Request an order for a sulfonamide antibiotic.
A. Increase fluid intake to 2000 mL/day.
Rationale: Patients who take methenamine can develop crystalluria and should increase fluid intake to prevent this effect. A reddish-brown color is a harmless side effect. Patients should have acidic urine, not alkaline urine. Methenamine taken with sulfonamides increases the risk of crystalluria.
The nurse is teaching a parent about administering nitrofurantoin suspension to a 5-year-old child. Which instruction will the nurse include in the patient teaching?
A. "Give the medication on an empty stomach."
B. "Have the child rinse the mouth after taking the drug."
C. "Limit the child's fluid intake to concentrate the urine."
D. "Report brownish-colored urine to the child's provider."
B. "Have the child rinse the mouth after taking the drug."
Rationale: Nitrofurantoin suspension can stain the teeth, so patients should rinse the mouth after taking it. Nitrofurantoin should be taken with food, and patients should increase fluids. A reddish-brown color is a harmless side effect.
A patient will begin taking a urinary antimuscarinic medication. Which symptom should the patient report immediately?
A. Dry mouth
B. Fatigue
C. Increased heart rate
D. Urinary retention
D. Urinary retention
Rationale: Urinary retention should be reported to the provider. Dry mouth, fatigue, and increased heart rate are side effects, but they do not necessarily warrant reporting immediately. Urinary retention is more serious.
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