NURS 354 UPDATED EXAM SCRIPT QUESTIONS AND
ANSWERS GRADED A+
✔✔manifestations of stones in the ureter - ✔✔acute, excruciating, colicky wavelike pain
- radiates down the thigh and to the genitalia
there is a desire to void but difficulty to
- blood usually present
✔✔stress incontinence - ✔✔the inability to control the voiding of urine under physical
stress such as running, sneezing, laughing, or coughing
✔✔urge incontinence - ✔✔involuntary leakage of urine with a sudden, strong desire to
urinate
✔✔functional incontinence - ✔✔due to physical or cognitive impairment
- difficulty recognizing the need to void
✔✔manifestations of urinary retention - ✔✔lower abdominal pain
distended bladder
strong urge to urinate
dribbling urine
residual urine in bladder
✔✔how to promote urinary elimination - ✔✔provide privacy
make sure the environment & position is conducive
assist pt to commode or bathroom
- avoid bedpan when possible
apply warmth (sitz bath, warm compress)
provide a hot caffeine-free beverage
can place pt's hand in warm water
turn on the sink
✔✔neurogenic bladder - ✔✔results from a disorder or dysfunction of the neuro system
that results in incontinence
✔✔types of neurogenic bladder - ✔✔spastic
flaccid
✔✔spastic neurogenic bladder - ✔✔results in loss of conscious sensation and cerebral
motor control
- bladder empties on reflex with minimal or no controlling
✔✔flaccid neurogenic bladder - ✔✔commonly results from trauma
- bladder continues to fill, becomes distended, and overflow incontinence occurs
- no discomfort associated
,✔✔assessment of neurogenic bladder - ✔✔monitor I&Os
assessment of pt's sensory awareness & motor control of bladder
✔✔management of neurogenic bladder - ✔✔catheterization
low calcium diet (to avoid stone formation)
ambulation
liberal fluid intake (reduces calcium & urinary stasis)
bladder retraining
double voiding (flaccid)
✔✔populations high at risk for CAUTI - ✔✔women
older adults
patients who are debilitated/chronically ill
diabetes
immunosuppression
✔✔symptoms of a CAUTI - ✔✔cloudy, malodorous urine
hematuria
fever
chills
anorexia
malaise
✔✔preventing CAUTI - ✔✔daily cleansing
- after bowl movement or contamination
- wipe front to back
- wash with soap and water
avoid routine catheter changes
ensure free flow of urine
if bag must be raised, clamp it to avoid back flow
do not regularly irrigate
liberal fluid intake
✔✔amoxicillin (Amoxil) - ✔✔USE - UTI, pyelonephritis
ADVERSE - rash, anaphylaxis, GI upset, superinfections
EDUCATION - take entire course, take within an hour of a meal
✔✔ciprofloxacin (Cipro) - ✔✔USE - UTI, pyelonephritis
ADVERSE - GI upset, photosensitivity, tendinitis/tendon rupture, risk of peripheral
neuropathy
, ADMINISTRATION - IV over 60 minutes, oral can be with food
EDUCATION - do not take within 2hr:
- dairy
- calcium juices
- antacids
- zinc
- iron
✔✔cephalexin (Keflex) - ✔✔USE - genitourinary infection
ADVERSE - GI upset, superinfections
✔✔phenazopyridine (Pyridium) - ✔✔USE - relief of burning, pain and other UTI
symptoms
ADVERSE - skin yellowing (report!)
EDUCATION - take with food, urine will turn a reddish/orange color
✔✔anemia - ✔✔condition characterized by lower than normal hemoglobin concentration
- causes less oxygen to reach tissues
- usually a sign of an underlying disorder
✔✔complications of anemia - ✔✔heart failure
paresthesias
delirium
✔✔assessment & diagnostics of anemia - ✔✔H&H levels
reticulocyte count
RBC
iron levels
CBC
- can determine if anemia is associated with another hematologic condition or not
bone marrow aspiration
✔✔hemoglobin levels for women - ✔✔12-16
✔✔hemoglobin levels for men - ✔✔14-18
✔✔hypo-proliferative anemias - ✔✔this group of anemias are caused by decreased
RBC production
- iron deficiency
- vitamin B12 deficiency
- folic acid deficiency
ANSWERS GRADED A+
✔✔manifestations of stones in the ureter - ✔✔acute, excruciating, colicky wavelike pain
- radiates down the thigh and to the genitalia
there is a desire to void but difficulty to
- blood usually present
✔✔stress incontinence - ✔✔the inability to control the voiding of urine under physical
stress such as running, sneezing, laughing, or coughing
✔✔urge incontinence - ✔✔involuntary leakage of urine with a sudden, strong desire to
urinate
✔✔functional incontinence - ✔✔due to physical or cognitive impairment
- difficulty recognizing the need to void
✔✔manifestations of urinary retention - ✔✔lower abdominal pain
distended bladder
strong urge to urinate
dribbling urine
residual urine in bladder
✔✔how to promote urinary elimination - ✔✔provide privacy
make sure the environment & position is conducive
assist pt to commode or bathroom
- avoid bedpan when possible
apply warmth (sitz bath, warm compress)
provide a hot caffeine-free beverage
can place pt's hand in warm water
turn on the sink
✔✔neurogenic bladder - ✔✔results from a disorder or dysfunction of the neuro system
that results in incontinence
✔✔types of neurogenic bladder - ✔✔spastic
flaccid
✔✔spastic neurogenic bladder - ✔✔results in loss of conscious sensation and cerebral
motor control
- bladder empties on reflex with minimal or no controlling
✔✔flaccid neurogenic bladder - ✔✔commonly results from trauma
- bladder continues to fill, becomes distended, and overflow incontinence occurs
- no discomfort associated
,✔✔assessment of neurogenic bladder - ✔✔monitor I&Os
assessment of pt's sensory awareness & motor control of bladder
✔✔management of neurogenic bladder - ✔✔catheterization
low calcium diet (to avoid stone formation)
ambulation
liberal fluid intake (reduces calcium & urinary stasis)
bladder retraining
double voiding (flaccid)
✔✔populations high at risk for CAUTI - ✔✔women
older adults
patients who are debilitated/chronically ill
diabetes
immunosuppression
✔✔symptoms of a CAUTI - ✔✔cloudy, malodorous urine
hematuria
fever
chills
anorexia
malaise
✔✔preventing CAUTI - ✔✔daily cleansing
- after bowl movement or contamination
- wipe front to back
- wash with soap and water
avoid routine catheter changes
ensure free flow of urine
if bag must be raised, clamp it to avoid back flow
do not regularly irrigate
liberal fluid intake
✔✔amoxicillin (Amoxil) - ✔✔USE - UTI, pyelonephritis
ADVERSE - rash, anaphylaxis, GI upset, superinfections
EDUCATION - take entire course, take within an hour of a meal
✔✔ciprofloxacin (Cipro) - ✔✔USE - UTI, pyelonephritis
ADVERSE - GI upset, photosensitivity, tendinitis/tendon rupture, risk of peripheral
neuropathy
, ADMINISTRATION - IV over 60 minutes, oral can be with food
EDUCATION - do not take within 2hr:
- dairy
- calcium juices
- antacids
- zinc
- iron
✔✔cephalexin (Keflex) - ✔✔USE - genitourinary infection
ADVERSE - GI upset, superinfections
✔✔phenazopyridine (Pyridium) - ✔✔USE - relief of burning, pain and other UTI
symptoms
ADVERSE - skin yellowing (report!)
EDUCATION - take with food, urine will turn a reddish/orange color
✔✔anemia - ✔✔condition characterized by lower than normal hemoglobin concentration
- causes less oxygen to reach tissues
- usually a sign of an underlying disorder
✔✔complications of anemia - ✔✔heart failure
paresthesias
delirium
✔✔assessment & diagnostics of anemia - ✔✔H&H levels
reticulocyte count
RBC
iron levels
CBC
- can determine if anemia is associated with another hematologic condition or not
bone marrow aspiration
✔✔hemoglobin levels for women - ✔✔12-16
✔✔hemoglobin levels for men - ✔✔14-18
✔✔hypo-proliferative anemias - ✔✔this group of anemias are caused by decreased
RBC production
- iron deficiency
- vitamin B12 deficiency
- folic acid deficiency
