A nurse instructs a class of older adult women about Kegel exercises. In which of the following urinary conditions would Kegel exercises be effective?

Functional incontinence

Stress incontinence

Urinary retention

Fecal incontinence

Answer and Explanation

The Correct Answer is B

A. Functional incontinence: Functional incontinence occurs when a person has difficulty reaching the toilet due to physical or cognitive impairments, such as mobility issues or dementia. Kegel exercises, which focus on strengthening the pelvic floor muscles, would not directly address the underlying causes of functional incontinence.

B. Stress incontinence: Stress incontinence is characterized by the involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, laughing, or exercising. Kegel exercises are specifically designed to strengthen the pelvic floor muscles, which can help support the bladder and reduce the occurrence of stress incontinence.

C. Urinary retention: Urinary retention refers to the inability to empty the bladder completely. While Kegel exercises may help improve bladder control, they are not typically used to address urinary retention, which often requires other interventions such as medications, catheterization, or surgery.

D. Fecal incontinence: Fecal incontinence involves the involuntary leakage of stool. Kegel exercises are not effective for addressing fecal incontinence, as they primarily target the pelvic floor muscles involved in urinary control, not bowel control. Treatment for fecal incontinence may include dietary modifications, medications, pelvic floor rehabilitation, or surgical interventions, depending on the underlying cause.

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Correct Answer is B

Explanation

A) Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic that promotes sodium and water excretion, leading to decreased blood volume and decreased potassium excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.

B) Spironolactone: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased sodium reabsorption and increased potassium retention. This mechanism of action can predispose clients to hyperkalemia due to potassium retention. Additionally, spironolactone can cause hyponatremia by promoting the excretion of sodium and water. Therefore, clients receiving spironolactone are at risk for both hyperkalemia and hyponatremia.

C) Furosemide: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, promoting sodium, chloride, potassium, and water excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.

D) Metolazone: Metolazone is a thiazide-like diuretic that acts similarly to hydrochlorothiazide by promoting sodium and water excretion. Like hydrochlorothiazide, it can cause hypokalemia due to increased potassium excretion but does not typically lead to hyperkalemia.

A. Turn the client on his side before starting oral care. B. Use the thumb and index finger to keep the client's mouth open C. Apply petroleum jelly to the client's lips after oral care. D. Use a stiff toothbrush to clean the client's teeth.

Correct Answer is A

Explanation

A. Turn the client on his side before starting oral care: This is the correct action. Turning the client on their side helps prevent aspiration of oral secretions or fluids during oral care, especially for an immobile client who may have difficulty swallowing or managing oral secretions effectively. Positioning the client on their side also facilitates better access to the oral cavity for oral care procedures.

B. Use the thumb and index finger to keep the client's mouth open: Using the thumb and index finger to keep the client's mouth open may cause discomfort or injury to the client. Instead, it's essential to encourage the client to open their mouth gently or use an appropriate oral device to keep the mouth open during oral care.

C. Apply petroleum jelly to the client's lips after oral care: Applying petroleum jelly to the client's lips after oral care can help keep the lips moisturized and prevent dryness. However, it is not the most immediate action necessary for oral care. Ensuring proper positioning and cleaning of the oral cavity take precedence during oral care for an immobile client.

D. Use a stiff toothbrush to clean the client's teeth: Using a stiff toothbrush can cause damage to the client's oral tissues, especially if the client has impaired oral hygiene or compromised oral health. It's essential to use a soft-bristled toothbrush or sponge swabs for oral care to prevent injury or trauma to the oral mucosa, especially in clients who are immobile.

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A nurse instructs a class of older adult women about Kegel exercises. In which of the following urinary conditions would Kegel exercises be effective?

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