A nurse is caring for older adult clients at a long-term care facility. Which of the following assessments should the nurse consider when monitoring clients for urinary retention? (Select all that apply.)
Dribbling of urine
Color of the urine
Voiding patern
Proteinuria
Bladder distension
Correct Answer : A,C,E
Choice A reason: Dribbling of urine can indicate urinary retention, as it may suggest that the bladder is not emptying
completely during voiding.
Choice B reason: While the color of the urine can provide information about hydration status and other health issues, it is not a direct indicator of urinary retention.
Choice C reason: The voiding patern is an important assessment for urinary retention. Infrequent voiding or small amounts despite a full bladder can be signs of this condition.
Choice D reason: Proteinuria is not typically used as an assessment for urinary retention. It can indicate kidney damage or disease but does not directly relate to the bladder's ability to empty.
Choice E reason: Bladder distension can be observed and palpated in cases of urinary retention, as the bladder may become enlarged due to the accumulation of urine.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: The pH of urine can vary, but having a more alkalotic urine does not necessarily promote the growth of bacteria. Urine is typically slightly acidic, which helps to prevent bacterial growth.
Choice B reason: The primary anatomical reason for the higher rates of UTIs in clients who have vaginas is the shorter length of the urethra compared to those who do not have vaginas. This shorter distance makes it easier for bacteria from the skin or rectal area to enter the bladder.
Choice C reason: The strength of the detrusor muscle, which controls the emptying of the bladder, does not have a direct correlation with the frequency of UTIs. UTIs are more related to bacterial invasion rather than muscle strength.
Choice D reason: Bladder capacity is generally not a factor in the frequency of UTIs. While residual urine can increase the risk of UTIs, this is not typically related to overall bladder capacity.
Correct Answer is D
Explanation
Choice A reason: An elevated creatinine level indicates reduced kidney function, which is often the reason a kidney biopsy is being performed in the first place. It is not a contraindication for the procedure.
Choice B reason: Urinary retention does not directly impact the ability to perform a kidney biopsy, as the procedure involves the kidneys and not the lower urinary tract where urine is stored.
Choice C reason: Flank pain is a common symptom in patients with kidney issues and is not a contraindication for a kidney biopsy. The procedure may help diagnose the cause of the ?ank pain.
Choice D reason: Bleeding tendencies are a significant contraindication for a kidney biopsy. Patients with a history of bleeding disorders or those on anticoagulant therapy are at increased risk of bleeding complications from the procedure.
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