A nurse is providing teaching to a client who has stress incontinence. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

"Perform Kegel exercises several times daily."

"Take prescribed diuretics no later than 2000."

"Maintain a daily fluid intake of 1,000 to 1,200 mL/day."

"Attempt to void every 2 hours."

"Maintain optimal body weight for height."

Answer and Explanation

Correct Answer : A,D,E

Rationale:
A. "Perform Kegel exercises several times daily.": Kegel exercises strengthen pelvic floor muscles, improving bladder control and reducing stress incontinence episodes. Regular practice is essential for effectiveness.

B. "Take prescribed diuretics no later than 2000.": Limiting evening diuretic use helps reduce nighttime incontinence but does not address stress incontinence, which is triggered by increased intra-abdominal pressure, not fluid timing.

C. "Maintain a daily fluid intake of 1,000 to 1,200 mL/day.": Restricting fluids excessively can lead to concentrated urine and urinary tract irritation. Adequate hydration is important; fluid restriction is not recommended for stress incontinence.

D. "Attempt to void every 2 hours.": Scheduled voiding helps prevent bladder overfilling, reducing leakage episodes and improving bladder control. This is an effective behavioral strategy.

E. "Maintain optimal body weight for height.": Excess weight increases intra-abdominal pressure, which can worsen stress incontinence. Maintaining a healthy weight helps reduce strain on pelvic floor muscles.

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Correct Answer is C

Explanation

Rationale:
A. White blood cell count 8,000/mm³ (5,000 to 10,000/mm³): A normal white blood cell count indicates that the body is not currently mounting an inflammatory or infectious response. This finding does not place the client at risk for developing a wound infection.

B. Temperature 36.8° C (98° F): A normal temperature suggests that the client is afebrile and not showing signs of infection or systemic inflammation. This finding reflects stable postoperative recovery and is not a risk factor for infection.

C. Body mass index of 32: Obesity increases the risk for surgical wound infection because excess adipose tissue has poor blood supply, impairing oxygen and nutrient delivery needed for wound healing. Additionally, increased tension on the incision site can lead to dehiscence and bacterial colonization.

D. Blood glucose 90 mg/dL (74 to 106 mg/dL): A normal blood glucose level supports effective immune function and normal wound healing. Hyperglycemia, not euglycemia, would predispose the client to infection by impairing leukocyte function.

A. The nurse positions a client who is postoperative in a semi-Fowler's position. B. The nurse uses clean gloves when administering an enema. C. The nurse performs auscultation of the lungs without lifting the gown. D. The nurse applies a cold compress to reduce localized swelling.

Correct Answer is C

Explanation

Rationale:
A. The nurse positions a client who is postoperative in a semi-Fowler's position: Semi-Fowler’s promotes lung expansion and comfort postoperatively, especially after abdominal or thoracic surgery, making this an appropriate nursing action.

B. The nurse uses clean gloves when administering an enema: Clean gloves are sufficient for enema administration since it is a clean (not sterile) procedure, and this reflects correct practice.

C. The nurse performs auscultation of the lungs without lifting the gown: Clothing or gowns interfere with accurate transmission of breath sounds, leading to possible misinterpretation. The gown should be lifted or moved aside to properly auscultate.

D. The nurse applies a cold compress to reduce localized swelling: Cold therapy decreases blood flow and inflammation, making this an appropriate intervention for localized swelling or injury.

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A nurse is providing teaching to a client who has stress incontinence. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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