After her bath, a 62-year-old patient asks the nurse for a perineal pad saying that she uses them because sometimes she leaks urine when she laughs or coughs. Which intervention is most appropriate to include in the care plan for the patient?
Teach the patient how to perform Kegel exercises.
Assist the patient to the bathroom q3hr.
Demonstrate how to perform Crede’s maneuver.
Place commode at the patient’s bedside.
The Correct Answer is A
Kegel exercises are designed to strengthen the pelvic floor muscles, which can help improve urinary incontinence. By teaching the patient how to perform Kegel exercises, the nurse can provide a non-invasive, effective intervention that the patient can perform on her own to help manage her urinary incontinence.
Assisting the patient to the bathroom q3hr (b) may help reduce the frequency of incontinence episodes but it does not address the underlying issue of weakened pelvic floor muscles.
Demonstrating how to perform Crede’s maneuver (c) involves applying manual pressure to the bladder to assist with urination and is not appropriate for managing urinary incontinence related to laughing or coughing.
Placing a commode at the patient’s bedside (d) may be appropriate for patients who have difficulty with mobility or accessing the bathroom, but it does not address the underlying issue of weakened pelvic floor muscles causing urinary incontinence.
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Related Questions
Correct Answer is B
Explanation
Sudden discontinuation of prednisone can result in adrenal insufficiency and can lead to life-threatening complications. The nurse should also instruct the patient to report any symptoms of an infection, such as fever, to the doctor promptly, as prednisone can mask signs of an infection.
Monitoring for mood alterations and daily weight measurement are also important aspects of care, but they are not as crucial as the need to gradually taper off the medication.
Correct Answer is A
Explanation
Electrocardiographic (ECG) changes and dysrhythmias related to hypokalemia are the main reasons for initiating cardiac monitoring in patients with diabetic ketoacidosis. In diabetic ketoacidosis, insulin deficiency causes the body to break down fat for energy, leading to the production of ketones and resulting in metabolic acidosis. In addition, glucose and potassium are lost in the urine due to osmotic diuresis. Hypokalemia can cause ECG changes and dysrhythmias, which can be life-threatening.
Hypokalemia is a common complication of DKA and can lead to ECG changes such as ST-segment depression, T-wave inversion, and U waves².
Hypovolemic shock related to osmotic diuresis is an important consideration in the management of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.
Cardiovascular collapse resulting from the effects of hyperglycemia is not a common complication of diabetic ketoacidosis, and it is not the primary reason for initiating cardiac monitoring.
Fluid overload resulting from aggressive fluid replacement is a potential complication of diabetic ketoacidosis, but it is not the primary reason for initiating cardiac monitoring.
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