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When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)

Observing for changes in urinary patterns, such as a sudden decrease in urinary output or frequent, small amounts of voiding.

Assessing for reports of urinary hesitancy, dribbling of urine, straining, or a sensation of incomplete bladder emptying during urination.

Encouraging the client to drink large amounts of fluid in a short period to stimulate bladder emptying.

Applying pressure over the lower abdomen to force urine out of the bladder.

Evaluating for palpable bladder distention after voiding to assess incomplete bladder emptying.

Answer and Explanation

Correct Answer : A,B,E

A. Observing for changes in urinary patterns, such as a sudden decrease in urinary output or frequent, small amounts of voiding. This can indicate urinary retention, as frequent, small voids may suggest incomplete emptying of the bladder.

B. Assessing for reports of urinary hesitancy, dribbling of urine, straining, or a sensation of incomplete bladder emptying during urination. These symptoms are common in urinary retention, indicating that the client is having difficulty fully emptying the bladder.

C. Encouraging the client to drink large amounts of fluid in a short period to stimulate bladder emptying: This is incorrect, as overhydration can worsen urinary retention, especially in clients with an impaired ability to empty their bladder.

D. Applying pressure over the lower abdomen to force urine out of the bladder: This is incorrect and can cause harm, as it may increase the risk of bladder injury.

E. Evaluating for palpable bladder distention after voiding to assess incomplete bladder emptying.
A distended bladder after voiding suggests incomplete emptying and potential urinary retention.

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Correct Answer is B

Explanation

A. I should avoid alcohol completely to prevent another episode of pancreatitis: This is correct advice, as alcohol is a common cause of pancreatitis and should be avoided.

B. I can resume my high-fat diet once my symptoms improve. A high-fat diet can trigger another episode of pancreatitis, as fat stimulates pancreatic enzymes that can exacerbate the condition. The patient should follow a low-fat diet.

C. I should take my prescribed medications as directed to manage my symptoms: This statement is appropriate and reflects adherence to the treatment plan.

D. I need to follow up with my healthcare provider regularly to monitor my condition: This is also correct, as regular monitoring is essential to managing pancreatitis.

A. Hypervolemia B. Hyperkalemia C. Hypernatremia D. Hypertension

Correct Answer is C

Explanation

A. Hypervolemia: This is unlikely during the diuretic phase, as the patient is typically losing large volumes of fluid.

B. Hyperkalemia: Hyperkalemia is more common in the oliguric phase of ATN, not the diuretic phase, when potassium levels usually decrease due to fluid loss.

C. Hypernatremia: During the diuretic phase of ATN, the kidneys start to recover but may not be able to concentrate urine effectively, leading to large volumes of dilute urine. This can result in fluid and electrolyte imbalances, particularly hypernatremia (high sodium levels) due to excessive fluid loss.

D. Hypertension: Hypotension is more likely due to excessive fluid loss during the diuretic phase, not hypertension.

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When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)

Nursing Test Bank

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Correct Answer is B

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Correct Answer is C

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