Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

Urinary output equal intake.

No terminal urinary dribbling.

Denies stress incontinence.

Absence of xerostomia.

Answer and Explanation

The Correct Answer is A

A) Urinary output equal intake:
This assessment finding suggests that the client is voiding an amount of urine equivalent to their fluid intake, indicating effective bladder emptying. Bethanechol is a cholinergic agonist that stimulates bladder contraction, helping to improve urinary retention by promoting the expulsion of urine from the bladder. Equal urinary output and intake indicate that the bladder is adequately emptying, which is a positive response to bethanechol therapy.

B) No terminal urinary dribbling:
While the absence of terminal urinary dribbling may be an indicator of improved bladder emptying, it is not as definitive as assessing urinary output equal to intake. Terminal urinary dribbling refers to the involuntary loss of urine that occurs after completing urination due to incomplete emptying of the bladder. While its absence may suggest improved bladder emptying, it is not as reliable an indicator as measuring urinary output.

C) Denies stress incontinence:
The absence of stress incontinence, which is the involuntary loss of urine during activities that increase intra-abdominal pressure (such as coughing, sneezing, or lifting), is not directly related to the effectiveness of bethanechol for urinary retention. Bethanechol primarily targets urinary retention by stimulating bladder contraction rather than addressing stress incontinence, which involves weakness of the pelvic floor muscles.

D) Absence of xerostomia:
Xerostomia refers to dryness of the mouth due to decreased saliva production and is a common side effect of anticholinergic medications. Bethanechol, as a cholinergic agonist, may actually increase saliva production and is not typically associated with xerostomia. However, the absence of xerostomia does not directly indicate the effectiveness of bethanechol for urinary retention.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

A) Obtain a soft bristle toothbrush for the client:
This is an appropriate action because bleeding and tender gums can indicate oral bleeding, which may be exacerbated by the use of a standard toothbrush. Switching to a soft bristle toothbrush can help minimize trauma to the gums and reduce bleeding.

B) Provide a PRN nonsteroidal anti-inflammatory drug (NSAID) for gum discomfort:
Administering NSAIDs in this situation is not recommended. NSAIDs can further increase the risk of bleeding due to their antiplatelet effects. Therefore, providing an NSAID could exacerbate the client’s bleeding symptoms.

C) Review most recent coagulation lab values:
This is a crucial action to assess the client’s coagulation status and determine if the bleeding and bruising are related to anticoagulant therapy. Reviewing coagulation lab values, such as prothrombin time (PT) and international normalized ratio (INR), can provide important information about the client’s clotting function and guide further management.

D) Report findings to the healthcare provider:
This is essential to ensure timely evaluation and management of the client’s symptoms. Bleeding and bruising after anticoagulant therapy may indicate an increased risk of bleeding complications, and the healthcare provider needs to be informed promptly for further assessment and possible adjustment of the anticoagulant regimen.

E) Complete a medication variance report:
While documenting the client’s symptoms and actions taken is important for quality assurance and tracking adverse events, completing a medication variance report may not be the immediate priority in this situation. The focus should be on assessing the client’s condition, managing symptoms, and communicating with the healthcare provider for appropriate intervention

A. Apply the lotion to plaques on the face. B. Rub the lotion into the area twice daily for 5 weeks. C. Use gloves to rub the lotion into the area. D. Massage the lotion into the psoriasis plaques.

Correct Answer is D

Explanation

A) Apply the lotion to plaques on the face: Betamethasone valerate lotion is a potent corticosteroid that is generally not recommended for use on the face due to the risk of adverse effects, such as skin thinning and irritation. Therefore, applying the lotion to plaques on the face is not advisable.
B) Rub the lotion into the area twice daily for 5 weeks: While it is essential to follow the prescribed frequency and duration of medication use, specific instructions for betamethasone valerate lotion may vary depending on the severity of the condition and the healthcare provider's recommendations. This instruction lacks specificity and may not be accurate for all clients.
C) Use gloves to rub the lotion into the area: While wearing gloves may be necessary when applying certain topical medications to prevent contact dermatitis or to protect the hands, it is not typically required when using betamethasone valerate lotion. This instruction may be unnecessary and could lead to unnecessary waste of gloves.
D) Massage the lotion into the psoriasis plaques: This instruction is appropriate because it ensures proper absorption of the medication into the affected skin. Massaging the lotion gently into the psoriasis plaques helps enhance its penetration and effectiveness in treating the condition.

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Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

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Naxlex Comprehensive Predictor Exams

After receiving the third dose of a new oral anticoagulant prescription, an older client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

A client with plaque psoriasis receives a new prescription for betamethasone valerate lotion. Which instruction should the nurse include in client teaching?

Correct Answer is D

Explanation

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