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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Correct Answer is A

Explanation

A) A dimly lit room:
Mydriatic medications cause pupil dilation by stimulating the dilator muscle of the iris. In bright light, dilated pupils can lead to photophobia (sensitivity to light) and discomfort for the client. Therefore, placing the client in a dimly lit room helps to minimize the discomfort associated with increased sensitivity to light. This environment also supports visual acuity and reduces the risk of visual disturbances that can occur with bright light.

B) A warm room temperature:
While maintaining a comfortable room temperature is important for overall client comfort, it is not specifically related to the administration of mydriatic medications. The choice of room temperature may vary based on the client’s preferences and individual comfort needs but is not directly influenced by the use of mydriatic medications.

C) Cool, humidified air:
Cool, humidified air may be beneficial for certain respiratory conditions or for promoting comfort in some clients. However, it is not directly relevant to the administration of mydriatic medications. The choice of room temperature and humidity level should prioritize the client’s overall comfort and specific health needs but does not specifically relate to the effects of mydriatic drugs.

D) A quiet, restful environment:
While providing a quiet, restful environment is important for promoting relaxation and comfort, it is not specifically related to the administration of mydriatic medications. Clients receiving mydriatic drugs may benefit from restful surroundings to minimize stress or anxiety, but this choice does not address the potential visual discomfort associated with pupil dilation induced by mydriatic drugs.

A. Advise the client to move slowly and cautiously when rising and walking. B. Monitor intake and output every 8 hours. C. Ensure the client knows to stop baclofen before using other antispasmodics. D. Evaluate muscle strength every 4 hours.

Correct Answer is A

Explanation

A) Advise the client to move slowly and cautiously when rising and walking: This intervention is essential because baclofen, a muscle relaxant, can cause dizziness, drowsiness, and muscle weakness as side effects. Instructing the client to move slowly and cautiously can help prevent falls and injuries due to these potential side effects.
B) Monitor intake and output every 8 hours: Monitoring intake and output is not directly related to the administration of baclofen. While it is essential to monitor fluid balance in some situations, it is not specifically indicated in this case.
C) Ensure the client knows to stop baclofen before using other antispasmodics: While it is important to avoid concurrent use of multiple antispasmodic medications without proper medical supervision, stopping baclofen abruptly without medical guidance can lead to withdrawal symptoms. Therefore, this intervention is not appropriate without further clarification from the healthcare provider.
D) Evaluate muscle strength every 4 hours: While monitoring muscle strength is essential for clients receiving muscle relaxants, such as baclofen, evaluating it every 4 hours may not be necessary unless there are specific concerns or as directed by the healthcare provider. Monitoring for signs of muscle weakness or adverse effects should be ongoing but may not require such frequent assessments.

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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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