N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

6. The RN should incorporate which instructions into the teaching plan for a client with a urinary diversion? a. Change the appliance every day b. Increase fluid intake c. Notify the physician if the stoma is deep pink &shiny d. Strands of blood may appear in the urine 7. Which of the following nursing interventions is appropriate care for a client with a retention catheter? a. Don sterile gloves b. Gently retract the labia majora away from the urinarymeatus c. Observe urine in the drainage bag d. Retape the catheter to the thigh 8. Which of the following nursing diagnoses would be appropriate for a client who has a retention catheter if the drainage bag is found lying on thefloor? a. Risk for impaired skin integrity related to catheterplacement b. Risk for infection related to improperhandling c. Self-care deficit related to presence of a retention catheter d. Risk for incontinence related to anobstruction 9. Which of the following desired client outcomes is correct for a client with the nursing diagnosis “stress urinary incontinence” related to sphincter incompetence? a. The client will empty her bladder every time shevoids b. The client will improve her incontinence within 1month c. The client will perform four to five squeezes for 5 to 10 seconds d. The client will stop the flow of urine whenvoiding 10. Which of the following expected outcomes or goals is correct for a client with the nursing diagnosis “urinary pattern alteration” related to an enlarged prostate? a. The client will avoid bladder distention b. The client will maintain fluid imbalance c. The client will remain free of skinbreakdown d. The client will voice increased discomfort

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