GU Quiz

Catheter-associated urinary tract infection is the most frequent type of healthcare acquired infection and represents as much as 80% of healthcare acquired infections in hospitals. The nurse should provide meticulous perineal care, encourage the client to obtain an adequate fluid intake, and assess the client for signs of infection such as an elevated temperature. It is not necessary to change the catheter daily. It is recommended that long-term use of an indwelling urinary catheter be evaluated carefully and other methods considered if catheter will be in place for longer than 2 weeks. It is not necessary to request a prescription for antibiotics as the client does not currently have an infection. 

The classic symptoms of cystitis are severe burning on urination, urgency, and frequent urination. Systemic symptoms, such as fever and nausea and vomiting, are more likely to accompany pyelonephritis than cystitis. Hematuria may occur, but it is not as common as frequency and burning. 

Kegel exercises strengthen the sphincter and supportive structural supports the bladder. Establishing a voiding schedule is more effective than carrying incontinence pad to prevent stress incontinence. In non-restricted clients, a fluid intake of at least 2 to 3L/day is encouraged clients with stress incontinence may reduce their fluid intake to avoid incontinence at the risk of developing dehydration and urinary tract infections. Natural diuretics- such as caffeine and alcoholic beverages may worsen stress incontinence. 

Instructing the client to avoid at regularly schedule intervals can help decrease the frequency of incontinence episodes. Providing a bedside commode does not decrease the number of incontinent episodes and does not help the client who leads an active lifestyle. Infections are not a common cause of urge incontinence, so antibiotics are not an appropriate treatment. Intermittent self-catheterization is appropriate for overflow or reflux incontinence but not urge incontinence, because it does not treat the underlying cause. 

The nurse should instruct the client to report signs of adverse reactions to the antibiotic or indications that the urinary tract infection is not clearing. Blood is urine is not an expected outcome, rash is an adverse response to the antibiotic, and an elevated temperature indicates a persistent infection. These signs should be reported to the HCP. Cloudy urine can be expected the first few days of antibiotic therapy, but it can be managed with eating small, frequent meals. Urinating every 3 to 4 hours or more is expected, particularly if the client is increasing the fluid intake as directed. 

Decreased force in the stream of urine is an early symptom of benign prostatic hyperplasia. The stream later becomes weak and dribbling. The client then may develop hematuria, frequency, urgency, urge incontinence, and nocturia. If untreated, complete obstruction and urinary retention can occur. Constipation or scrotal edema is not associated with benign prostatic hyperplasia.