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Examen

Module 17 Lesson 5 Post-Test questions and answers

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A patient with a double-lumen urinary catheter has an order for closed intermittent catheter irrigation. The nurse performs hand hygiene, applies clean gloves, draws up 50 mL of room temperature irrigating solution into a sterile syringe, and places a sterile cap on the end. The nurse wipes the catheter and drainage tubing junction with an alcohol swab, disconnects the catheter from the drainage tube, inserts the needleless syringe, and gently instills the irrigating solution at an even, steady rate. The nurse reconnects the drainage tubing and observes the fluid return for color and any sediment or clots. What aspect of skill performance, if any, was in error? The nurse disconnected the drainage tubing from the catheter. The patient is to have intermittent irrigation of a double-lumen urinary catheter. The patient asks why the nurse is kinking the drainage tubing and putting a rubber band on it. What is the nurse's best response? "This prevents the irrigating solution from going down into your drainage bag rather than into your bladder." The nursing assistive personnel (NAP) reports the patient who is 1 day postoperative from bladder surgery is complaining of lower abdominal pain. The nurse palpates the patient's bladder and finds it is distended and there has not been any change in the amount of urine in the last 2 hours in the drainage bag. The patient's vital signs are within normal limits. What is the nurse's best action? Ensure there are no kinks in drainage tubing, and if none, notify health care provider for possible bladder irrigation order. A patient returned from urological surgery with closed continuous bladder irrigation. The patient's vital signs are within normal limits. The patient's wife voices concern regarding the "bloody-red" appearance of the drainage. What is the nurse's best response? "This is normal at this time; the drainage will become lighter and appear blood tinged in 2 to 3 days." The nurse is preparing continuous bladder irrigation. Which of the following actions by the nurse would be appropriate? (Select all that apply.) Monitoring and emptying the drainage bag as needed. Calculating urinary output as the amount of irrigant infused subtracted from the amount in the drainage bag. Priming the infusion tubing with irrigating solution. Performing hand hygiene and donning clean gloves. A nurse is performing preoperative teaching for a patient who is having urological surgery. The nurse informs the patient he will likely require closed bladder irrigation following the surgery. The patient asks what the purpose is for bladder irrigation. What would be a correct response by the nurse? (Select all that apply.) "Bladder irrigation may be used to instill medication into the bladder." "Irrigating the bladder prevents any clots or sediment from blocking urinary drainage."

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Subido en
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