1. What condition do the assessment findings and lab reports point toward? 2. The medical director makes rounds and writes orders to start an IV of D5½ NS at 75 mL/hr and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral meds, the medical director ordered ciprofloxacin (Cipro) 400 mg q12h IV piggyback (IVPB). Is the type of fluid and rate appropriate for M.Z.’s age and condition? Explain. 3. While administering the IVPB ciprofloxacin, which adverse effects might occur? (Select all that apply.) 4. You enter the room to start the IV and insert the Foley catheter and find that the NAP has taken the patient to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe the patient wiping herself from back to front. What do you need to do at this time? 5. Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.? 6. What issues need to be considered in protecting M.Z.’s safety? Describe your actions in working with the nursing assistant. 7. As you assess M.Z., you notice that her catheter tubing is not secured. Why does the tubing need to be secured, and where is the correct placement of the catheter tubing? 1. Are M.B.’s VS appropriate for a man of his age? If not, offer a rationale for the abnormal readings. 2. Given M.B.’s chief complaint, what would you expect to find during your initial assessment? 3. What do you need to know about his use of the finasteride (Proscar)? 4. What are your priorities for this patient? 5. After examining M.B., the ED physician asks you to insert an indwelling urethral Foley catheter. What will you include in M.B.’s teaching before placing the Foley? 6. After two unsuccessful attempts to advance the catheter into the bladder, you stop. What is your next intervention? Why? What could be causing this problem? 7. The ED physician successfully inserts the indwelling catheter with the use of a coudé catheter, and urine begins to drain. How is this catheter different? 8. As the physician begins to inflate the catheter balloon, M.B. winces in pain and states, “Ouch, you are hurting me!” What happened, and what will the physician do? 9. You watch the urine drain into the bag and note that the amount is approaching 500 mL. What do you do at this time? 10. After the catheter is in place, the ED physician writes orders to discharge M.B. with instructions to see his primary care provider (PCP) on the following day. It is your responsibility to give discharge instructions. Outline your care plan. 11. The next day, M.B. is seen by his PCP, who changes M.B.’s medication to alfuzosin (Uroxatral). The catheter will be discontinued 2 days later. What teaching is essential regarding this new medication? 1. You begin your assessment and look at the transparent urostomy pouch covering the ileal conduit. The stomal opening is red and is draining urine with mucus. Is this normal? 2. A nursing student who is working with you asks you to explain the difference between an ileal conduit and an ileostomy. How do you answer? 3. The student replies, “So, eventually, A.T.’s ileal conduit will become continent, and she won’t need to wear a pouch, right?” How do you answer? 4. What is the proper size for an appliance for an ileal conduit? 8. Which statements about the stoma are true? (Select all that apply.) a. “The lining of the stoma is the same type of tissue as the inside of your mouth.” b. “It has touch receptors, just like your skin, and you should have feeling in it.” c. “The color should be a beefy red, and the stoma should feel wet.” d. “Normally, the stoma is dry. Feeling moisture is a problem.” 9. A.T. asks you, “How will I know when to empty it? What about at night? Do I have to get up at night to empty this little pouch?” How do you answer her? 10. What other topics need to be addressed when doing teaching regarding an ileal conduit? 11. Should you follow through on this suggestion? Why or why not? 12. What are the signs and symptoms of a urinary tract infection (UTI) in a patient with an ileal conduit? 13. A.T. asks you, “How will they collect a urine specimen when it just dribbles out all the time?” How will you answer her? 14. As you make rounds, you notice that A.T.’s pouch has sprung a urine leak and she has placed a washcloth over the pouch to absorb the urine. She asks you for tape to attach the washcloth to the bag. How will you respond to her request?
Genitourinary Disorders
Scenario
Case Study Progress
Scenario
Case Study Progress
Scenario
Case Study Progress
Case Study Progress
Genitourinary Disorders
