Author Question: A nurse is caring for a patient with a continent urinary reservoir. Which action will the nurse ... (Read 53 times)

amal · **on:** Jul 22, 2018

A nurse is caring for a patient with a continent urinary reservoir. Which action will the nurse take?

a. Teach the patient how to self-cath the pouch.
b. Teach the patient how to perform Kegel exercises.
c. Teach the patient how to change the collection pouch.
d. Teach the patient how to void using the Valsalva technique.

Question 2

A nurse is watching a nursing assistive personnel (NAP) perform a postvoid bladder scan on a female with a previous hysterectomy. Which action will require the nurse to follow up?

a. Palpates the patient's symphysis pubis
b. Wipes scanner head with alcohol pad
c. Applies a generous amount of gel
d. Sets the scanner to female

Benayers · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

ANS: A
In a continent urinary reservoir, the ileocecal valve creates a one-way valve in the pouch through which a catheter is inserted through the stoma to empty the urine from the pouch. Patients must be willing and able to catheterize the pouch 4 to 6 times a day for the rest of their lives. The second type of continent urinary diversion is called an orthotopic neobladder, which uses an ileal pouch to replace the bladder. Anatomically, the pouch is in the same position as the bladder was before removal, allowing a patient to void through the urethra using a Valsalva technique. In a ureterostomy or ileal conduit the patient has no sensation or control over the continuous flow of urine through the ileal conduit, requiring the effluent (drainage) to be collected in a pouch. Kegel exercises are ineffective for a patient with a continent urinary reservoir.

Answer to Question 2

ANS: D
The nurse will follow up if the NAP sets the scanner to female. Women who have had a hysterectomy should be designated as male. All the rest are correct and require no follow-up. The NAP should palpate the symphysis pubis, the scanner head should be cleaned with an alcohol pad, and a generous amount of gel should be applied.