The charge nurse is observing a newly licensed nurse catheterize ...

[CQXA]

The charge nurse is observing a newly licensed nurse catheterize an older adult client admitted with an enlarged prostate. Which action by the newly licensed nurse requires intervention from the charge nurse?
 
  A) The newly licensed nurse injects 10 mL of 2 lidocaine gel into the client's urethra.
  B) The newly licensed nurse inserts a 16 French coud-tipped catheter.
  C) The newly licensed nurse clamps the catheter after draining 500 mL.
  D) The newly licensed nurse clamps the catheter after draining 800 mL.

Question 2

The nurse is assessing an adult client in a urology clinic. The client reports that she has been having accidents and expresses frustration about this normal part of aging. Which response by the nurse is the most appropriate?
 
  A) Incontinence is not a normal part of aging. Tell me more about the incontinence you are experiencing.
  B) You may need to have surgery to manage this problem.
  C) I understand you are frustrated about this occurrence.
  D) Unfortunately, aging and incontinence go hand in hand.

[ms_sulzle]

Answer to Question 1

Answer: D

Draining 800 mL before clamping might cause a vasovagal response, so the charge nurse would need to intervene. Using 2 lidocaine gel 10 mL injected into the male urethra reduces discomfort during catheterization and the risk of catheter-associated infection, and it promotes pelvic muscle relaxation. A coud-tipped catheter is passed more easily in the older man with an enlarged prostate. Some clients experience a vasovagal response, becoming pale, sweaty, and hypotensive, if the bladder is rapidly drained. Draining urine in 500 mL increments and clamping the catheter for 5-10 minutes between increments may prevent this response.

Answer to Question 2

Answer: A

As the body ages, there are anatomical changes can increase the risk for urinary incontinence; however, this is not a normal part of aging. It is appropriate for the nurse to gather more information regarding the client's incontinence. It is beyond the nurse's scope of practice to recommend surgery to the client. Telling the client the nurse understands does not help to determine the cause of the client's incontinence.