Author Question: The nurse is caring for a patient who has urinary frequency. Which nursing diagnosis is the highest ... (Read 70 times)

Brittanyd9008 · **on:** Jul 23, 2018

The nurse is caring for a patient who has urinary frequency. Which nursing diagnosis is the highest priority for this patient?

a. Risk for compromised human dignity r/t occasional incontinence
b. Risk-prone health behavior r/t living alone at home with nocturia
c. Risk for contamination r/t urine contact with perineal area skin
d. Risk for falls r/t hurried trips to the bathroom during the day and night

Question 2

The nurse is caring for a patient who will undergo ultrasound testing of the bladder and kidneys the next morning. Which instruction will the nurse provide to the patient about the test?

a. A small IV will be inserted into your arm to inject the contrast dye.
b. You will need to drink lots of water but not use the toilet.
c. You should not have anything to eat or drink after midnight.
d. You will receive a cleansing enema before you have the test.

pami445 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: D
Risk for falls is the highest priority diagnosis for this patient because rushing to the bathroom can lead to loss of balance and serious injury. Walking to the bathroom at night is even more dangerous because of low lighting conditions and sleepiness. Living alone with a history of nocturia does not demonstrate risk-prone health behavior. Risk for impaired skin integrity would be appropriate for the patient's potential skin breakdown caused by incontinence and skin contact with urine.

Answer to Question 2

ANS: B
No preparation is needed for kidney and bladder ultrasound other than having the patient drink lots of fluid beforehand. The patient is instructed not to use the toilet so that the bladder will be filled and easy to visualize. No contrast dye, enemas, or fasting is required.