What would be the best nursing action to facilitate bladder continence for the client who is cognitively impaired?

Offer toileting reminders every 2 hours

Provide clothing that is easy to manipulate

Explain the need to call for the nurse to help with toileting

Encourage avoidance of fluids between meals

Answer and Explanation

The Correct Answer is A

A. Offer toileting reminders every 2 hours: This is the best nursing action because it helps prevent urinary incontinence by prompting the client to use the bathroom regularly. Clients with cognitive impairment may have difficulty recognizing the need to void or remembering when to do so. Providing frequent reminders helps maintain bladder continence and reduces the risk of accidents.

B. Provide clothing that is easy to manipulate: While providing clothing that is easy to manipulate can be helpful for clients with cognitive impairment to independently manage toileting, it does not directly address the issue of facilitating bladder continence. Easy-to-manipulate clothing may assist with toileting independence but does not address the need for regular voiding to prevent urinary incontinence.

C. Explain the need to call for the nurse to help with toileting: While educating the client about when to seek assistance for toileting needs is important, it may not be sufficient for facilitating bladder continence in a client with cognitive impairment. Clients may still have difficulty recognizing the need to void or remembering to call for assistance, making frequent reminders more effective in promoting continence.

D. Encourage avoidance of fluids between meals: Encouraging avoidance of fluids between meals is not an appropriate strategy for promoting bladder continence. Restricting fluids can lead to dehydration and other health complications. Maintaining adequate hydration is essential for overall health, and clients should be encouraged to drink fluids regularly throughout the day. Additionally, restricting fluids does not address the underlying issue of cognitive impairment affecting toileting behaviors.

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Correct Answer is ["A","C","D"]

Explanation

A. Chronic:

Chronic pain is characterized by pain that persists beyond the expected time for tissue healing, typically lasting for more than 3 to 6 months.

In this scenario, the client's pain has been present for 1 year, indicating a prolonged duration consistent with chronic pain.

Documenting the pain as chronic provides important information about the nature and duration of the client's pain experience.

C. Intractable:

Intractable pain refers to pain that is difficult to manage or control despite various treatment modalities.

The client's report of intense, sharp pain persisting at a high level (rated 9 out of 10) despite opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and acupuncture suggests that the pain is intractable.

Documenting the pain as intractable highlights the challenges associated with managing the client's pain and the need for additional interventions or referral to specialized pain management services.

D. Neuropathic:

Neuropathic pain arises from damage or dysfunction of the nervous system and is often described as sharp, shooting, burning, or like an electric shock.

The client's description of their leg pain as "an intense sharp quality 'like an electric shock'" is consistent with neuropathic pain.

Documenting the pain as neuropathic helps identify the underlying pathophysiology of the pain and guides appropriate treatment strategies targeting neuropathic pain mechanisms.

B. Visceral:

Visceral pain originates from internal organs and is typically described as deep, dull, or cramping.

While the pain in this scenario is associated with spinal nerve injury, which can involve visceral pain pathways, the client's description of the pain as sharp and electric shock-like is more indicative of neuropathic pain rather than visceral pain.

Therefore, visceral pain may not be an appropriate descriptor for the client's pain experience in this case.

E. Cutaneous:

Cutaneous pain arises from the skin or subcutaneous tissues and is often described as superficial, sharp, or burning.

While the client's leg pain may involve cutaneous innervation, the description provided ("like an electric shock") suggests involvement of deeper structures and neuropathic pain mechanisms rather than purely cutaneous pain.

Therefore, cutaneous pain may not fully capture the nature of the client's pain experience in this scenario.

A. Baked chicken, canned peas & carrots, macaroni & cheese, and hot tea B. Pepperoni pizza, salad, and a diet soda C. Baked turkey breast, corn on the cob, dinner roll, and skim milk D. Bologna sandwich on whole wheat bread, potato chips, sliced cucumbers, and iced tea

Correct Answer is C

Explanation

A. Baked chicken, canned peas & carrots, macaroni & cheese, and hot tea: This meal option contains canned vegetables, which are likely to be high in sodium due to added salt for preservation. Additionally, macaroni and cheese are typically high in sodium, and hot tea may contain added sodium if processed or prepared with salt. Therefore, this option is not suitable for a client on a low-sodium diet.

B. Pepperoni pizza, salad, and a diet soda: Pepperoni pizza is a high-sodium food due to the processed meats and cheese. Salad can be a healthy option, but it depends on the dressing and toppings; if these are high in sodium, it may not be appropriate. Diet soda typically does not contain sodium, but it is not an ideal beverage choice for a client with fluid volume excess. Overall, this option is not suitable for a low-sodium diet.

C. Baked turkey breast, corn on the cob, dinner roll, and skim milk: This is the correct answer. Baked turkey breast is a lean protein source that is naturally low in sodium. Corn on the cob and skim milk are also low in sodium. A dinner roll may contain some sodium, but if chosen wisely, it can be a suitable option for a low-sodium diet. Overall, this meal option provides a balanced and low-sodium meal for a client with fluid volume excess.

D. Bologna sandwich on whole wheat bread, potato chips, sliced cucumbers, and iced tea: Bologna, potato chips, and iced tea are all high-sodium food items and not suitable for a client on a low-sodium diet. While sliced cucumbers are low in sodium, they alone cannot offset the high sodium content of the other items in this meal option.

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What would be the best nursing action to facilitate bladder continence for the client who is cognitively impaired?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","D"]

Explanation

What meal option should a nurse choose for a client with fluid volume excess who has been placed on a low-sodium diet?

Correct Answer is C

Explanation

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