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When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)

Observing for changes in urinary patterns, such as a sudden decrease in urinary output or frequent, small amounts of voiding.

Assessing for reports of urinary hesitancy, dribbling of urine, straining, or a sensation of incomplete bladder emptying during urination.

Encouraging the client to drink large amounts of fluid in a short period to stimulate bladder emptying.

Applying pressure over the lower abdomen to force urine out of the bladder.

Evaluating for palpable bladder distention after voiding to assess incomplete bladder emptying.

Answer and Explanation

Correct Answer : A,B,E

A. Observing for changes in urinary patterns, such as a sudden decrease in urinary output or frequent, small amounts of voiding. This can indicate urinary retention, as frequent, small voids may suggest incomplete emptying of the bladder.

B. Assessing for reports of urinary hesitancy, dribbling of urine, straining, or a sensation of incomplete bladder emptying during urination. These symptoms are common in urinary retention, indicating that the client is having difficulty fully emptying the bladder.

C. Encouraging the client to drink large amounts of fluid in a short period to stimulate bladder emptying: This is incorrect, as overhydration can worsen urinary retention, especially in clients with an impaired ability to empty their bladder.

D. Applying pressure over the lower abdomen to force urine out of the bladder: This is incorrect and can cause harm, as it may increase the risk of bladder injury.

E. Evaluating for palpable bladder distention after voiding to assess incomplete bladder emptying.
A distended bladder after voiding suggests incomplete emptying and potential urinary retention.

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Correct Answer is D

Explanation

A. I should eat only plant-based proteins to manage my symptoms: While plant-based proteins may be a part of the diet, limiting protein intake solely to plant-based sources is not necessary, and animal proteins like chicken and fish are recommended for tissue repair.

B. I should avoid all sources of protein to prevent flare-ups: Protein is necessary for healing and should not be completely avoided.

C. I should follow a low-protein diet to reduce intestinal inflammation: There is no evidence that a low-protein diet helps reduce inflammation in Crohn's disease. High-protein intake is beneficial.

D. I should include high-protein foods like chicken and fish in my diet. During active inflammation in Crohn's disease, a high-protein diet is important for healing and maintaining muscle mass, especially since malabsorption can be a concern.

A. A low fat diet B. A low sodium diet C. A high fiber diet D. A high protein diet

Correct Answer is A

Explanation

A. A low-fat diet: A low-fat diet is recommended for clients with chronic cholecystitis to reduce the workload on the gallbladder and prevent biliary colic, which can be triggered by the digestion of fats.

B. A low-sodium diet: While a low-sodium diet may be recommended for other conditions, it is not specifically indicated for biliary colic or cholecystitis.

C. A high-fiber diet: Although fiber is beneficial for overall health, it does not directly prevent biliary colic related to cholecystitis.

D. A high-protein diet:A high-protein diet is not recommended for biliary colic. Fat content is the primary concern, not protein.

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When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)

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Correct Answer is D

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