Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

Urinary output equal intake.

No terminal urinary dribbling.

Denies stress incontinence.

Absence of xerostomia.

Answer and Explanation

The Correct Answer is A

A) Urinary output equal intake:
This assessment finding suggests that the client is voiding an amount of urine equivalent to their fluid intake, indicating effective bladder emptying. Bethanechol is a cholinergic agonist that stimulates bladder contraction, helping to improve urinary retention by promoting the expulsion of urine from the bladder. Equal urinary output and intake indicate that the bladder is adequately emptying, which is a positive response to bethanechol therapy.

B) No terminal urinary dribbling:
While the absence of terminal urinary dribbling may be an indicator of improved bladder emptying, it is not as definitive as assessing urinary output equal to intake. Terminal urinary dribbling refers to the involuntary loss of urine that occurs after completing urination due to incomplete emptying of the bladder. While its absence may suggest improved bladder emptying, it is not as reliable an indicator as measuring urinary output.

C) Denies stress incontinence:
The absence of stress incontinence, which is the involuntary loss of urine during activities that increase intra-abdominal pressure (such as coughing, sneezing, or lifting), is not directly related to the effectiveness of bethanechol for urinary retention. Bethanechol primarily targets urinary retention by stimulating bladder contraction rather than addressing stress incontinence, which involves weakness of the pelvic floor muscles.

D) Absence of xerostomia:
Xerostomia refers to dryness of the mouth due to decreased saliva production and is a common side effect of anticholinergic medications. Bethanechol, as a cholinergic agonist, may actually increase saliva production and is not typically associated with xerostomia. However, the absence of xerostomia does not directly indicate the effectiveness of bethanechol for urinary retention.

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Correct Answer is B

Explanation

A) Avoid taking the medication on an empty stomach:
While it’s generally recommended to take lithium carbonate with food or milk to minimize gastrointestinal side effects, taking it on an empty stomach does not pose a significant risk. Therefore, it is not the most crucial instruction to emphasize to the client.

B) Maintain a fluid intake of 1,500 to 3,000 mL per day:
This instruction is crucial because lithium can cause dehydration, especially if the client becomes dehydrated due to increased sweating or decreased fluid intake. Adequate fluid intake helps maintain stable lithium levels in the blood and reduces the risk of toxicity. Emphasizing the importance of maintaining hydration is essential for clients taking lithium.

C) Report fluctuations in weight to the healthcare provider:
Weight fluctuations can indicate changes in fluid balance or other metabolic effects of lithium. While it’s important for the client to report changes in weight, this instruction is not as critical as ensuring adequate fluid intake, which directly affects lithium levels and toxicity risk.

D) Keep medication fliers for frequent review and reference:
While it’s helpful for clients to have medication information for reference, this instruction is more about general medication adherence and education rather than a specific requirement related to lithium carbonate.

A. Begin therapy 1 week before the next normal menstrual cycle. B. Use condoms and a backup method of birth control to prevent pregnancy. C. Ensure a negative pregnancy test result 2 weeks before therapy. D. Call the healthcare provider immediately if there is a chance of conception.

Correct Answer is A

Explanation

A) Begin therapy 1 week before the next normal menstrual cycle:
Misoprostol is often prescribed to prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) and is typically taken regularly with meals and at bedtime. The timing of therapy initiation is not necessarily linked to the menstrual cycle. Therefore, instructing the client to begin therapy specifically 1 week before the next normal menstrual cycle is incorrect and indicates a need for further teaching.

B) Use condoms and a backup method of birth control to prevent pregnancy:
Misoprostol is contraindicated during pregnancy due to its potential to induce uterine contractions and cause miscarriage or fetal abnormalities. Therefore, advising the client to use condoms and a backup method of birth control to prevent pregnancy while taking misoprostol is appropriate and aligns with safety precautions.

C) Ensure a negative pregnancy test result 2 weeks before therapy:
Confirming a negative pregnancy test result before initiating misoprostol therapy is essential because the medication can cause harm to a developing fetus. This instruction is correct and reinforces the importance of avoiding pregnancy while taking misoprostol.

D) Call the healthcare provider immediately if there is a chance of conception:
Given the teratogenic effects of misoprostol, advising the client to contact the healthcare provider immediately if there is a chance of conception is crucial. This instruction emphasizes the importance of avoiding pregnancy while taking the medication and seeking medical guidance promptly if pregnancy is suspected.

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Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

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