A nurse is providing instructions about a 24-hour urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Discard the first voided specimen.
Void every hour.
Save the final specimen in a separate container.
Cleanse the perineum with a povidone-iodine solution prior to voiding.
The Correct Answer is A
Choice A rationale
The first voided specimen is discarded to ensure that the 24-hour urine collection starts with an empty bladder and accurately reflects the urine produced over the entire period.
Choice B rationale
Voiding every hour is not necessary and may not be practical for a 24-hour urine collection.
Choice C rationale
The final specimen should be included in the same container as the rest of the 24-hour urine collection.
Choice D rationale
Cleansing the perineum with a povidone-iodine solution is not required for a 24-hour urine collection.
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Correct Answer is C
Explanation
Choice A rationale
Holding urine for extended periods may indicate urinary retention, which is not the desired outcome of treatment for enuresis. The goal of enuresis treatment is to help the child develop better bladder control and responsiveness to the need to urinate.
Choice B rationale
Kegel exercises primarily target pelvic floor muscles and may not directly address the underlying causes of enuresis. While Kegel exercises can be beneficial for strengthening pelvic muscles, they are not typically the primary focus of conditioning therapy for enuresis.
Choice C rationale
Waking to urinate in response to the alarm indicates improved bladder control and responsiveness to conditioning therapy for enuresis. This statement suggests that the child is becoming more aware of the need to urinate and is responding appropriately to the alarm, which is a positive sign of treatment effectiveness.
Choice D rationale
Drinking less may not necessarily indicate treatment effectiveness and could lead to dehydration. It is important for children to maintain adequate hydration, and reducing fluid intake is not a recommended strategy for managing enuresis.
Correct Answer is B
Explanation
Choice A rationale
Increased throat pain is common after a tonsillectomy and can be managed with pain relief measures. It is not the most critical finding.
Choice B rationale
Frequent swallowing can indicate bleeding at the surgical site, which is a serious complication that requires immediate attention.
Choice C rationale
Refusal to drink clear liquids is concerning for dehydration but is not as immediately critical as signs of bleeding.
Choice D rationale
Crying often can be due to pain or discomfort but is not as critical as signs of bleeding.