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Nursing (Nurs 172) Urinary Pattern - HESI Case Study

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John Marsh
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Gateway Community College, Phoenix

Nursing (Nursing 172)

Urinary Pattern – HESI Case Study

Urinary Pattern
Meet the Client: Hunter Ellis
Hunter Ellis, a 76-year-old African American male, is a resident in a long-term care facility. He has been
unable to control the urge to void since experiencing a stroke 1 month ago. He is alert and oriented and has
no verbal deficits since his stroke.
Physiologic Integrity
1. Mr. Ellis states that prior to his stroke, he would get up five or six times during the
night to empty his bladder but that he was able to control the urge long enough to
make it to the bathroom. How should the nurse describe the urinary pattern that Mr.
Ellis is describing?
A. Dysuria
B. Frequency
C. Nocturia
D. Diureses
Rationale: This refers to frequently voiding at night. The incidence of nocturia
increases greatly in the older male client who has an enlarged prostate, or who may
possibly indicate an inability to concentrate urine because of poor blood flow to the
kidneys.
2. Since Mr. Ellis now voids spontaneously without recognizing the need to void, how
should the nurse document his current urinary pattern in the medical chart?
A. Polyuria
B. Incontinence
C. Retention
D. Oliguria
Rationale: Incontinence is the involuntary loss of urine. In the case of this client, it may
be the result of neurologic impairment secondary to the stroke.
Safe and Effective Care Environment
3. To help manage Mr. Ellis’ incontinence, the nurse initiates a bladder training
program. Which instruction should the nurse provide to the unlicensed assistive
personnel (UAP) who will be helping care for Mr. Ellis?
A. Restrict oral fluids to 1,000 ml daily in evenly divided amounts.
B. Offer warm coffee, cocoa, or tea every 2 hours while awake.
C. Limit client socialization until voiding patterns are established.
D. Remind the client to void every 2 hours while awake.
Rationale: A toileting schedule is an effective means to retrain the bladder. Bladder
training should start with voiding every 2 hours in the daytime and every 4 hours at

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Nursing (Nurs 172) Urinary Pattern - HESI Case Study

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