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Fundamentals II > Bowel and Urinary Elimination > Flashcards

Bowel and Urinary Elimination Flashcards

(75 cards)

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1
Q

Define micturition

A

the act of urinating

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2
Q

What are 8 factors influencing micturition?

A
  1. growth and development
  2. sociocultural factors
  3. psychological factors
  4. personal habits
  5. fluid intake
  6. pathological conditions
  7. surgical procedures
  8. diagnostic examinations (caths)
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3
Q

What is decreased in older adults related to micturition?

A

amount of nephrons, bladder tone, bladder capacity, and the amount of time between the urge to go and releasing urine

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4
Q

What is increased in older adults related to micturition?

A

bladder irritability, bladder contractions during bladder filing, risk of urinary incontinence

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5
Q

What is urinary retention

A

the inability to partially or completely empty the bladder

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6
Q

How can you diagnose post-void residual

A

ultrasound of bladder after urination

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7
Q

does a nurse need an order to scan the bladder after a patient urinates

A

no

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8
Q

what is the most common bacteria in the urinary tract?

A

e. coli

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9
Q

what is bacteriuria

A

bacteria in the urine (doesn’t necessarily mean UTI)

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10
Q

What are 8 examples of risk factors of UTIs

A
  1. has a catheter
  2. any instrument in the urinary tract
  3. urinary retention
  4. urinary / fecal incontinence
  5. poor perineal hygiene
  6. females
  7. frequent sexual intercourse
  8. uncircumcised males
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11
Q

what are the top 2 focal points about CAUTIs

A

early recognition and prompt intervention

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12
Q

what is urinary incontinence

A

involuntary loss of urine

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13
Q

What are the 3 forms of urinary incontinence

A

urgency
stress
overflow

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14
Q

what are the 9 risk factors for urinary incontinence

A
  1. women / elderly
  2. obesity
  3. multiple pregnancy / vaginal births
  4. neuro disorders (Parkinson’s, CVA, spinal cord injury, MS)
  5. Medication
  6. Confusion
  7. Dementia
  8. Immobility
  9. Depression
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15
Q

Why is it important to assess a patients bladder / urination pattern?

A

to find a baseline or what is normal to compare to when things change

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16
Q

What are s/s of urinary alterations

A

urgency
dribbling
hematuria
retention
polyuria
hesitancy

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17
Q

how do you assess for kidney tenderness

A

percuss the costovertebral angle (CVA) which is the space formed by the 12th rib and the spine

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18
Q

what is the normal urine output

A

> 30 ml / hour

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19
Q

When should the nurse be concerned about urinary output amount

A

< 30 ml / hour for 2 hours

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20
Q

If urine appears thick and cloudy, what could the nurse infer

A

may have bacteria and WBC present but could also be urine from the first urination of the day (may appear this way because the urine has sat in the bladder all night)

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21
Q

if we need to know the exact amount of urine a patient makes in an hour what is the best way to do this

A

by use of a urinary catheter

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22
Q

when collecting urine for a urinalysis what is the best practice

A

to get fresh urine - not urine that has been sitting in the bag

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23
Q

how quickly must the nurse get urine off for a culture

A

30 minutes

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24
Q

what is the purpose of an abdominal xray in relation to urination

A

determines size, shape, symmetry, and location of structures of the urinary tract

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25
what special prep needs to be included for a patient that is to have an abdominal xray
none
26
What are some health promotion topics the nurse could share with a patient with urinary problems
promote self care practices maintain normal routine promote healthy nutrition and fluid intake avoid constipation if possible avoid smoking strengthen pelvic floor muscle for men: be vigilant about prostate health report any changes to the doctor
27
what is the appropriate / ideal amount of fluid intake per day
2300 ml
28
what are some ways to help patients increase their fluid intake
schedule times to drink identify fluid preferences have high fluid foods (fruits) stop drinking about 2 hours before bed to avoid night urination
29
when would the nurse encourage double voiding
in cases of bladder retention
30
what are some nursing actions the nurse can do independently for urinary retention
assess and monitor urine output assess for bladder distention assist patient to normal position for urination run water / flush commode to stimulate urination apply cold compress to abdomen
31
What are the do's of skin care with incontinence of the bladder
treat and identify early use skin risk assessments use barrier creams ensure adequate hydration
32
what are the don'ts of skin care with incontinence of the bladder
use traditional soap and water double padding the bed leaving soiled pads
33
who would need a coude tip catheter
men with an enlarged prostate
34
when would a suprapubic catheter be placed
when there is blockage of the urethra or when an indwelling catheter causes irritation
35
within how many hours should a patient void after removing a catheter
6-8 hours
36
when is it considered constipation
having < 3 bowel movements per week
37
what are some common causes of constipation
irregular bowel habits improper diet reduced fluid intake lack of exercise stress certain medications ignoring the urge to go GI disorders
38
what are some reasons that older adults are more at risk of constiplation
lack of muscle tone slowed peristalsis lack of exercise not enough fluid intake too many dairy products lack of fiber medications
39
what are 4 specific complications of constipation
hemorrhoids anal fissure fecal impaction rectal prolapse
40
what position does the patient need to be in for an enema insertion
left lying lateral sims
41
if a patient complains of pain while administering an enema
slow the rate by lowering the height of the bag
42
if the patient's abdomen becomes rigid while administering an enema what should the nurse do
stop the administration
43
impaction results from what
results from unrelieved constipation and the inability to expel hardened feces retained in the rectum
44
what could happen if a fecal impaction is not relieved
intestinal obstruction
45
who is at risk for fecal impaction
those that are debilitated, confused, or unconscious
46
how would you check for a fecal impaction
a digital exam of the rectum
47
what are the s/s of fecal impaction
inability to pass stool for several says despite the urge to go continuous oozing of liquid stools loss of appetite N/V abdominal cramping abdominal distention rectal pain
48
what is an intervention for fecal impaction
digital removal of stool
49
what is diarrhea
loose watery bowel movements
50
what are the potential causes of diarrhea
foodborne pathogens, food intolerances / allergies, surgery, diagnostic testing, enteral feeings
51
what are 3 specific complications from diarrhea
skin irritation, dehydration, and nutritional concerns
52
what type of anti-diarrheal agent would you use against c. diff
nothing, you don't want to use anti-diarrheal agents with c.diff
53
who is at risk for c.diff
those taking antibiotics, elderly, immunocompromised, those in long-term care facilities, GI procedures, previous hx of c.diff
54
what are the complications of c.diff
dehydration, kidney failure, toxic megacolon, bowel perforation, death
55
how do you prevent c.diff
washing hands with soap and water, avoid unneeded antibiotics, clean surfaces with bleach, and use contact D isolation
56
what is bowel incontinence
inability to control passage of feces and gas from the anus
57
what are the potential causes of bowel incontinence
muscle / nerve damage any physical condition that impairs the anal sphincter function constipation / diarrhea large volume stools surgery rectal prolapse
58
what are some of the risk factors of bowel incontinence
age female nerve damage dementia physical disability
59
what are s/s of flatulence
abdominal distention, cramping, bloating, pain
60
what are potential causes of flatulence
constipation, food intolerance, GI diseases (IBS, chrons), stress
61
to avoid gas, the nurse would suggest what type of fiber
insoluble fiber
62
what foods contain insoluble fiber
whole wheat, nuts, green beans, potatoes
63
what foods contain soluble fiber
flax, broccoli, Brussel sprouts
64
what are hemorrhoids
dilated / engorged veins in the lining of the rectum
65
what causes hemorrhoids
increased venous pressure from straining
66
what are potential treatments for hemorrhoids
proper diet, increase activity, fluids, topical medications, surgery, sitz bath
67
what are the risk factors for colon cancer
african americans, high intake of red meat/processed meat with low fiber, obesity, 50+, lack of physical activity, alcohol / tobacco use, family hx, hx of inflammatory bowel disease and personal hx of colorectal cancer, colorectal polyps
68
what are the warning signs of colon cancer
changes in bowel habits bleeding from anus blood in stool abdominal pain loss of appetite persistent lethargy and looking pale jaundice unexplained weight loss
69
when assessing bowel movements what should be included in the assessment
amount, color, odor, consistency, frequency, shape, and constituents
70
what does a fecal occult blood test test for
hidden blood / detects cancer
71
what are the2 purposes of an NG tube
decompression and enteral feedings
72
when and how often does guaiac fecal occult blood test done
annual and 45
73
when and how often should someone start getting colonoscopies
every 10 years, starting at 45
74
how do you assist a patient on to a bed pan that can assist with movement
raise head of bed 30-60 degrees have patient flex knees and move hips upward help lift patients bottom up to slide bedpan under
75
how do you assist a patient on to a bed pan that cannot assist with movement
roll patient on side place bed pan against bottom roll patient on back raise patient head of bed 30 degrees bend knees

Fundamentals II (4 decks)

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