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Fundamentals II > Bowel and Urinary Elimination > Flashcards

Bowel and Urinary Elimination Flashcards

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
Q

what special prep needs to be included for a patient that is to have an abdominal xray

A

none

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26
Q

What are some health promotion topics the nurse could share with a patient with urinary problems

A

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

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27
Q

what is the appropriate / ideal amount of fluid intake per day

A

2300 ml

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28
Q

what are some ways to help patients increase their fluid intake

A

schedule times to drink
identify fluid preferences
have high fluid foods (fruits)
stop drinking about 2 hours before bed to avoid night urination

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29
Q

when would the nurse encourage double voiding

A

in cases of bladder retention

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30
Q

what are some nursing actions the nurse can do independently for urinary retention

A

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

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31
Q

What are the do’s of skin care with incontinence of the bladder

A

treat and identify early
use skin risk assessments
use barrier creams
ensure adequate hydration

32
Q

what are the don’ts of skin care with incontinence of the bladder

A

use traditional soap and water
double padding the bed
leaving soiled pads

33
Q

who would need a coude tip catheter

A

men with an enlarged prostate

34
Q

when would a suprapubic catheter be placed

A

when there is blockage of the urethra or when an indwelling catheter causes irritation

35
Q

within how many hours should a patient void after removing a catheter

A

6-8 hours

36
Q

when is it considered constipation

A

having < 3 bowel movements per week

37
Q

what are some common causes of constipation

A

irregular bowel habits
improper diet
reduced fluid intake
lack of exercise
stress
certain medications
ignoring the urge to go
GI disorders

38
Q

what are some reasons that older adults are more at risk of constiplation

A

lack of muscle tone
slowed peristalsis
lack of exercise
not enough fluid intake
too many dairy products
lack of fiber
medications

39
Q

what are 4 specific complications of constipation

A

hemorrhoids
anal fissure
fecal impaction
rectal prolapse

40
Q

what position does the patient need to be in for an enema insertion

A

left lying lateral sims

41
Q

if a patient complains of pain while administering an enema

A

slow the rate by lowering the height of the bag

42
Q

if the patient’s abdomen becomes rigid while administering an enema what should the nurse do

A

stop the administration

43
Q

impaction results from what

A

results from unrelieved constipation and the inability to expel hardened feces retained in the rectum

44
Q

what could happen if a fecal impaction is not relieved

A

intestinal obstruction

45
Q

who is at risk for fecal impaction

A

those that are debilitated, confused, or unconscious

46
Q

how would you check for a fecal impaction

A

a digital exam of the rectum

47
Q

what are the s/s of fecal impaction

A

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
Q

what is an intervention for fecal impaction

A

digital removal of stool

49
Q

what is diarrhea

A

loose watery bowel movements

50
Q

what are the potential causes of diarrhea

A

foodborne pathogens, food intolerances / allergies, surgery, diagnostic testing, enteral feeings

51
Q

what are 3 specific complications from diarrhea

A

skin irritation, dehydration, and nutritional concerns

52
Q

what type of anti-diarrheal agent would you use against c. diff

A

nothing, you don’t want to use anti-diarrheal agents with c.diff

53
Q

who is at risk for c.diff

A

those taking antibiotics, elderly, immunocompromised, those in long-term care facilities, GI procedures, previous hx of c.diff

54
Q

what are the complications of c.diff

A

dehydration, kidney failure, toxic megacolon, bowel perforation, death

55
Q

how do you prevent c.diff

A

washing hands with soap and water, avoid unneeded antibiotics, clean surfaces with bleach, and use contact D isolation

56
Q

what is bowel incontinence

A

inability to control passage of feces and gas from the anus

57
Q

what are the potential causes of bowel incontinence

A

muscle / nerve damage
any physical condition that impairs the anal sphincter function
constipation / diarrhea
large volume stools
surgery
rectal prolapse

58
Q

what are some of the risk factors of bowel incontinence

A

age
female
nerve damage
dementia
physical disability

59
Q

what are s/s of flatulence

A

abdominal distention, cramping, bloating, pain

60
Q

what are potential causes of flatulence

A

constipation, food intolerance, GI diseases (IBS, chrons), stress

61
Q

to avoid gas, the nurse would suggest what type of fiber

A

insoluble fiber

62
Q

what foods contain insoluble fiber

A

whole wheat, nuts, green beans, potatoes

63
Q

what foods contain soluble fiber

A

flax, broccoli, Brussel sprouts

64
Q

what are hemorrhoids

A

dilated / engorged veins in the lining of the rectum

65
Q

what causes hemorrhoids

A

increased venous pressure from straining

66
Q

what are potential treatments for hemorrhoids

A

proper diet, increase activity, fluids, topical medications, surgery, sitz bath

67
Q

what are the risk factors for colon cancer

A

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
Q

what are the warning signs of colon cancer

A

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
Q

when assessing bowel movements what should be included in the assessment

A

amount, color, odor, consistency, frequency, shape, and constituents

70
Q

what does a fecal occult blood test test for

A

hidden blood / detects cancer

71
Q

what are the2 purposes of an NG tube

A

decompression and enteral feedings

72
Q

when and how often does guaiac fecal occult blood test done

A

annual and 45

73
Q

when and how often should someone start getting colonoscopies

A

every 10 years, starting at 45

74
Q

how do you assist a patient on to a bed pan that can assist with movement

A

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
Q

how do you assist a patient on to a bed pan that cannot assist with movement

A

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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