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Elimination Flashcards

1
Q

Your patient coughs and pees a little, what is this known as?

A

Stress Incontinence

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2
Q

You need to get a urine sample from a patient’s foley. Your instructor says you must take it from the port. Why?

A

It won’t be a clean sample because (theoretically) the foley has been in for a few days

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3
Q

What does C & S mean when collecting a urine sample?

A

Culture and sensitivity

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4
Q

T/F Specific gravity of the patients urine is high. This may be because the patient has a fluid volume deficit.

A

True

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5
Q

Your patient is ordered for a urine C&S. Why would this test be performed?

A

To identify the specific antibiotic needed

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6
Q

What kegel exercises do for your patient?

A

To strengthen the pelvic floor muscles

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7
Q

T/F collecting urine for a urinalysis is a sterile procedure?

A

False, it is a clean procedure

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8
Q

Your patient’s urine is cloudy with sediment, this is known as…

A

Pyuria

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9
Q

If you are having difficulty placing a urinary catheter, it is best not to attempt to force the catheter due to possible perforation of ______

A

the urethra

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10
Q

How is the foley (indwelling) different from a straight cath?

A

The indwelling has a balloon

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11
Q

Your patient is anuric. You need a urine sample. What do you use?

A

A straight catheter

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12
Q

How many days can a straight (intermittent) catheter be left in place in your patient?

A

ZERO days

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13
Q

What is the purpose of the triple lumen urinary catheter

A

Bladder irrigation and infusion of medication

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14
Q

Your patient has had their bladder removed. This will result in the creation of…

A

A urostomy

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15
Q

T/F If an ileal conduit is emptied on a regular basis, the patient will not need to wear a collection pouch

A

False, because the urine is flowing continuously. If you take the pouch off the urine will keep going

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16
Q

Your patient now has a continent urostomy. This means

A

An internal collection pouch has been created from part of the intestines. Instead of the opening, it can collect in the body (content because it can be emptied)

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17
Q

Your patient has a continent urostomy. This is possible because a urostomy has a _____

A

Valve

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18
Q

Where does the suprapubic catheter insert?

A

Abdominal wall

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19
Q

Why would a patient have a suprapubic catheter aside from any other catheter?

A

The catheter could not be passed through the urethra

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20
Q

The nurse has an order to flush the patient’s nephrostomy tube. What is the purpose?

A

To decrease urine backflow (flushing in the kidney and towards the bottom; keep it patent)

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21
Q

T/F A condom catheter is an invasive technique

A

False

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22
Q

You decide to use the bladder scanner on your patient. What is the purpose of this device?

A

To check for post void residual

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23
Q

You infuse dialysate, allow the fluid to dwell and empty the fluid to complete the exchange. This describes ____

A

Peritoneal dialysis
Purpose: to get rid of toxins

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24
Q

What is the purpose of hemodialysis?

A

To cleanse toxins out of the blood

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25
The patient is admitted to the ED and needs immediate hemodialysis. The physician needs to place a ________
a Shiley venous catheter
26
Your renal patient went to the OR. The surgeon used artificial tubing to join an artery and vein. This is called ______
an ateriovenous graft
27
T/F An arteriovenous graft can be used within 24 hours of placement
False
28
Your patient's AV fistula has a positive bruit and positive thrill. What is the next step of the nurse?
Document this as normal
29
What is used for immediate versus long term dialysis?
A Shiley venous catheter is used for immediate dialysis. Fistula (your own artery and vein) and graft (artificial tube) has to mature so it is long term.
30
In addition to taking multiple narcotics, your patient is taking iron and is hypovolemic. What is your patient at risk for?
Constipation
31
Your patient has N/V, has not had a bowel movement in 5 days but does have some leakage of liquid brown stool. This could be a result of...
A fecal impaction
32
Your patient needs a stool sample for O&P, What does this stand for?
Ova and parasites
33
T/F Checking for occult blood in stool by smearing a sample on a test card is a sterile procedure
False
34
T/F If polyps are noting during a colonscopy, they can be removed immediately
True
35
You are infusing a large volume enema of normal saline. The patient complains of cramping, what could you do to help?
Adjust the rate with the roller clamp
36
Your patient is on bedrest and has severe/continuous diarrhea. What device may be helpful?
A flexi-seal
37
How many stomas can be involved in a fecal diversion?
2 stomas
38
How does a patient clean a new ostomy?
Soap and water with a wash cloth is fine
39
A characteristic of a double barrel colostomy is ____
It has two separate bags
40
Your patient has a colostomy in which the colon is not completely severed in half. This is a _____ colostomy
Loop
41
A patient with a new descending colostomy. They ask you about irrigation
Done every 24 hours, it allows the patient to go without bag
42
How much fluid volume per void is normal?
250 to 400 ml per void
43
How much fluid (ml/hr) is expected for normal urine output?
minimum of 30 ml/hr
44
Average urine output (cc) for the average, healthy adult per 24 hours
1200-1500 cc
45
What is the clarity for normal urine?
Clear without sediment, light yellow, no odor
46
How is polyuria defined? Urine output within a 24-hour period?
2500-3000ml in a 24-hour period
47
How is oliguria defined? Urine output within a 24-hour period?
Reduced urine output < 500 ml in 24 hours
48
How is anuria defined? Urine output within a 24-hour period?
No urine < 100 ml in 24 hours
49
What is urgency?
Inability to delay urination
50
What is urine frequency
Small voids, approximately 250 ml
51
Pyuria
Pus; (microorganisms white blood cells, usually an odor accompanying that, milky white). The presence of white blood cells, or pus, in the urine
52
Urinary retention
Inability to void
53
What is stress incontinence?
Where urine leaks when pressure increases in the abdomen, such as during physical activity like coughing, sneezing, laughing, or exercise
54
What is functional incontinence?
Unable to go to the bathroom. When someone loses bladder control, not because of a problem with the bladder itself. But because of physical, psychological, or environmental factors that prevent them from reaching a toilet in time.
55
What is total incontinence?
the complete loss of bladder control, resulting in continuous and involuntary leakage of urine.
56
What is a random specimen? How is it collected?
A sample collected at any time of day without specific preparation or time restriction. Non sterile and into a container or nun's cap
57
What is a clean catch specimen? How is it collected?
a urine sample collected to minimize contamination from bacteria on the skin around the urinary opening. Sterile and use 3 wipes
58
What does a 24 hour urine specimen test?
Kidney function, must include all urine
59
What is a catheter sample
a urine specimen obtained through a catheter, straight or indwelling, and is used for diagnostic purposes
60
How are urine samples collected from young children?
Collection bag
61
What does a specific gravity test measure?
The weight or concentration of urine compared to water
62
What tool is used for specific gravity test?
Urinometer
63
What is the expected specific gravity for a normal adult?
1.010 to 1.025
64
What do reagant strips measure?
Measures substances in urine such as glucose, proteins and ketones
65
How many cc's are collected for a urinalysis?
20cc to 30cc sample
66
Why would a Urine C&S be ordered?
To identify microorganisms (mostly to figure out which antibiotic to use)
67
Risks of urinary catheters
Infection and trauma
68
What are the 3 types of urinary catheters?
Straight, Indwelling (Foley), and triple lumen
69
Why would a nurse perform bladder irrigation?
Washout of bladder Prevent clot formation Treat bladder calculi Antibiotics
70
What is an Ileal conduit?
A surgery to divert urine flow, typically performed after bladder removal (cystectomy) or when the bladder is damaged.
71
After an Ileal conduit, where does the urine flow and how does it flow (when released, continuous, spontaneous)
The urine flows continually into a pouch.
72
What is a Continent Urostomy
A type of urinary diversion surgery where an internal reservoir is created to hold urine, allowing for control over when urine is released, usually through a catheter inserted into a stoma.
73
How is a continent urostomy emptied?
Emptied via self catheterization
74
What is the expected suction rate for a purewick?
40 mmHg
75
What type of device is a bladder scan and what does it assess?
An ultrasonic device to assess urinary retention and post void residual
76
Peritoneal Dialysis
a type of dialysis treatment that uses the peritoneum of the abdomen to filter waste and excess fluid from the blood when the kidneys are unable to do so effectively.
77
How is Peritoneal dialysis placed?
Surgically
78
How many "exchanges" occur in a day for a person with peritoneal dialysis? What are "exchanges?"
four "exchanges" Exchanges are the process of filling and draining dialysis fluid from the abdomen, which removes waste and excess fluid from the body
79
Arteriovenous graft
Artificial tubing joining artery and vein
80
What are the different options for hemodialysis access and what are their timelines (when can you access and how long do they stay)?
Venous Catheter (Shiley) for immediate access. Arteriovenous graft for long term use (2-3 weeks after placement) AV Fistula (mature before use)
81
What is an AV Fistula? What can it assess?
Surgically created connection between artery and vein, bruit and thrills
82
How can you access an AV Fistula and Arteriovenous graft?
With a needle
83
Can a nurse perform hemodialysis?
Specially trained dialysis nurses can
84
What is a fecal impaction?
An accumulation of feces in the rectum
85
What can the nurse do to help a patient with a fecal impaction?
Digital disimpaction
86
What is an O & P (what does it stand for and when is one ordered)
A diagnostic tool used to identify intestinal parasites and their eggs in a stool sample. This is ordered when a patient has constant diarrhea
87
What is a barium swallow?
An X-ray test that examines the upper gastrointestinal (GI) tract
88
What organs does a barium swallow view?
Esophagus, stomach, and duodenum
89
What is a barium enema?
an X-ray procedure used to examine the large intestine (colon) and rectum by using a contrast agent, barium, to outline the structures for clearer images
90
What organs does a barium enema view?
Views rectum, large intestine and lower part of small intestines
91
What is an ERCP?
Endoscopic retrograde cholangiopancreotography which is used to diagnose and treat problems in the liver, gallbladder, bile ducts and pancreas
92
What organs does an ERCP view?
liver, gallbladder, bile ducts, and pancreas
93
What is an EGD?
Esophagogastroduodenoscopy, also known as upper endoscopy. It's a procedure that uses a thin, flexible tube with a light and camera (an endoscope).
94
What organs does an EGD view?
Views esophagus, stomach and duodenum | Can be used for biopsy
95
What is the purpose of an colonoscopy?
To view the entire length of the large intestine and look for polyps (abnormal growths), bleeding, and ulcers
96
How many ccs are in a small volume enema? What kind of fluid do you use for a small enema?
150 cc. Commercially prepared, oil or water
97
How many ccs are in a large volume enema? What kind of fluid do you use for a large enema? | Child? Infant? Adult?
1000 cc for adults 240 cc to 350 cc for a child 15cc to 60 cc for an infant Warm tap water or saline.
98
What does the return flow from an enema treat? How many cc's are used?
To treat Flatus 300cc to 500cc
99
What is a flexi-seal used for?
Fecal collection bag for severe/continuous diarrhea
100
What is a fecal diversion?
Intestine surgically brought through the abdominal wall to outside the body
101
How can you clean a colostomy?
Soap and water
102
What is expected during the visual assessment of a colostomy?
The ostomy is pink, no pain, flush to skin
103
T/F The specific gravity of the patient's urine is high. This may be because the patient has a fluid volume deficit
True
104
What does low specific gravity indicate?
Over hydration of your patient
105
Indications of urinary catheters
Inability to void, accurate measurement, irrigation, comfort
106
Indications of a foley
Accurate urine measurement
107
A baby arrives to the ED, and you need to get a urine sample, what type of catheter would you use?
Straight Cath
108
A patient just had bladder surgery, and you need to irrigate the bladder to prevent blood clots from impeding urine flow. What type of catheter would you use?
Triple Lumen Cath
109
A patient had total urinary incontinence due to spinal cord injury. What type of catheter would you use?
Foley
110
What is the nurses role when their patient has a nephrostomy tube?
Nurses flush to decrease risk of back up
111
How long does dialysate "dwell"
4-6 hours in abdomen, emptied = exchange
112
What central catheter can be used in an emergent situation while waiting for arteriovenous graft?
Shiley
113
What side do you lay the patient on during an enema?
On the left side
114
How do you regulate an enema flow rate?
With a clamp
115
Why would you use a large volume enema?
Disimpaction

Foundations (10 decks)

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