Elimination

Question 1

Enuresis

Answer 1

the involuntary passage of urine when control should be established

Question 2

Nocturnal Enuresis

Answer 2

the involuntary passage of urine during sleep

Question 3

Glycosuria

Answer 3

excretion of carbohydrates into the urine

Question 4

Polyuria

Answer 4

aka diuresis; the production of abnormally large amounts of urine by the kidneys- often several liters more than the client’s usual daily output.

Question 5

Polydipsia

Answer 5

a medical condition where extreme thirst leads to compulsive intake of fluid; associated with polyuria

Question 6

Anuria

Answer 6

the absence of urine production

Question 7

Oliguria

Answer 7

scant urine output, usually less than 500mL/day or 30mL/hr in an adult

Question 8

Urinary Frequency

Answer 8

voiding at frequent intervals, more than 4-6 times per day

Question 9

Nocturia

Answer 9

voiding at night

Question 10

Urgency

Answer 10

sudden strong desire to void

Question 11

Dysuria

Answer 11

voiding that is either painful or difficult; can accompany a stricture of the urethra

Question 12

Urinary Hesitancy

Answer 12

a delay and difficulty in initiating voiding, often associated with dysuria

Question 13

Neurogenic Bladder

Answer 13

client unable to perceive bladder fullness or control urinary sphincter

Question 14

Nocturnal Frequency

Answer 14

voiding at frequent intervals during the night

Question 15

Diuretics

Answer 15

drugs that increase urine formation by preventing the re-absorption of water and electrolytes

Question 16

Urinary Incontinence

Answer 16

involuntary leakage of urine

Question 17

Urinary retention

Answer 17

inability to empty bladder completely

Question 18

Prostatic hyperplasia

Answer 18

enlargement of the prostate, may be benign or malignant

Question 19

Cancer of the urinary system

Answer 19

abnormal cellular growth within the organs of the urinary tract

Question 20

Kidney stones

Answer 20

formation of calculi in the calyx of the kidney

Question 21

Renal Failure

Answer 21

insufficient or absent kidney function

Question 22

Urinary tract infection

Answer 22

invasion of the bladder, ureter, or kidney by microorganism

Question 23

Manifestations of Urinary Incontinence

Answer 23

Incontinence associated with stress (coughing, lifting, sneezing)
Incontinence related to urgency (inability to get to a toilet fast enough)
Incontinence related to neurological deficit (after spinal cord injury)

Question 24

Manifestations of urinary retention

Answer 24

Complete lack of voiding
incomplete bladder emptying
overflow incontinence
pain
constant urge to urinate
weak urinary flow

Question 25

Manifestations of prostatic hyperplasia

Answer 25

``` urinary retention dribbling at the end of urination incontinence nocturnal enuresis pain ```

Question 26

Manifestations of cancer of the urinary system

Answer 26

blood in urine frequent urination painful urination back or pelvic pain

Question 27

Manifestations of kidney stones

Answer 27

mild to severe pain to one side and back, in the abdomen, or during urination cloudy or foul smelling urine frequent urination nausea and vomitting

Question 28

Manifestations of renal failure

Answer 28

``` decreased urine output fluid retention shortness of breath confusion chest pain or pressure ```

Question 29

Manifestations of urinary tract infection

Answer 29

persistent urge to urinate burning sensation during urination cloudy, red, or strong smelling urine pelvic or rectal pain

Question 30

Interventions and treatments for urinary incontinence

Answer 30

``` kegel exercises surgery bladder training pharmacologic agents vaginal devices ```

Question 31

Interventions and treatments for urinary retention

Answer 31

``` Crede maneuver urinary catheter insertion discontinuing medications that cause retention surgery urinary dilation ```

Question 32

Interventions and treatments for prostatic hyperplasia

Answer 32

``` surgical removal medications kegel exercises scheduled bathroom visits limits on alcohol and caffeine ```

Question 33

Interventions and treatments for cancer of the urinary system

Answer 33

surgery chemotherapy radiation therapy

Question 34

Interventions and treatments for kidney stones

Answer 34

analgesics lithotripsy dietary alterations to reduce risk of recurrence increased fluid intake

Question 35

Interventions and treatments for renal failure

Answer 35

administration of diuretics if some kidney function remains Dialysis kidney transplant

Question 36

Interventions and treatments for urinary tract infection

Answer 36

administration of antibiotics if infection is caused by bacteria increased fluid intake cranberry juice to increase urine pH

Question 37

Residual urine

Answer 37

urine that remains in the bladder after voiding

Question 38

Fluid and Food intakes effect on urinary elimination

Answer 38

fluid intake increase leads to fluid output increase alcohol increases fluid output by inhibiting production of ADH food and fluid high in sodium cause fluid retention

Question 39

Muscles tone's effect on urinary elimination

Answer 39

Good muscle tone allows bladder to fill adequately and empty comepletely

Question 40

Psychosocial factors' effect on urinary elimination

Answer 40

stimulation of mictruition reflex may be affected by privacy, positioning, sufficient time, and occasionally running water. anxiety may increase muscle tension which inhibits voiding time pressures may cause individuals to voluntarily suppress urination

Question 41

pathological coniditons' effect on urinary elimination

Answer 41

glomerular dysfunction leads to abnormal levels of protein or blood in the urine renal failure leads to anuria conditions that cause a lack of blood flows to the kidneys decrease urine production conditions that cause fluid loss decrease urine production

Question 42

Surgery and diagnostic procedures effect on urinary elimination

Answer 42

Can affect the passage of urine | can cause hematauria

Question 43

Medications effect on urinary elimination

Answer 43

Many affecting ANS may cause urinary retention | diuretics cause urine production by preventing re-absorption of water

Question 44

Changes in urinary elimination: fetuses

Answer 44

the fetal kidney begins excreting urine between the 11th and 12th week of devlopment

Question 45

Changes in urinary elimination: infants

Answer 45

ability to concentrate urine is minimal urine appears light yellow voluntary urinary control is absent

Question 46

Changes in urinary elimination: children

Answer 46

Kidney reaches maturity between 1 and 2 urine is concentrated effectively, normal amber color between 18 and 24 months child recognizes bladder fullness, able to hold urine beyond urge to void between 2.5 and 3 years child can perceive bladder fullness, hold urine after urge, and communicate need to void full urinary control by 4-5 daytime urinary control by 3

Question 47

Changes in urinary elimination: adults

Answer 47

Kidney reaches maximum size between 35 and 40 after age 50 begins to shrink most shrinkage occurs in cortex as nephrons are lost

Question 48

Changes in urinary elimination: older adults

Answer 48

estimated 30% of nephrons lost by 80 renal blood flow decreases ability to concentrate urine decreases bladder muscle tone diminishes causing urinary frequency and nocturia diminished bladder muscle tone leads to residual urine in bladder urinary incontinence may occur

Question 49

Modifiable risk factors for urinary problems

Answer 49

obesity pregnancy UTI increased consumption of bladder irritants poor lifestyle habits Medical conditions, procedures, and treatments

Question 50

Urinalysis: amount in 24 hours

Answer 50

normal 1200-1500 mL | abnormal <1200 mL; a large amount over intake

Question 51

Urinalysis: color

Answer 51

normal light straw to amber | abnormal dark amber, dark orange, red or dark brown

Question 52

Urinalysis: Appearance/clarity

Answer 52

normal transparent/clear | abnormal cloudy, mucous plugs, viscous, thick

Question 53

Urinalysis: odor

Answer 53

normal faint/aromatic | abnormal offensive

Question 54

Urinalysis: sterility

Answer 54

normal no microorganisms present | abnormal: microorganisms present

Question 55

Urinalysis: pH

Answer 55

normal 4.5-8 | abnormal 8

Question 56

Urinalysis: specific gravity

Answer 56

normal 1.005-1.030 | abnormal 1.030

Question 57

Urinalysis: protein

Answer 57

normal 2-8 mg/dL | abnormal >8 mg/dL

Question 58

Urinalysis: glucose

Answer 58

normal not present | abnormal present

Question 59

Urinalysis: ketone bodies

Answer 59

normal not present | abnormal present

Question 60

Urinalysis: RBC's

Answer 60

normal none | abnormal >2 per low power field

Question 61

Urinalysis: WBC's

Answer 61

normal 3-4 per low power field | abnormal >4 per low power field

Question 62

Urinalysis: casts

Answer 62

normal occasional hyaline | abnormal fatty, granular, renal, tubular epithelial, waxy casts

Question 63

Hemodialysis

Answer 63

clients blood flows through vascular catheters, passes by the dialysis solution in the external machine, and then returns to the client

Question 64

Peritoneal dialysis

Answer 64

dialysis solution is instilled into the abdominal cavity through a catheter, allowed to rest there while fluids and molecules exchange, and then is removed by the catheter

Question 65

Defecation

Answer 65

expulsion of feces from the anus or rectum

Question 66

Peristalsis

Answer 66

wave like muscular contractions that propels food and digestive products through the digestive tract

Question 67

Diet's effect on bowel elimination

Answer 67

Sufficient bulk is necessary to provide volume low residue foods move slowly through the GI tract irregular eating can impair regular defecation spicy foods can produce diarrhea and flatus excessive sugar can cause flatus cabbage, onions, cauliflower, bananas, and apples can cause gas brans, prunes, figs, chocolates and alcohol are laxatives cheese, pasta, eggs, and lean meat produce constipation

Question 68

Fluid's effect on bowel elimination

Answer 68

healthy fecal output requires daily fluid intake of 2000-3000 mL reduced fluid intake slows the passage of chyme resulting in dry hard feces

Question 69

Activity's effect on bowel elimination

Answer 69

activity stimulates peristalsis facilitating the movement of chyme through the colon

Question 70

Defecation habits' effect on bowel elimination

Answer 70

early bowel training may establish the habit of defecating at a regular time

Question 71

Medication's effect on bowel elimination

Answer 71

Some medications have side effects that interfere with normal elimination some medications directly affect elimination medications may also affect the color of the feces

Question 72

Diagnostic procedures effect on bowel elimination

Answer 72

before certain diagnostic procedures clients restriction from ingesting food as well as cleansing enemas may impact normal defecation

Question 73

Anesthesia and surgical products' effect on bowel elimination

Answer 73

general anesthetics cause the normal colonic movements to cease or slow by blocking parasympathetic muscles of the colon

Question 74

Pathological conditions effect on bowel elimination

Answer 74

Spinal cord injuries may reduce sensory stimulation impaired mobility may limit ability to respond to urge poorly functioning anal sphincters may cause incontinence

Question 75

Pain's effect on bowel elimination

Answer 75

clients who experience discomfort when defecating often suppress the urge to avoid pain. this leads to constipation.

Question 76

Psychological factors effect on bowel elimination

Answer 76

anger or anxiety may lead to increased peristaltic activity | depression may slow peristaltic activity

Question 77

Ileus

Answer 77

temporary cessation of intestinal motility (24-48 hrs) caused by direct handling during surgery.

Question 78

Changes in fecal elimination: Newborns

Answer 78

Pass meconium normally in first 8-24 hours, almost always within 48 Transitional stool for next day or too and then stool should become entirely fecal

Question 79

Changes in fecal elimination: infants

Answer 79

Frequency in bowel movements can be one every 2 or 3 days or up to 10 a day breastfed infants may defecate after every meal, stool will be mustard yellow and have seedy appearance formula fed infants will not defecate as often as breastfed infants, stools will be tan to yellow to green

Question 80

Changes in fecal elimination: toddlers

Answer 80

some daytime control starts between 1.5 and 2 and full daytime control is normally present by 2.5

Question 81

Changes in fecal elimination: children and adolescents

Answer 81

same as adults

Question 82

Changes in fecal elimination: older adults

Answer 82

up to half of older adults suffer from constipation older adults should be advised that normal patterns of defecation range from 3 times a day to 3 times a week older adults should be warned that the consistent use of laxatives inhibits natural defecation reflexes

Question 83

Changes in fecal elimination: pregnant women

Answer 83

elevated progesterone levels result in delayed gastric emptying and decreased peristalsis cardiac sphincter may relax causing heartburn bowels tend to be sluggish after birth women who has a cesarean birth may experience some initial discomfort from flatulence

Question 84

Meconium

Answer 84

tarry black stools formed by the fetus in utero consisting of amniotic fluid, intestinal secretions, and shed mucosal cells

Question 85

Gastrocolic reflex

Answer 85

increased peristalsis of the colon after the food has entered the stomach

Question 86

Reflux

Answer 86

a backwards flow of acidic secretions into the lower esophagus

Question 87

Constipation

Answer 87

infrequent passage of hard stool

Question 88

Diarrhea

Answer 88

passage of liquid stools

Question 89

Bowel incontinence

Answer 89

inability to control the release of feces

Question 90

Impaction

Answer 90

mass or collection of hardened feces in the rectum

Question 91

Bowel Cancer

Answer 91

abnormal growth of cells in the bowel

Question 92

Obstruction

Answer 92

blockage in the bowel preventing or reducing the passage of fecal material

Question 93

Manifestations of constipation

Answer 93

straining with defecation lumpy or hard stools sensation of incomplete emptying fewer that 3 bowel movements per week

Question 94

Manifestations of diarrhea

Answer 94

``` frequent, runny stools hyperactive bowel sounds bowel incontinence abdominal cramps fever dehydration ```

Question 95

Manifestations of bowel incontinence

Answer 95

leakage of feces from the anus loss of pelvic muscle control lack of ability to respond to urge to defecate

Question 96

Manifestations of impaction

Answer 96

``` constipation fecal incontinence abdominal cramping straining during defecation small, semi formed stools loss of bladder control ```

Question 97

Manifestations of bowel cancer

Answer 97

``` early cancer possibly no signs blood in stool persistent changes in bowel habits abdominal pain unexplained weight loss anemia bowel obstruction vomiting ```

Question 98

Manifestations of obstruction

Answer 98

``` abdominal distention and cramping abdominal fullness constipation or diarrhea vomiting inability to pass gas ```