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Essentials of Nursing > Exam 3 > Flashcards

Exam 3 Flashcards

November 25th (119 cards)

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1
Q

Nursing interventions for acute urinary problems

A

keep elimination habits similar
medication to stimulate detrusor muscle contractions
catheterization

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2
Q

How can medications influence urination

A

diuretics (increase urine)
sedatives (incontinence)
can change urine color

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3
Q

Types of catheter lumen materials

A

plastic- intermittent only
latex- 3 weeks max
silicon/teflon- long term (2-3 mos)

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4
Q

What does nil per os mean

A

nothing by mouth; NPO patients

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5
Q

How often do you perform mouth and nares care for NG tube

A

every 2 hours

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6
Q

What are indications for an intermittent catheter used

A

one time use
to relieve bladder distention to if clean catch sample is not a possibility
assess residual urine (if no bladder scan)

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7
Q

What type of urine specimen collection cannot be delegated

A

sterile specimen (catheter)

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8
Q

What are delegated tasks related to catheterization

A

report if pt has pain, leakage, or abnormal urine
empty drainage bag
perineal care

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9
Q

What are some ways to prevent CAUTI

A

keep closed drainage system
empty urine bag when 1/2 full
clean spigot
perineal care every 8hrs

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10
Q

Salem Sump characteristics

A

double lumen
air vent “pigtail”
for decompression/ lavage
decreased risk of gastric mucosa damage
main lumen connects to suction

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11
Q

Characteristics of elderly bowel movements

A

-decreased peristalsis, weakened anal sphincters, esophageal emptying slows
-decreased ability to thoroughly chew food

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12
Q

When would you start over a 24 hours urine collection

A

if contaminated or missed collection

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13
Q

When might NPO diet be necessary

A

after surgery, blockage, bleeding

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14
Q

Why is it critical to change ostomy bag?

A

for skin integrity (ileostomy enzymes/acids)
assess stoma
prevent odors
increase self esteem/comfort

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15
Q

Part of small intestines that absorbs water, fat, iron, and bile

A

ileum

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16
Q

What is a urostomy

A

continuously drains urine into collection pouch
urine drains from ureter –> intestine –> stoma

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17
Q

What are restorative care interventions for urinary problems

A

pelvic floor muscle training
lifestyle changes
voiding schedule
bladder retraining (mentally)

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18
Q

Nursing interventions for impaired bowel movements

A

establish toileting routine
encourage fluid intake
review dietary intake (need fiber)
enema to promote bowel cleansing

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19
Q

Why might a patient have a disturbed body image r/t bowel movements

A

bowel divisions (colostomy)
refusal to learn how to use it

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20
Q

What are some possible consequences of a catheter irrigation

A

irrigation solution doesn’t return
bright red blood (notify provider)
pain from clots of kinked tube

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21
Q

What are catheter irrigations

A

after bladder surgery
flush that remove clots/sediment from entering catheter
continuous or intermittent
must have closed catheter system to prevent infection
keeps catheter patent

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22
Q

Part of GI tract that allow storage, mixing, and emptying

A

stomach

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23
Q

Nursing diagnosis for diarrhea and cause

A

malabsorption. bloating, cramping, loose stools
r/t antibiotics, antidepressants, antacids, oral hypoglycemics

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24
Q

What are nursing interventions for urge urinary incontinence

A

limit nighttime intake, avoid bladder irritants, strengthen pelvic floor

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25
What are some sociocultural factors that influence urination
Gender (men w/ enlarged prostates & women w/ pelvic prolapse) Bathroom privacy and school/work environment
26
Type of hemorrhoid with visible purple thrombosis
external hemorrhoid
27
Type of hemorrhoid in anal canal with inflammation or distention
internal hemorrhoid
28
What are complications of NG tube placements
resistance= move steadily vomiting= clear airway gag=withdraw slightly on insertion respiratory distress= remove tube to back nasopharynx
29
Purpose and steps to Kegel exercises
strengthens pelvic floor muscles 1) stop urination midstream 2) tighten muscles as if lifting a marble (don't hold breath)
30
Process of an enema
for diagnostic tests or constipation doesn't require sterile technique pt lays on left side/right knee flexed (Sim's) use warm solution
31
What part of catheter irrigations can be delegated
pain, discomfort, change in urine, leakage
32
How is urinary issues related to a nursing diagnosis of impaired skin integrity
constant moisture from incontinence can lead to skin breakdown/irritation becomes an infection risk
33
How can medications influence bowel movements
opioids slow peristalsis antibiotics decrease intestinal bacteria=diarrhea laxatives promote defecation cathartics control diarrhea
34
What type of procedure is classified as a urinary diversion
urostomy
35
What type of patients might require an intermittent catheter
spinal injury neuromuscular degeneration incompetent bladder
36
What should you do if the irrigation solution doesn't return
reposition patient check for kinks use a new syringe to passively return/empty
37
Nephrostomy
tubes go through skin to the renal pelvis (on back) drains renal pelvis if ureters are obstructed
38
Reasons that constipation may occur
improper diet reduced fluid intake meds lack of exercise
39
Term for unformed stool than can lead to skin breakdown
diarrhea
40
What is effluent?
fecal material
41
What type of ostomy has less odor and a liquid consistency
ileostomy
42
Term for unrelieved constipation; stool cannot be expelled in rectum
Impaction
43
What can bowel impaction turn to if left untreated
intestinal obstruction
44
Coudé catheter characteristics
single lumen stiffer curved tip, easier to guide, less traumatic
45
How do you verify NG tube placement
ask patient to talk X-ray confirmation aspirate syringe for gastric contents (<5 pH)
46
What are nutrition changes for an ostomy
low fiber at first eat slow/chew completely 10-12 water glasses daily avoid gassy foods
47
Term for temporary or permanent abdominal wall opening
bowel diversion (stoma and ostomy)
48
Urge incontinence
overactive urge to pee; muscles will contract and urine won't stop once it begins (nocturia)
49
What is a suprapubic catheter
surgically inserted if flow blockage through urethra long term intervention
50
Double Lumen NG Tube characteristics
large bore; 12+ French for gastric decompression or removing gastric secretions Salem sump
51
Functional incontinence
incontinence not related to urinary tract issues mobility issues, cognitive impairment, environmental barriers
52
What are symptoms of bowel impaction
oozing liquid stool seeping around mass loss of appetite distention cramping
53
How does growth and development influence urination
gain voluntary bladder control @ 18-24 months decreased bladder capacity in elderly
54
Single Lumen NG Tube characteristics
fine/small bore for med and enteral feedings
55
Characteristics of infants bowel movements
-infants have a smaller stomach capacity, less enzymes, faster peristalsis -can't control defecation until 2-3 yrs
56
Part of small intestines that absorbs carbs, proteins, electrolytes
jejunum
57
What type of urine specimen collection can be delegated
midstream specimen
58
How do you document I's and O's for NG tube
Intake: irrigation solution Outtake: gastric drainage
59
What are nursing interventions for stress urinary incontinence
Kegel exercises, stop smoking (prevents coughs), empty bladder completely
60
What type of ostomy increased risk of electrolyte imbalance
ileostomy
61
What is the process of discontinuing a NG tube
assess for bowel sounds (disconnect suction) standard precaution pt takes deep breath, kink tubing, steadily remove After: assess abdomen tenderness, N/V, nostrils
62
Ways to maintain an NG tube
mouth care every 2hrs NPO maintain patency= turn frequently
63
What is collected during 24 hour urine sample
hour 0 (1st void) not collected all in between collected hour 24 collect last sample
64
What are some nursing urinary interventions for elderly
educate on making a void schedule adequate hydration empty bladder before/after meals limit fluids 2 hrs before bed
65
Part of small intestines the gets fluid from the stomach
duodenum
66
How do diagnostic tests influence bowel movements
colonoscopies require laxatives to fully empty bowel will have increased gas and soft stool
67
Acute urinary retention
sudden onset from an infection or post surgical (anesthesia/meds)
68
Stress incontinence
urine leaks because of an incompetent urethral sphincter high intra abdominal pressure during coughing, laughing, exercise
69
What is another name for intermittent catheters
straight catheter single lumen
70
What is post void residual and how is it measured
urine left in the bladder after voiding can be seen with a bladder scan
71
How can fluid and diet intake influence bowel movements
fiber absorbs fluid=softer stool whole grains, fruits, veggies are high fiber foods may produce gas which increases colon motility
72
How can psychological factors influence bowel movements
emotional stress increases peristalsis possible diarrhea and gas distention depression slows peristalsis= constipation
73
Overflow incontinence
bladder is overdistended/ full but cannot fully empty (retention) due to a urethral blockage
74
What are possible complications of NG tube removal
abdominal pain sore throat aspiration
75
Nursing diagnosis for constipation and cause
no stool for several days, hypoactive bowels, firm abdomen r/t pain meds, decreased fluids, decreased mobility
76
How to place in patient
place patient in High Fowler's start titling their head back then tilt forward swallow so epiglottis blocks trachea
77
Term for involuntary urine leakage
urinary incontinence
78
Term for dilated/engorged veins
hemorrhoids
79
Term for inability to completely empty bladder
urinary retention
80
How does pain influence bowel movements
hemorrhoids, rectal surgery, and fissures= defecation discomfort
81
Pathological factors that influence urination
spinal cord injury, enlarged prostate, neurological deficits
82
Levin Tube characteristics
single lumen no pigtail air vent for meds, tube feeding, decompression
83
Who Is ask risk for bowel impaction
debilitated, confused, unconscious patients
84
What are nursing interventions for UTI/infection prevention
educate on proper hygiene/UTI symptoms promote voiding at regular intervals
85
How can physical activity influence bowel movements
increases peristalsis maintain muscle tone= able to increase intrabdominal pressure to open sphincter
86
When would a coudé be beneficial
enlarged prostate
87
Term for inability to control feces/gas
incontinence
88
What can lead to increased risk of hemorrhoids
straining, pregnancy, heart failure, chronic liver disease
89
How does positioning during defecation influence bowel movement
difficult to go if supine lean forward, extra intrabdominal pressure, gluteal muscles contract
90
Purpose of NG tube
decompress GI tract (obstruction) enteral feeding GI bleed lavage (poisoning)
91
Indications for short-term indwelling catheter
2 weeks or less urine obstruction (ex. prostate enlargement) after bladder or urethral surgery prevent obstruction from blood clots after genitourinary surgery measure urine output of critically ill
92
How are UTI's related to iatrogenic procedures
(in hospital procedure) catheter (CAUTI) or invasive diagnostic procedure due to break in sterile procedure
93
How does fluid intake influence urination
caffeine and alcohol= diuretic effects
94
How does pregnancy influence bowel movements
fetus increases= increased rectal pressure peristalsis slows in 3rd trimester hemorrhoids from straining
95
Understand the process of digital removal of stool
if enema fails; used for impaction liquid stool oozes/abdominal distention can possibly stimulate vagal n. = bradycardia/hypotension
96
Who would benefit from a condom catheter
patients with spontaneous bladder emptying (incontinence/nocturia)
97
How does surgery and anesthesia influence bowel movements
anesthetics temporarily shuts down peristalsis
98
What type of ostomy is odorous due to bacteria and semi liquid/solid
colostomy
99
Part of GI tract that digests using chyme and absorbs nutrients
small intestines
100
Term for when gas accumulates in intestines causing fullness, pain, and cramping
Flatulence
101
What are the physiological steps of elimination
intestinal contents trigger peristalsis stool in rectum causes distention sphincter relaxed abdominal muscles contract
102
How do you measure the NG tube
tip of nose --> earlobe --> xiphoid process
103
How does the French sizing work for catheters
the larger the number the larger the lumen and tube circumference
104
Indications for long-term indwelling catheter
1 month or more severe urinary retention & UTIs skin rashes, ulcers, wounds that are irritated by urine comfort for terminal illness
105
What part of the GI tract blocks airway when food enters
epiglottis
106
What are physical/bodily factors that influence urination
pregnancy overweight/obese (increased abdominal pressure)
107
Process of NG tube irrigation
aseptic technique confirm tube placement saline syringe into irrigation tube/install If resistance: check for kinks, pt on left side aspirate fluid reattach to suction
108
Chronic urinary retention
from medication a progressive blockage (prostate) neural pathway interruption (stroke, MS, trauma)
109
Term for bowel diversion of large intestines
colostomy
110
How does surgery influence urination
pelvic surgery or anesthesia inhibit micturition reflex
111
Term for bowel diversion of small intestines
ileostomy
112
Contraindications for NG tube
- head/neck trauma (can lead to intracranial insertion) - nasal surgery - Hx of alcoholism (esophageal varices)
113
What are the benefits of Kegel exercises for men/women
Men: improve fecal/urinary incontinence & erectile dysfunction Women: improve fecal/urinary incontinence & painful sex
114
what part of the large intestines absorbs, secrete, and eliminates food blouses
colon
115
Orthotropic neobladder
creation of a new bladder from part of the intestines used if there is disease in the bladder or cystectomy
116
What are possible causes of bowel incontinence
cognitive impairments C. Diff food intolerance
117
What are the components of a triple lumen catheter
urinary drain connected to collection bag balloon connector irrigation/instillation
118
Pathway of the NG tube in the body
enter nares pass nasopharynx pass through esophagus goes to stomach
119
How can personal habits affect bowel movements
busy schedules don'y allow regular elimination habits

Essentials of Nursing (2 decks)

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