GI + GU Systems

Question 1

Incontinence Definition

Answer 1

Inability to control urination / bowel movement

Question 2

Anuria

Answer 2

Absence of urine, very low urine output under 50 mL a day

Question 3

Oliguria

Answer 3

Urine output less than 300 mL a day

Question 4

Hematuria

Answer 4

Blood in urine

Question 5

Peristalsis

Answer 5

Contraction of intestines to push stool out

Question 6

Cystitis

Answer 6

Inflammation of the bladder usually caused by bacterial infection.

Question 7

Flatus

Answer 7

Air that moves from the digestive tract through the mouth

Question 8

Causes of incontinence (5)

Answer 8

Traumatic (surgery)
Neurological (dementia, MS)
Inflammatory (e-coli infection, IBS)
Pelvic foor dysfunction (child birth)
Functional (physical mobility issues, aware but unable)

Question 9

Management for bowel incontinence

Answer 9

Educate: wipe front to back, peri care after bowel movement
Keep skin clean and dry
Commode at bedside or bed pan
Bowel training program (regular bowel schedule)

Question 10

Constipation

Answer 10

Decrease in frequency of bowel movement
When fecal mass remains in rectal cavity for long time, more water is absorbed causing small, hard, dry, painful to pass stool

Question 11

Causes of constipation

Answer 11

Medication
Low fiber intake
Low fluid intake
Aging process
Metabolic \ neurologic conditions
Decreased mobility

Question 12

Constipation S+S

Answer 12

Abdominal pain / distention
Indigestion
Rectal pressure
Dry hard stool

Question 13

Barium enema

Answer 13

Like an X-Ray, very clear image of structure
Detects obstruction of colon
Barium liquid injected into large intestine through anus

Question 14

Colonoscopy

Answer 14

Colonoscope inserted into anus through colon
Examines entire colon and colon walls
Can collect tissue
Lots of fluid taken before procedure to cleanse colon out

Question 15

What diagnostic studies are used for constipation?

Answer 15

Abdominal X-Ray
Colonoscopy
Barium enema
Physical examination (1st)

Question 16

Fecal impaction

Answer 16

Severe constipation, inability to pass stool even with use of suppositories and enemas
Digital removal is required (disimpaction)

Question 17

What should you monitor after manually performing disimpaction?

Answer 17

Heart rate and blood pressure

Question 18

Hesitancy urine

Answer 18

Difficulty starting a stream of urine or keeping it flowing ( may stop before bladder is empty )

Question 19

Urethritis

Answer 19

Inflammation of the urethra

Question 20

Pyelonephritis

Answer 20

Infection of one or both kidneys

Question 21

intermittency urine

Answer 21

Urinary stream that is not continuous (starts and stops)

Question 22

Dysuria

Answer 22

Painful or difficult urination

Question 23

Nocturia

Answer 23

Excessive urination at night time

Question 24

Nocturnal enuresis

Answer 24

“Bed wetting” at night time, involuntary urination during the night.

Question 25

Leukocytosis

Answer 25

Increased white blood cells in urine and blood

Question 26

Urine retention

Answer 26

Inability to empty all urine from bladder

Question 27

UTI Risk factors

Answer 27

Incomplete emptying of bladder Contamination Instruments / tubes inserted in urinary meatus Previous UTI Aging Stress Stasis / retention Female anatomic

Question 28

S+S of UTI

Answer 28

Voiding urgency Dysuria Cloudy, foul smelling urine Fever Decreased mental status

Question 29

What tests are used for UTI assessment

Answer 29

Dipstick urinalysis If obstruction is suspected, Intravenous pyelogram / CT scan GU assessment, inspection and palpation

Question 30

What does the dipstick urinalysis identify, and what tests follow it?

Answer 30

First to identify presence of nitrates, white blood cells and leukocyte esterase (enzyme in WBC's) If test is positive it is followed by a urine culture and sensitivity test

Question 31

What are the different types of incontinence?

Answer 31

Stress Urge Functional Overflow Total Transient Reflex

Question 32

Teaching interventions for UTI

Answer 32

-Increase water intake and cranberry juice -Void as soon as urge occurs -Wipe front to back -Avoid perfumed products -Void after sexual intercourse to flush bacteria -Teach signs and symptoms

Question 33

Teaching interventions for urinary incontinence

Answer 33

Kegal exercises Encourage fluid intake 2-3L Avoid alcohol and caffeine Discuss use of peripads void at regular patterns Don’t hold urine