Maegan's Exam #3 - Elimination Flashcards Preview

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Flashcards in Maegan's Exam #3 - Elimination Deck (95):
1

What are the 11 Parts to the Anatomy of Bowel Elimination?

  

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1. Small Intestine

2. Large Intestine

3. Duodenum

4. Jejunum

5. Ileum

6. Ascending

7. Transverse

8. Descending

9. Sigmoid

10. Rectum

11. Anus

 

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2

Small Intestine;

Absorbs nutrients & _______

Small Intestine;

Absorbs nutrients & WATER

3

What does the Colon/Large Intestine Reabsorb?

Water

4

What is the term for the bowel moving through the intestine?

Parastolosis

(Moving Content Forward)

5

What is the purpose of the Mucoid (Mucous) Protection?

To protect from stomach acid and hold feces together.

6

If you get a disease in the intestine's, there might be a problem doing what?

Absorbing Nutrients

7

When waste products are in the lower GI for extended period of time what happens?

More Water is removed

RESULTING IN:

Hard, Dry Stools

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8

What are the characteristics of NORMAL feces?

Brown in Color

Have fecal odor from normal flora (Bacteria)

Small amounts of fat

Soft and formed

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9

How many times a day/week is considered

"Normal" Defication?

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Several Times a Day

2-3 Times Per Week

(Remember, Norms are different for everyone, Look for variation in their NORMS)

10

What can Cause BLACK TARRY STOOLS?

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Upper GI Bleed

Increase in Iron

11

What causes Hard, dry stools?

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Dehydration

12

What can cause watery stools?

Poor Absorbtion

Poor Movement

13

What would cause Ribbon-Like, Narrowed Stools?

Obstruction of Rectum

14

What can cause pieces of undigested food in stool?

Malabsorbtion

15

What can cause shreds of mucous?

Inflammatory condition

16

What is large amounts of fat in stools called?

Steatorrhea

17

What is the definition of Constipation?

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Hard, infrequent stools that may be painful

18

What are some causes of constipation?

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Lack of fiber

Inactivity

Lack of adequate water intake

Poor habits - no regularity, no time, avoiding urge

Overuse/Dependent on laxatives

Medications - Narcotics, antacids, statins, iron, Anticholinergic

Neurological - Stroke (CVA) Spinal Cord Damage

Certain Foods - Cheese, Eggs, Milk

19

What causes Hemorrhoids (Enlarged Vein)?

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Straining

Prolonged Sitting

Chronic Constipation

Obesity

Pregnancy/Labor

20

What are anal fissures?

Cracklike Lesion

Tear in lining of anus

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21

What is Fecal Impation?

Large or hard fecal mass

Results from Prolonged retention and accumulation of fecal material. (Poor defecation habit)

Will Experience the passage of liquid fecal seepage (Diarrhea) and no normal stool.

 

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22

What are some Constipation Interventions?

Increase Fiber

Increase fluid to 2000-3000ml/Day if not contraindicated

Offer warm fluids especially after breakfast (Increases Parastolosis)

Measure I/O

Avoid highly refined foods like fast food, sweetners & Flours

LAST RESORT - Laxatives

 

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23

What is gas or air in colon passed through the anal canal called?

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FLATUS

24

What  can cause Flatus?

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Action of bacteria on chyme

Swallowed air

Gas forming foods- IE Cabbage, Onion

Food Allergies

(Usually absorbed into the bloodstream)

25

What are some Flatus Interventions?

Avoid Gas-producing foods

Provide low fat meals

Warm blanket or pad to abdomen (Increases blood flow)

Correct positioning for meals

Obtain order for rectal tube

Avoid chewing gum or drinking with a straw

Enemas PRN

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26

What is liquid, unformed stools with increased frequency of defication?

DIARRHEA

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27

What is a result of Diarrhea?

Serious Fluid and Electrolyte Imbalance

Especially in Very young and older adults

28

What are some causes of Diarrhea?

Bacterial/Viral Infections

Medication Side Effects

Drug or Food Allergies

Malabsorbtion Syndrome

Digestive Diseases (Crohn's)

29

What are some Diarrhea Interventions?

Provide liquid diet and advance as tolerated
(Allow bowel to rest andn Rehydrate them)

Monitor and Record amount, Consistency, and Frequency of stools, monitor skin for breakdown, and monitor for dehydration

Give meds as appropriate including PRN anal ointments/barriers & antidiarrheals

Teach to avoid ETOH(Alcohol) and Caffeine if chronic

 

30

What are Fecal Impaction Interventions?

Manual Rectal Exam PRN

Assess Abdominal Distention

Enemas as Ordered

31

What is the loss of voluntary control of stools?

Fecal Incontinence

32

What causes Fecal Incontinence?

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Impaired sphincter muscle control

Impaired Nerve Supply

 

33

What are some Fecal Incontinence Interventions?

Bowel Training
(Place on toilet every hour)

Provide METICULOUS skin care

Use mild dilute soap & water

Provide clean linens 

Use adult incontinence aids

Provide Emotional Support

34

What is the ULTIMATE goal for bowel movements?

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Client has soft, Formed brown stool by certain time

35

To reach Ultimate Goal what is the main thing you want to encourage?

GOOD BATHROOM HABITS

Going to bathroom same time each day

Don't sit longer than 5 min (Can cause you to pass out because of nerve)

Don't supress the urge

Don't strain

Don't rely on laxatives/enemas

36


What are some System Specific Assessments for Bowels?

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Abdonminal Assessment is PRIORITY - ESP bowel sounds

Characteristics of stool

Last BM

Bloating/Distention

Fluid/Food/Fiber Intake

Exercises

Position

Regular Defication Pattern

37


What do the following Color Bowel Movements Mean:

Clay =

Black =

Light Brown/Pale =

Red = 

Yellow =

Green =

Clay = Absence of Bial

Black = Upper GI Bleed, Diet high in red meat, Dark green Veggies, Excess Iron, Pepto

Light Brown/Pale = Malabsorption of Fats, diet high in milks, low in meats

Red = Bleeding in lower GI, beets

Yellow = bile, may be seen in diarrhea

Green = Intestinal infection, food dyes

38


What are some labs you would run during your assessment of Bowels?


Stool Culture - Obtain culture BEFORE antibiotics

Ova and Parasites

Occult blood (Hemocult)

Barium enema vs upper GO

Scopes

39


True or False:

You cannot delegate getting stool specimen to aide

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FALSE

40


Bowels do not take priority over ABC.  You always auscultate BEFORE Palpate (LISTEN 1st).  If their abdomen is ______ or _______ it needs to be assessed QUICKLY.

Bowels do not take priority over ABC.  You always auscultate BEFORE Palpate (LISTEN 1st).  If their abdomen is RIGID & HARD it needs to be assessed QUICKLY.

41

What medication is used tto help client pass painful gas?


Anti-flatulents

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42

What is used to treat or prevent constipation or to prepare the bowel for radiologic or endoscopic procedures?


Laxatives

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43

Excessive or prolonged use of laxatives can lead to _____________

Excessive or prolonged use of laxatives can lead to DEPENDENCE

44

What are the different types of laxatives?


Stimulants (Ducolax)

Saline Laxatives (Magnesium Salts and Phosphates)

Stool Softeners (Colace)

Bulk-Forming Agents (Citrucel)

Osmotic Cathartics (Miralax)

45


What are Anti-Diarrheals?


They are used to control/relieve acute or chronic diarrhea

They slow intestinal motility (Imodium)

They can change the fluid content of the stool (Pepto)

 

46


What is an opioid used to treat diarrhea?


Lomotil

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47


What are the 2 MAIN things you do when dealing with stools?


WASH HANDS

WEAR GLOVES

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48


When a patient has C-Diff what is MUST DO when entering or leaving room?


Wash hands with soap and water

FOAM DOESN'T WORK

49


How many grams of fiber a day do you need to add bulk to stool and to develop regular bowel?


20-35 grams of fiber a day

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50


What are some natural bowel remedies you should know?


Fiber - Apples, bananas, bran cereal, dates, Prunes

Natural Laxatives - Prune Juice, honey, Coffee/tea, warm drinks

Colon clensings and Juice Fastings

51

What are the 5 anatomical components of urine elimination?

Kidney
Regulates fluid & Electrolyte blance

Renal Pelvis

Ureter
Connects Kidney to Bladder

Urinary Bladder
Resevoir (holds urine)
 

Urethra
Extends from bladder to opening (Urinary meatus)

52


How many ml of blood circulates through the kidney's every minute?


1200 ml

53


Normal urine output is equal to fluid ______


Normal urine output is equal to fluid INPUT

54


Average adult daily output is _____-_____ ml/Day

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Average adult daily output is 1200-1500 ml/Day

55


The average bladder holds 500-1000ml.  But you "feel the urge" around _____ ml.


The average bladder holds 500-1000ml.  But you "feel the urge" around 200ml.

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56


When urine output is less than 30ml/Hour it may indicate _____ _____ _____ or _______ _______ and MUST be reported!!!


When urine output is less than 30ml/Hour it may indicate Low Blood Volume or Kidney Malfunction and MUST be reported!!!

57


What is it when a client does not preceive bladder fullness and is unable to control the urinary sphincters?


Neurogenic Bladder

58


What are some interventions you would do for urinary retention?


Observe and palpate for bladder distension

Utilize normal voiding position

Monitor I & O

Run Water

Offer Sitz Bath

Place urinary catheter (LAST RESORT)

59


Urinary incontinence is defined as _______ _______

Urinary incontinence is defined as Involuntary Urination

60


What are some of the types of urinary incontinence?


Stress
Couging, sneezing, laughing etc.

Urge
Associated with overactive bladder

Functional
Cognitive Disorders (Able to but don't)

Reflex
Spinal Cord Damage

Mixed
Stress & Urge
 

61


What can cause a UTI?

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Stasis of Urine

Bacteria

Improper hygeine

62


What are some UTI Interentions you can do as a nurse?

 Give Anti-Infectives as ordered

Monitor I&O

Increase fluid intake to 2000 ml

Follow up UA

Offer Sitz bath

Drink (8) 8oz glasses of water daily

Void frequently
2-4 hours

 

63


What are some interventions you can have the client do for UTI's?

Void immediately after intercourse

Avoid bubble baths/Harsh soaps

Avoid tight fitting clothes

Wear cotton underwear

Females wipe front to back

Take showers

Increase acidity of urine
(Vit C, Cranberry Juice)

64

What is the most important thing to do when assessing urine elimination?


URINE OUTPUT
(Might even do hourly)

65

What is the accumulation of urine in the bladder and inability of the bladder to empty itself?


Urinary Retention

66

What is a temporary or permanent inability of the external sphincter muscles to control the flow of urine from the bladder?


Urinary Incontinence

67


What is the process of emptying the bladder?


Urination (micturition, voiding)

68

What is the failure of the kidneys to produce urin, resulting in a total lack of urination or output of less than 100ml/day in adults?


Anuria

69


What is painful or difficult voiding?

Dysuria

70


What is the production of abnormally small amounts of urine by the kidney's?


Oliguria

71


What is it called when you void two or more times per night?


Nocturia

72


What is the involuntary passing of urine in children after bladder control is acheived (Bed-wetting)?


Enuresis

73

What is the presence in the urine of abnormally large quantities of protein, usually albumin?

Proteinuria

74


What is the production of large amounts of urine by the kidney's without an increased fluid intake?


Diuresis

75

What is a decrease in the force of the stream of urine, often with difficulty in beginning the flow ?

Hesitancy

76

What is the presence of an excessive number of white blood cells in the urine, typically more than four leukocytes per high-power field count  (Sign of UTI)?

Pyuria

77


What is the feeling that one must urinate?


Urgency

78

What is the abnormal presence of blood in the urine?

Hematuria

79

What is the excretion of an abnormally large quantity of urine?

Polyuria

80


True or False:

You can delegate Urine Specimen to aide


TRUE

81


True or False:

You can delegate foley irrigation or insertion to LPN


TRUE

82


What kind of medicine is administered for UTI's?


Antibiotics

Ex: Bactrim, Septra, Levaquin, Cipro

MUST GIVE FULL COURSE TO PREVENT RESISTENCE

83


What medication is used to increase the formation and secretion of urine?


Diuretics

Ex: Lasix
Give potassium with it to prevent electrolyte imbalance because you will urinate off potassium with Lasix.

84


What are the norms for Urine:

Blood

Ketone Bodies

Color

Odor

pH

Glucose

Blood - Not present

Ketone Bodies - Not present

Color - Straw, Amber, Transparent

Odor - Faint aromatic

pH - 1.010-1.025

Glucose - Not present

85


What medication is given to help with urinary Retention?


Cholinergics
Ex: Bethanechol

86


What medication is given to help with impact elimination?


Anti-Cholinergics
Ex: Detrol, Atropine, scopolamine

Side Effects:
Urinary retention or hesitency, decreased GI secretions, can cause ileus(twitch in bowel)

87


What medicine can change your urine blue/Green?


Elovil

88


What medication can turn your urine blue?


Urilgesic Blue

89


What medication can turn your urine orange?


Pyridyiam

90


What infection control items do you need to do when dealing with urine?

Wash Hands

Wear gloves

Use sterile technique when inserting foley catheter

91


You need to teach ______ exercises for females to strengthen perineal muscles.


Kegel

92


What is important to do when evaluating a clients home when dealing with urinary issues?


Assess to toilet facilities
No barriers, not too far away

Night Lights

Grab bars, elevated toilet seats

Clothing easily removed for toileting

93


What are some bladder UTI remedies that you should know?


Cranberry Juice - 10oz/Day

Blueberries - 1-2 servings/Day

94


Why are the elderly at an increased risk for elimination problems?


Slower Metabolism

Less Activity

Less Fiber/Fluids

Muscle Weakness

95