Module 17 - Elimination

Question 1

Urinary elimination

Answer 1

Passage of urine through urinary tract by means of urinary sphincter and urethra

Question 2

Bowel elimination

Answer 2

Passage of stool through intestinal tract and dispelling of stool by means of smooth muscle contraction

Question 3

Normal urinary elimination terms

Answer 3

Micturition, urination, voiding, etc.

Question 4

Altered urinary elimination terms

Answer 4

Incontinence, enuresis, dysuria, etc.

Question 5

Normal bowel elimination terms

Answer 5

Bowel movement, defecation, etc.

Question 6

Altered bowel elimination terms

Answer 6

Incontinence, diarrhea, constipation, borborygmus, etc.

Question 7

Risk factors for altered urinary elimination

Answer 7

Neurological impairment, mobility impairment, cognitive impairment, infection, medications, etc.

Question 8

Risk factors for altered bowel elimination

Answer 8

Neurological impairment, mobility impairment, cognitive impairment, diet (low fiber/little fluid), medications, etc.

Question 9

QUESTION:

What is the age range for children to start controlling their elimination?

Answer 9

CORRECT ANSWER:

Between 2 and 5 years of age

Question 10

QUESTION:

Is the following statement true or false? - “Men can have retention issues due to prostate enlargement.”

Answer 10

CORRECT ANSWER:

True

Question 11

QUESTION:

As a nurse, what should you ask about/look for during an elimination assessment?

Answer 11

CORRECT ANSWER:
Usual elimination pattern, changes in elimination pattern, changes in color/frequency/quality of urine or stool, diet, medications, etc.

Question 12

QUESTION:

What is the minimum amount an average adult should void in one hour?

Answer 12

CORRECT ANSWER:

30 mL

Question 13

Characteristics of normal urine

Answer 13

Clear/straw/amber color, no microorganisms/blood/glucose/acetone/protein, etc.

Question 14

Characteristics of normal stool

Answer 14

Brown (for adults), cylindrical shape, soft, formed, etc.

Question 15

Examples of urinary diagnostic tests

Answer 15

Urinalysis C/S, Intravenous Pylogram (IVP), etc.

Question 16

Examples of bowel diagnostic tests

Answer 16

Endoscopy, colonoscopy, sigmoidoscopy, barium enema, etc.

Question 17

Nursing interventions

Answer 17

DO NOT NEED ORDER FOR; toileting schedule, privacy, positioning, strengthen muscles (Kegels), “Heed the need” (don’t make the patient wait)

Question 18

Over-active bladder (OAB)

Answer 18

Acetylcholine sends messages that make it feel like one has to void, but there is nothing to void

Question 19

Medications for altered urinary elimination

Answer 19

Antispasmotics/anticholinergics:
oxybutynin (Ditropan)
darifenacin (Enablex)
fesoterodine (Toviaz)
solifenacin (Vesicare)
tolerodine (Detrol Detrol LA)
trospium (Sanctura)

Anti-infectives:
cinoxacin (Cinobac)
nitrofurantoin (Furadantin)

Anti-infectives (not specific to UTIs):
ciprofloxacin (Cipro)
cotrimoxazole (Bactrim, Septra)

Question 20

Side-effects of antispasmotics/anticholinergics

Answer 20

N/V, tachycardia, dry mouth, urinary retention, and constipation

Question 21

Side-effects of anti-infectives

Answer 21

N/V/, diarrhea, anorexia, bladder irritation, dysuria; usually affect GI tract

Question 22

phenazopyridine (Pyridium)

Answer 22

A urinary analgesic (painkiller); urine is color of pill (red)

Question 23

Medications for altered bowel elimination

Answer 23

Chemical laxative:
bisacodyl (Dulcolax) (OTC)

Bulk laxatives:
magnesium hydroxide (milk of magnesia)
psyllium (Metamucil)
polyethylene glycol (MiraLAX, GoLYTELY)

Lubricant laxative:
docusate (Colace)

Gastrointestinal stimulant:
metoclopramide (Reglan)

Antidiarrheal:
ioperamide (Imodium)

Question 24

QUESTION:
A female patient has stress incontinence.  Which of the following data from the patient’s history contributes to this condition (select all that apply)?
A. History of 3 vaginal deliveries
B. History of competitive swimming
C. Client's age of 28
D. Female gender

Answer 24

CORRECT ANSWER:

A and D

Question 25

QUESTION: The nurse is instructing the client to do Kegel exercises. What should the nurse tell the patient to do to perform these pelvic floor exercises? A. Tighten the stomach muscles B. Lift both legs while lying down C. Perform leg squats D. Stop the flow of urine while urinating

Answer 25

CORRECT ANSWER: | D

Question 26

``` QUESTION: Following a cystoscopy with biopsy, the nurse should monitor the patient to ensure that he: A. Has a bowel movement B. Has no blood in his urine C. Remains NPO D. Is able to urinate ```

Answer 26

CORRECT ANSWER: | D

Question 27

QUESTION: A male patient is unable to void while lying supine. What can the nurse do to facilitate his ability to urinate? A. Assist him to a standing position B. Tell him he must void prior to discharge C. Pour cold water over his genitalia D. Ask his wife to assist him in using the urinal

Answer 27

CORRECT ANSWER: | A

Question 28

QUESTION: The day after having a barium enema test, the patient is alarmed because his stools are white in color. Which statement by the nurse is most helpful? A. “Don’t worry, this is normal after a barium enema.” B. “This is expected, be sure to drink plenty of fluids.” C. “The stool should return to normal color after 2-3 days.” D. “This is expected, let me know if your stools are still white after 5 days.”

Answer 28

CORRECT ANSWER: | B

Question 29

QUESTION: Which of the following should the nurse teach a patient to prevent recurrent urinary tract infections? A. Take bubble baths instead of showers B. Urinate every 6-8 hours C. Limit your fluid intake so you don’t have to urinate so often D. Avoid urinary tract irritants such as coffee, tea, and cola

Answer 29

CORRECT ANSWER: | D

Question 30

QUESTION: The nurse must perform a straight catheterization for residual urine. In order to carry out this order, the nurse would instruct the nursing assistant: A. “Let me know when the patient needs to void.” B. “Let me know as soon as the patient voids.” C. “Increase this patient’s oral fluid intake.” D. “Record this patient’s urine output.”

Answer 30

CORRECT ANSWER: | B

Question 31

Enuresis

Answer 31

Involuntary urination

Question 32

Functional incontinence

Answer 32

State in which a person experiences an involuntary, unpredictable passage of urine

Question 33

Hematuria

Answer 33

Blood in the urine

Question 34

Kegel exercises

Answer 34

Repetitious contraction and relaxation of the pubococcygeal muscle to improve vaginal tone and urinary incontinence

Question 35

Mixed incontinence

Answer 35

Symptoms of urge and stress incontinence are present, although one type may predominate

Question 36

Nocturia

Answer 36

Excessive urination during the night

Question 37

Overflow incontinence

Answer 37

Involuntary loss of urine associated with over-distention and overflow of the bladder

Question 38

Post-void residual (PVR)

Answer 38

Urine that remains in the bladder after the act of micturition; "residual urine"

Question 39

Reflex incontinence

Answer 39

Emptying of the bladder without the sensation of the need to void

Question 40

Stress incontinence

Answer 40

State in which the person experiences a loss of urine of less than 50 mL that occurs with increased abdominal pressure

Question 41

Total incontinence

Answer 41

Continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation

Question 42

Transient incontinence

Answer 42

Occurrence that appears suddenly and lasts for 6 months or less and usually is caused by treatable factors, such as confusion secondary to acute illness, infection, and as a result of medical treatment, such as the use of diuretics or intravenous fluid administration

Question 43

Urge incontinence

Answer 43

State in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void

Question 44

Urinary incontinence

Answer 44

Any involuntary loss of urine

Question 45

Bowel incontinence

Answer 45

The inability of the anal sphincter to control the discharge of fecal and gaseous material

Question 46

Colostomy

Answer 46

An opening into the colon that permits feces to exit through the stoma

Question 47

Constipation

Answer 47

Passage of dry, hard fecal material

Question 48

Diarrhea

Answer 48

Passage of liquid, unformed stools

Question 49

Endoscopy

Answer 49

Direct visualization of hollow organs of the body using an endoscope (a flexible, lighted tube)

Question 50

Enema

Answer 50

Introduction of solution into the lower bowel

Question 51

Fecal impaction

Answer 51

Collection in the rectum of hardened feces that cannot be passed

Question 52

Fecal incontinence

Answer 52

Involuntary or inappropriate passing of stool or flatus

Question 53

Hemorrhoids

Answer 53

Abnormally distended rectal veins

Question 54

Ileostomy

Answer 54

Opening into the small intestine allows fecal content from the ileum to be eliminated through the stoma

Question 55

Laxative

Answer 55

Drug used to induce emptying of the intestinal tract

Question 56

Occult blood

Answer 56

Blood present in such minute quantities that it cannot be detected with the unassisted eye

Question 57

Ostomy

Answer 57

General term referring to an artificial opening; usually used to refer to an opening created for excretion of body wastes

Question 58

Peristalsis

Answer 58

Involuntary, progressive, wave-like movement of the musculature of the gastrointestinal tract

Question 59

Stoma

Answer 59

Artificial opening for waste excretion located on the body surface

Question 60

Suppository

Answer 60

Oval-/cone-shaped substance that is inserted into a body cavity and that melts at body temperature

Question 61

Anuria

Answer 61

Decreased urine output of less than 50 mL in 24 hours

Question 62

Bacteriuria

Answer 62

Bacteria in the urine

Question 63

Diuresis

Answer 63

Increased urine volume

Question 64

Dysuria

Answer 64

Painful or difficult urination

Question 65

Frequency

Answer 65

Voiding more frequently than every 3 hours

Question 66

Proteinuria

Answer 66

Protein in the urine

Question 67

Pyuria

Answer 67

White blood cells in the urine

Question 68

Cystectomy

Answer 68

Surgical removal of the urinary bladder

Question 69

Cystitis

Answer 69

Inflammation of the urinary bladder

Question 70

Urethritis

Answer 70

Inflammation of the urethra

Question 71

Urosepsis

Answer 71

Spread of infection from the urinary tract to the bloodstream that results in a systemic infection

Question 72

Antispasmotics/anticholinergics

Answer 72

Agents that block muscle spasm associated with irritation or neurological stimulation

Question 73

Urgency

Answer 73

The feeling that one needs to void immediately; associated with infection and inflammation in the urinary tract