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Nursing 101 > Test 4 > Flashcards

Test 4 Flashcards

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1
Q

What dz’s pose a urinary risk?

A

DM, ESRD, enlarged prostate, stricture, MS, spinal injury

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2
Q

What is an obvious symptom of a UTI in the older adult?

A

Behavioral changes (altered pain sensation)

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3
Q

What is the max time to allow before intervening with a Cath?

A

8 hours (by then 240 ml would have been filtered)

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4
Q

How much urine does the bladder hold?

A

200-450ml

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5
Q

Name some factors that can influence urinary elimination.

A 
Path: 
bladder/kidney infection
Stones
Hypertrophy of prostate (male)
Impaired Mobility 
Decrease glomeruli blood flow:
Neurological, communication, and cognition probes
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6
Q

What objective data during urinary assessment is essential?

A 
Inspection:skin/mucosa, urethral meatus
Palpation: bladder (distention), kidney
Dx testing
Risk asses
Age related changes
Intake/output 
Color:pale straw to amber, depends on concentration CLarity: transparent Odor:ammonia
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7
Q

What are some types of urine specimens and studies?

A

Urinalysis (Freshly voided,Clean catch,Sterile,24 HR)
Dipstick testing
Specific gravity (concentration value of particles, norm 1.002-1.028)
Urine culture and sensitivity (72 hrs determine bacterial growth)

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8
Q 
What are the correct values of the following characteristics of urine:
Ph
Protein
Glucose
Ketones
Hematuria
A 
4.6-8
Neg
Neg
Neg
Neg
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9
Q

What are some normal age related changes in the urinary system?

A

Reduced:glomerular filtration rate, nephrons, blood flow, bladder capacity.
Increased:night time urine flow rates

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10
Q

Name some alterations in urinary elimination.

A

UTI
Urinary Retention
Incontinence (functional, stress, urge, reflex)

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11
Q

Diff 4 types of urinary incontinence.

A

Functional:non urinary factors (can’t get to toilet in time, can’t feel need to void)
Stress:involuntary urine loss 2ndary to abd pressure (dribble, urgency, frequency)
Urge:sense urge but unable to reach toilet
Reflex:loss of urine in predictable interval

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12
Q

What are some simple ways to manage urinary incontinence?

A 
Prevent skin break down
Kegels
Encourage/teach lifestyle modifications
Bladder training 
Anti-incont device
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13
Q

What are some nursing interventions to promote urination?

A 
Privacy
Position 
Assistance
Warmth (to relax sphincters)
Sound of water
Encouragement, comfort, pain tx 
Elim habit maitenence, promote emptying 
Fluid intake (2000-2500 ml/day)
Strengthens Pelvic floor muscles, bladder compression
Drug therapy 
Hygiene
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14
Q

What are the types of acute care intervention Caths?

A 
Straight Cath
Indwelling (foley)
Suprapubic
Condom (male)
Intermittent
Caude (male)
Three way
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15
Q

What is the nurse to keep in mind in care of Caths?

A 
UTI prevention
Urine back flow
Encourage fluids
Perineal hygiene 
Remove Cath ASAP
(Surgical/med asepsis technique, measure I&O)
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16
Q

What can the hourly urinary output of an unconscious patient tell?

A

Kidney function/death

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17
Q

Describe the method of measuring output for the incontinent patient (no Cath).

A

Note the amount of times the pt was incontinent and urine characteristics. Try to take the pt to the bathroom every 2 hours to prevent incont and use measuring device.

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18
Q

What are some things to remember while collecting a routine urine specimen?

A

Urinate into clean pan, avoid feces contamination. If female is menstruating then note this with the lab slip. Remind the pt not to put tissue in pan. Use aseptic technique to poor into specimen jar, label appropriately and do not allow urine to sit.

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19
Q

What are 2 ways a sterile specimen can be collected?

What technique is required? Explain.

What should you keep in mind regarding syringe size?

A

Specimen port of an indwelling Cath or Straight Cath procedure.

Sterile-alcohol swab, sterile container, gloves

Type of lab test (3ml-10ml)

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20
Q

What are some common reasons for using a Cath?

A

Relieving urinary retention
Obtaining sterile specimen
Needing a specimen due to other factors affecting (mens traction or incont)
Emptying bladder pre/post diag/surg proc.
Making terminal ill pts comfortable
Monitoring critical Ill pt renal function

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21
Q

Define self concept.

A

mental image or picture of self; includes body image, subjective self, ideal self, and social self

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22
Q

Self knowledge includes:

A 
Basic fact (age/race/culture/etc.).
Position in social group.
Qualities or traits that describe typical behaviors, feelings, moods, and other characteristics.
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23
Q

Self expectation is a sense of ____________. And has two various sources. Explain.

A

Who do I want to be?
false self: a sense of self with emotional need to respond to the needs and ambitions that significant people, such as parents, have for them.
ideal self: self a person would like to be or thinks one should be; includes aspirations, moral ideas, and values.

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24
Q

Explain what self evaluation represents.

A

self-esteem: person’s perception of one’s total being, including self-worth and body image

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25
Define sexual health
sexual health: the integration of the somatic, emotional, intellectual, and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication, and love
26
What is sexual expression?
methods by which people gain satisfaction through sexual stimulation
27
In assessment, what pts will require a sexual hx (and physical assess)?
Any inpatient or outpatient receiving care for pregnancy, STI, infertility, or contraception Any patient experiencing sexual dysfunction Any patient whose illness will affect sexual functioning and behavior in any way
28
Physical examination of the reproductive or genitourinary system is necessary for either male or female patients under the following circumstances?
As part of a routine physical examination Annual women’s health care examination, including a Pap smear Suspected STI Suspected pregnancy Workup for infertility Unusual lump, discharge, or appearance of the genital organs noticed by the patient Request for birth control Change in urinary function
29
Assessment for self concept will include what 5 factors? This is to identify?
personal identity, body image, self-esteem, and role performance. It is important to identify and label a patient’s positive self-concept as it is to note problems.
30
Energy in units is measured in ________.
Calories | In=cal burned
31
What is BMR?
``` Basal metabolism (rate) Energy req to carry on INVOLUNTARY activities of the body at rest. ```
32
What are some causes of increased/decreased BMR?
Increased: Growth, infection, fever, emotion, extreme environ temps, increased hormones/preg., athletes, stren activity Decreased: aging, prolonged fasting, sleep (Men have higher BMR)
33
What is the method of calculating caloric requirements?
Male-healthy weight (lbs) X 11cal/lb=cal/day Female-healthy weight (lbs) X 10cal/lb=cal/day Then determine activity level and X cal/day by that (cal/day X activity___, ____ + cal/day=total daily cal
34
Describe the activity levels and percentage used to calculate BMR.
20-sedentary (mostly sitting) 30- light (exercise/walk) 40-moderate (exercise/little sitting) 50-high (athlete, physical job)
35
How is ideal body weight discovered?
``` Females 100lb for 5ft + 5lbs for every additional inch Males 106lbs (for 5ft) + 6lbs for ea. Add. Inch ```
36
Define anorexia and its causes.
Lack of appetite psycosocial: fear, anxiety, depression, pain
37
What BMI is defined as under/over weight?
Less than 18.5 is underweight 25-29.9 overweight ``` Over 30 (20% above ideal weight) obese Over 40 ext obese ```
38
ID the 6 classes of nutrients.
Macro: carbs, fat, protein (energy, tissue building) Micro: vitamins, minerals, water (reg body process's, 0 cals)p
39
What are non essential nutrients?
Synthesized by the body (excess carbs/prot turns to fat then stored as trig)
40
When discussing carbs, what is the primary energy source? Physiological functions? Tot cal/day?
Starch and sugar Increase insulin sec, glucagon, feeling of fullness (satiety), increase absorp of Na and Ca. 45-65%
41
What is the vital component of every living cell?
Protein
42
What is the major function of protein? Cal intake?
Maintain/repair body tissue 10-35% 0.8g/kg
43
What are some functions of lipids? Cal intake?
Temp control Protect organ/bone Synths bile acid, Vit D, HDL/LDL 20-35%
44
Vitamins are necessary for ____________ of _____, _______, and _____.
Metabolism | CHO, protein, and fat.
45
What are the two classes of vitamins and assoc. vitamins?
Fat sol:KADE | Water Sol: B's and C's
46
What are the major minerals?
``` Sodium Magnesium Sulfur Potassium Calcium Phosphorus ```
47
What are some functions of the mineral sodium?
Fluid bal, action pot/muscle contrac., cardvas support, Extracellular fluid bal.
48
What are some effects of mineral potassium?
INTRA/extra cell fluid bal., action pot./muscle cont., b/p reg.
49
What are the benefits of the mineral calcium?
Bone strength, cardiac contraction, blood clot, nerve trans.
50
What are the affects of Mg?
Bone nourishment, enzyme catalyst, cardvas sup, nerve cont, muscle cont.
51
How is the mineral phosphorus beneficial?
Energy transfer from DNA/RNA, acid base balance, bone formation
52
What are EAR, UL, AI, RDA?
Est. avg. req-nutrient amount est to meet req of half of healthy people Tolerable upper intake level-highest safest daily intake of a nutrient Adequate intake-est when RDA can't be Recom diet allow-avg daily nut intake sufficient for all healthy peep req.
53
What is the min output that is safe for a pt?
30 ml/HR | 1-2 L/day
53
What are the 4 categories of nutritional assessment objective data?
``` (ABCD) Anthropometric measurements Biochemical/lab analysis Clinical/physical assessment Diet/nutritional hx ```
55
What labs measure nutrient long/short term status? Name some other lab values reflecting nutrition.
Short-pre albumin Long-serum albumin Hemoglobin/hematocrit-iron BUN creat-dehydration/prot malnutrition Transferrin, blood glucose, blood cholesterol, blood triglycerides, urea
56
What assessments are done for nutritional purposes in the physical exam?
Gen. Survey, v/s alterations, poor turgor/wound healing, concave abd/as cites, muscle mass changes, dec. teeth/taste, swollen tongue, dull/dry hair.
57
In nutrition assessment, we'll first screen the pt considering what food intake factors? Then take what type of measurements, specifically?
Diet hx, 24 HR recall, food freq. flyer, food diary. Anthropometric-waist/mid arm circum, skin folds, weight, height, BMI
57
How do you determine BMI? And % weight change?
Weight lbs X703 _________________ Height in X H in Usual W-present W/usual weight X 100
59
What are some nutritional changes in the older adult?
``` Calories decrease (fe, ca, mg, Vit d/b) Prone to dehydration Chewing problems (loss of teeth) Loss of smell/taste/appetite/thirst Dec peristalsis ```
60
How often does peristalsis occur?
Every 3-12 min
61
Manipulation of bowel during abd surgery inhibits _______, causing?
Peristalsis Paralytic/postoperative ileus
62
Hidden blood in the stool not seen on gross examination is called?
Occult blood
63
What types of drugs induce the emptying of intestinal tract?
Cathartics and laxatives
64
How long should one retain the oil from an oil-retention enema?
At least 30 minutes (for best cleansing result)
65
How is Valsalva's maneuver a contraindication in cardiovascular patients?
Decreases blood flow to the heart during the holding of breath, once released, a rush of blood is sent through back to heart.
66
What is considered flatulence? Vs flatus.
Excessive formation of fluid/stool/air in the stomach/intestine causing distention Vs Expelling of gas from body oriface
67
What characteristics of stool should the nurses consider?
``` Volume Color Odor Consistency Shape Constituents ```
68
What is Melena vs hematocheia?
Tarry black Vs Bright blood
69
How much fiber and fluid should be consumed to prevent constipation?
20-35 g fiber and 1.8 to 2.4 L water daily
70
What are the musts of a bowel training program?
``` Goal (reg bowel movement) Plenty of fluid intake/bulk foods Pt willingness to participate Mobile activity routinely every day Recognize the urge and respond quickly ```
71
What are the eight distinct stages of Eric Erickson's theory of psychosocial development? Give a brief description.
1. Trust vs mistrust (infancy):Learning to rely on caregiver versus in adequate care. 2. Autonomy vs shame and doubt (toddler): Learn independence through encouragement vs over expectations giving inadequacy. 3. Initiative vs guilt (preschool): Learning and actively seeking new experiences vs hesitating challenging skills 4. Industry vs inferiority (school aged kids): Pleasure from finishing projects and accomplishment versus non-accepted feelings, lack of self-worth 5. Identity vs role confusion (adolescents): Physical changes occur and can become rebellious while acquiring sense of self versus unable to establish identity. 6. Intimacy vs isolation (young adult hood): Unite self identity with friends versus fear of commitment, isolation 7. Generativity vs stagnation (middle adulthood): Involvement with family, desire to reproduce vs self absorbed, regressing to earlier coping methods. 8. Ego integrity vs despair (later adulthood): Sense of fulfillment and purpose versus despair from a life of failure

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