Test #4 study guide

Question 1

Elements of the pain experience:

Answer 1

• Transduction
• Transmission
• Perception of pain
• Modulation

Question 2

Acute vs. chronic pain – symptoms :

Answer 2

Acute- rapid onset, no warning.

Chronic- (3 months) , gradual and ongoing.

Question 3

Types of pain:

Answer 3

• somatic
• visceral
• nociceptive
• neuropathic: Pain from a lesion or disease of the central or peripheral nerves
• cutaneous

Question 4

Factors that may affect a person’s pain experience:

Answer 4

• pain threshold
• adaptation
• modulation of pain

Question 5

Non pharmacologic pain relief measures :

Answer 5

A distraction like the TV, relaxing techniques, playing a video game, humor, music, imagery, etc

Question 6

Side effects of analgesics:

Answer 6

Euphoria, dysphoria, agitation, seizures, hallucinations.
Lowered blood pressure and heart rate.
Muscular rigidity and contractions.
Nausea and vomiting.
Non-allergic itching.
Pupil constriction.
Sexual dysfunction.
Urinary retention.

Question 7

Variables that influence urination

Answer 7

Pathologic and surgical conditions
Privacy issues and embarrassment
Medications
Food and fluid intake
Ambulatory ability
Muscle tone
The cause of enuresis (involuntary passing of urine)
Developmental factors
Psychosocial factors

Question 8

Normal characteristics of urine:

Answer 8

Urine can be dilute or concentration
Normal urine is sterile
It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi.
Urine can be produced in small or large amounts (1.5 L per day)
DOES NOT HAVE protein, glucose (little to none), or ketones.

Question 9

Diagnostic tests procedures r/t urinary elimination:

BUN and Creatinine

Answer 9

-measure kidney function

Question 10

Creatinine

Answer 10

waste product from muscle breakdown

Question 11

BUN

Answer 11

a measure of the urea level in the blood

Question 12

Diagnostic tests procedures r/t urinary elimination: Urinalysis

Answer 12

Specific gravity, pH, protein, glucose, ketones, microscopic analysis
Screens for UTI, kidney disease, etc.

Question 13

Diagnostic tests procedures r/t urinary elimination: 24-hour urine collection

Answer 13

First specimen is discarded and then the time starts for 24 hours.
Keep urine on ice

Question 14

Diagnostic tests procedures r/t urinary elimination: Intravenous pyelography

Answer 14

X-ray of the kidneys, bladder, ureters, and urethra

Images show the size, shape, and position of the urinary tract.

Question 15

Diagnostic tests procedures r/t urinary elimination: Computed tomography

Answer 15

Used to diagnose kidney stones, bladder stones, or blockage of the urinary tract.
With contrast

Question 16

Diagnostic tests procedures r/t urinary elimination: Cystoscopy

Answer 16

Camera inserted into the urethra

Question 17

Diagnostic tests procedures r/t urinary elimination:

Cystoscopy

Answer 17

Camera inserted into the urethra

Question 18

Nursing diagnosis. (Urination)

Answer 18

Nursing diagnosis:
Impaired urinary elimination
Urge urinary incontinence
Pain
Ineffective coping
Stress urinary incontinence
Functional urinary incontinence
Risk for infection

Question 19

Implement and evaluate nursing care (urination)

Answer 19

• Nurse focuses on activities that will help the patient with compromised urinary elimination return of the NORMAL STATE OF FUNCTION OR TO ADAPT TO CHANGES IN THE STATE OF FUNCTION.
• Follow ups are needed to assure quality in the care provided and to determine need for further nursing interventions

Question 20

Lab values: Auria, Oliguria, Polyuria

Answer 20

Auria: 50-100mls
Oliguria: 100-400mls
Polyuria: over 2,500 mls

Question 21

Alteration in renal function. - renal, pre-renal, post-renal

Answer 21

Pre-renal: reduced blood flow to kidneys
Renal: Actual kidney damage
Post-renal: obstruction of urine flow

Question 22

Types of incontinence:

Answer 22

• Stress
• Urge
• Mixed
• Functional
• Overflow

Question 23

UTI prevention:

Answer 23

Avoid wearing tight-fitting clothing
Drink at least 8 8oz glasses of water every day
Urinate when the urge is felt
Women and girls wipe “front to back”
Urinate after sexual intercourse
Showers are preferred over baths
Good perineal hygiene is essential

Question 24

Identify variables/factors that influence bowel elimination:

Answer 24

Developmental considerations
Daily patterns
Food and fluid intake
Activity and muscle tone
Lifestyle
Psychological variables
Pathologic conditions
Medications
Diagnostic studies 
Surgery and anesthesia

Question 25

Stool collection for laboratory analysis: (guidelines for handling it)

Answer 25

- Medical aseptic technique is imperative. (not sterile) - Hand hygiene, before and after glove use, is essential. - Wear disposable gloves. - Do not contaminate the outside of the container with stool. - Obtain stool and package, label, and transport according to agency policy.

Question 26

Stool collection for laboratory analysis: (Directions)

Answer 26

Void first so that urine is not in the stool sample. Defecate into the container rather than the toilet bowl. Do not place toilet tissue in the bedpan or specimen container. Avoid contact with soaps, detergents, and disinfectants as these may affect test results. Notify the nurse when the specimen is available.

Question 27

Direct and indirect visualization studies of the gi tract and nursing care/teaching:

Answer 27

- Indirect visualization studies: RADIOGRAPHIC (NON INVASIVE) views of the GI tract, used to detect gallstones, fecal impaction, and distended bowel. Tests include Abdominal Flat Plate, Barium Enema (BE), Ultrasonography, CT scan, and MRI - Direct visualization studies: used for diagnostic and treatment purposes only, ARE INVASIVE PROCEDURES conducted by a gastroenterologist who inserts various instruments to examine the interior of the GI tract. Tests include: esophagogastroduodenoscopy (EGD), sigmoidoscopy, fiberoptic colonoscopy

Question 28

Nursing interventions to promote regular bowel habits and ease defecation:

Answer 28

- Timing, positioning, nutrition, privacy, exercise, and teaching clients when they should seek medical assistance. . - Providing hydration and nutrition (More fiber and fluid intake, FRUIT).

Question 29

Nursing diagnosis (Bowel)

Answer 29

- Constipation - Diarrhea - Bowel incontinence - Self-care deficit - Disturbed body image

Question 30

Implement and evaluate nursing care involving bowel elimination:

Answer 30

- Evaluation of the goals and outcomes for the patient with bowel elimination problems is important to achieve the desired outcomes. - Whether the goals include a return to normal bowel function or maintaining existing function within the parameters of the patient’s condition, it is important for the nurse to determine whether they have been met, and if not, why.

Question 31

Common laxative types

Answer 31

- Bulk-forming - Stimulant - Osmotic: Draws water into the bowel - Lubricant - Stool softener: Brings liquid into the stool

Question 32

Function and role of the respiratory and cardiovascular system:

Answer 32

Respiratory : - Inspiration and expiration - Pulmonary ventilation: movement of air into and out of the lungs - Respiration: Intake of O2, release of CO2. Cardiovascular - Composed of the heart and blood vessels - Transport blood all over the body - Blood bring O2 around the body, and deoxygenated O2 back to the lungs

Question 33

Care of patients with oxygenation problems:

Answer 33

``` Teach about a pollution-free environment Promote comfort Promote optimal function Promote proper breathing Manage chest tubes Promote and control coughing Perform chest physiotherapy Suction the airway Meet O2 needs w medications and teach patients about them ```

Question 34

Factors that affect respiratory and cardiovascular function:

Answer 34

``` Level of health Developmental considerations Medication considerations Lifestyle considerations Environmental considerations Psychological health considerations ```

Question 35

Diagnostic & lab studies and nursing care/teaching: Cardiac coronary catheterization

Answer 35

We put a probe through the femoral artery and it goes into the heart- -they put a catheter in the heart valve or wherever to keep it open for blood flow, used especially when there is plaque build up.

Question 36

Medications for oxygen?

Answer 36

- Bronchodilators - Nebulizers - Meter-dose inhalers: you get the same amount of medicine no matter what type of breath you take - Dry-powder inhalers: have to take a deep breath to get the medicine - Cough suppressants - Expectorants: Facilitates the removal of the secretions and liquifying the secretions more so it is easier to cough up - Lozenges: Contains a local anesthetic (benzocaine) like cough drops, throat spray, etc.

Question 37

Electrolytes lab values:

Answer 37

``` Sodium : 135-145 mEq/L Potassium : 3.5-5.0 Chloride : 95-105 Calcium : 8.5-10.5 Phosphate : 1.7-2.6 Magnesium : 1.3-2.1 ```

Question 38

Respiratory and renal role in acid base balance:

Answer 38

Respiratory: Balance CO2 and O2 by either increasing respirations or decreasing them. Renal: Can either keep hydrogen if we are going to be more basic, or let them go through the urinary tract if we are going more acidic.

Question 39

Tingling of hands and feet

Answer 39

Hypocalcemia