Advanced Elimination Lecture Flashcards
What is anuria
Less than 50-100mL
What can happen with CKD
Anuria or oliguria
What does it mean if there is acute anuria
Medical emergency, maybe DIALYSIS
What is oliguria
100-500mL
What is polyyria and what is it common is
Excessive urine production >2,500mL a day, uncontrolled DM
What is nocturia
Excessive urination at NIGHT
What is dysuria and what are some common causes
PAINFUL urination, common with UTI, STIs, STONES
What is hematuria
BLOOD in the urine
What is stress incontinence
Leakage when SNEEZE, COUGHING
What are some treatments of stress incontinence
Kegels, sling surgery
What is urge incontinence
I GOT TO GO
What are the treatments of urge incontinence
Reduce bladder IRRIANTS, ANTICHOLINERGICS, BETA 3 agonists
What are some bladder irritants
C: cirtus, chocolate, carbonated drinks, coffee
A: alcohol, acidic
T: tomato
S: spicy
DAIRY
What are the classic symptoms of UTIs
Frequency and dysuria
What is the common UTI pathogen
E coli
What are some preventions of UTIs
TIGHT clothing, COTTON, WATER, PEE, WIPE front to back, PEE after SEX, SHOWERS, CATHETER removal
What is a suprapubic assessment
Inseption and palpation for bladder distention
What is a bladder scanner used for
See how much volume is in the bladder
What are two urinary labs
BUN and creatinine
What is a BUNand what does it look at
Blood urea nitrogen, urea is normally cleared by the kidneys
What is an abnormal BUN and what could that be from
If it’s high, DEHYDRATION, kidney DISEASE, DM, HTN, high-PROTEIN, BURN, heart FAILURE
What is the serum creatinine and what does it look at
Creatinine is a waste product that is cleared by the kidneys, NOT affected by DIET or PHYSICAL activity
What is an abnormal serum creatinine
If it’s HIGH that could mean kidney DISEASE
What is the best test to look at kidney function
Serum creatinine
What are UA used for
UTI, kidney DISEASE, DM, PREECLAMPSIA
What are the components of an UA
Specific gravity, pH, protein, glucose, ketones, nitrites and leukocye esterase, blood, blood cell counting
What does specific gravity look at
Looks at balance of water and solid matter in urine
What has a direct effect on specific gravity
Fluid intake
What can a high specific gravity mean
Dehydration
What is a normal uringe pH and what can an abnormal urine pH lead to
Normal is 6, can lead to stones
Tell me about protein in urine
Normal: negative protein
If protein in: EXERCISE, PREGNACY, kidney DISEASE
Tell me about glucose in urine
Normal: negative
If present: (glycosuria), DM, kidney DISEASE
If they have DM: some MEDS can cause it
Tell me about ketones
Normal: negative
If ketones in urine: DKA, lwo CHO DIET, FASTING, VOMITING
Tell me about nitrites and leukocyte esterase
Normal: negative
If not: both are indicative of UTI
What is a microscopic analysis
Looks at bacteria, yeast, parasites, blood cells
What can RBC in urine indicate
Blood in the urine, possibly from a kidney stone
What can WBC in urine indicate
Poosible infection
What will happen if there are WBCs, positive nitrites and leukocyte esterase are present
Highly suspect UTI, CULTURE and SENSITIVITY
What does a C&S look at
What ORGANISM is growing and a SENSITIVITY report
What is the purpose of a 24-hour urine collection
Measures CREATININE clearance: KIDNEY FUNCTION
What are some tips with 24-hour urine collections
Start time AFTER first void (don’t collect that void), keep COOL
What do bladder/kidney/renal ultrasounds look at
SIZE, SHAPE, LOCATION of KIDNEYS, detect CYSTS, MASSES, and STONES, HYDRONEPHROSIS (swelling of kidneys)
What are the pros and cons of bladder ultrasounds
Pro: safe, noninvasive
Cons: not sensitive, hard to see in obese pts
What is the pt prep of ultrasounds
FULL bladder, drink fluid and don’t pee
What do Kidney, ureter, and bladder (KUB) X-rays look at
STONES, STENTS
What are ureteral stents used to treat
Hydronephrosis so kidney can drain urine
What do CT scans look at
TONES, MASSES, TUMORS, HYDRONEPHROSIS, OBSTRUCTIONS
What test has the best look at the kidneys and ureters
CT scan, with/out contrast
What is a cystoscopy
Small camera to visualise the bladdre and urethra
Where is a cystoscopy camera inserted
Through the urethra
What is the best way to visualize and assess the bladder
Cystoscopy
What can cystoscopys look at
CAUSE of hermaturia, incontience, dysuria, frequency, urgency, and retention, BIOPSY
Is anestesia required for cystoscopies
No
What are the cons of cystoscopy
Potential infecition, retention, hematuria
What are some nursing diagnosis for urinary issues
IMPAIRED urination/ self-toileting, urinary RETENTION, stress/urge incontinence, risk for impaired SKIN integrity, difficulty COPING, acute PAIN
What are some urinary nursing interventions
BEDPAN, URINALS, bedside COMMODE, PRIVACY, toileting SCHEDULE, FLUID intake
How do you use a bedpan
HIGH-FOWLERS, no longer than 10 MINUTES
How can you provide privacy
COVER SHEET
How often should you encourge unrination
Every 2hrs
What is the normal intake of fluids
15/2000ml
If a person has nocturia when should they stop drinking fluids
2hrs before bed
What is hemodialysis
Takes blood out, filters it, puts it back in
How long does hemodialysis take
SEVERAL HRS, 3X a week
What do dialysis pts have
AV fistula, artery and vein together (THRILL and BRUIT)
What does peritoneal dialysis do
Instill solution into ABDOMJNAL CAVITY, soultion stays in there and then it filters
Where is peritoneal dialysis donw
At HOME, DAILY
What are the riskd of peritoneal dialysis
INFECTION (peritonitis), weight GAIN, HIGH blood sUGAR
What do stool cultures do
Determine CAUSE of DIARRHEA, detect PARASITES
What are the indications for a stool culture
DIARRHEA for several days, blood or mucus, loose stool, contaminated food or water, TRAVEL
What should you do if a stool culture is negative
Look for other causes
What happens if a stool cultre is positive
IDETNIFY organism and do a SENSITIVITY report
What does fecal occult blood tests (FOBT) look at
Measures for MICROSCOPIC BLOOD in feces
What is occult blood
Microscopic blood in stool
What are some possible causes of blood in the stool
Cancerous GROWTHS, HEMORRHOIDS, anal FISSURES, intestinal INFECTION, UC, CROHN;s diseases, DICERTICULAR diseases, peptic ULCERS
What is the FOBT diet
2-3 before test avoid: BEETS, GRAPEFRUIT, FORESERADISH, RED meat, VIT C
What is a positive FOBT test
Blue
What do you need to do an upper GI series
barium swallow, to look at esophagus, stomach and duodenum
What are the things that upper GI series help diagnose
Ulcers, tumors, herias, scarring, abnormalities
What is the pt prep for barium swallow
NPO for 4-8hrs, then ingest barium liquid
What do you need for a lower GI series
Barium enema, to look at rectum, colon, and lower portion of the small intestine
What doesa lower GI series help disgnose
Growths, polys, diverticula, cancer
What is the pt prep for a lower GI series
Full liquid diet 2 days propor, clear liquid diet 24hr before, laxative/enema hrs before procedure
What are the side effects of the barium
Constipation, BMs may be WHITE for 7-14 days
What does an endoscopy (EGD) look at
Cmera to visualize the esophagus, stomach, and duodenum
What are the indications for an EGD
Swallowing difficulties, vomiting, bleeding, gastric reflux, pain
What is the patient prep for EGD
NPO for at least 8hrs prior
What happens with endoscopy
Light sedation, does not affect breathing
What is a colonoscopy
Camera used to visualize inflamed tissue, ulcers, or growths in the anus, rectum, and colon
What can a colonoscopy identify
CANCER, CHANGES, PAIN, BLEEDING, WEIGHT LOSS
What is the patient prep for a colonscopy
Clear liquids for 1-3 days, NPO at midnight, laxativeenem, avoid drinks with red/purp;e dyes
What happens during a colonoscopy
pt lie on left side, light sedation, camera goes in rectum
What is diarrhea
HYPERACTIVE bowel sounds, LOOSE/WATERY stools, weight LOSS, CRAMPING, SOFT DISTENTED abdomen
What is constipation
NARCOTIC pain MEDS, less FLUID intake, low FIBER, HYPOACTIVE bowel sounds, FIRM and TENDER abdomen
What is bowel incontinence
SPHINCTER deficiency, RECOGINZE urge, STRIKING
What are some nursing interventions for elimination
HIGH FIBER, PLENTY of FLUIDS, WAM liquids, FRUIT jucies, EXERCISE
What do antidiarrheals do
Treat DIARRHEA, slows motility to promote absorbption
What do laxatives do
Treat constipantion, AVOID DAILY USE, CONTRAindicated for those with NV or UNDIAGNOSED abdominal pain
What do stool softeners do
Treat constipation
What do suppositories do
Treat constipation
What do enemas do
Treat constipation
