Chapter 31 and 32: Urinary and Bowel Elimination

Question 1

Intake measurements include…

Answer 1

All oral fluids and parenteral fluids

Question 2

Output measurements include…

Answer 2

Urine, liquid stool, vomit, drainage from wound or operative site and drainage from nasogastric tube

Question 3

How many mL difference should there be between input and output?

Answer 3

300 mL

Question 4

How is input and output measured?

Answer 4

in mL

Question 5

How many mL/oz?

Answer 5

30 mL = 1 oz

Question 6

What are the expected characteristics of urine?

Answer 6

1) Volume: at least 30 mL/hr ; usually 1500 mL - 2000 mL in a day
2) Color: more dilute=light yellow, more concentrated = dark yellow
3) Clarity: Clear
4) Odor: more dilute=lighter smell, more concentrated= strong ammonia smell; diet affects smell also

Question 7

abdominal contractions such as coughing and sneezing cause voiding because of weak muscles

Answer 7

Stress Incontinence

Question 8

Patient feels the urge but cannot make it to the bathroom

Answer 8

Urge Incontinence

Question 9

When the bladder reaches a certain amount it automatically voids itself

Answer 9

Reflex Incontinence

Question 10

Patient is unable to feel the urge and get to the restroom

Answer 10

Total Incontinence

Question 11

Patient can feel the urge but may have a mobility or psychological problem that prevents them from getting to the restroom

Answer 11

Functional Incontinence

Question 12

Nursing interventions for incontinent patients…

Answer 12

Regulating fluid intake, Kegal exercises and schedule voiding

Question 13

How do you take care of an incontinent patient?

Answer 13

Good skin care and prevention of skin breakdown are very important for incontinent patients , so gentle cleansing after each episode of incontinence is standard incontinence care

Question 14

Specimen collected in a urinal, bedpan or hat directly into a specimen cup ; sterile urine is not required

Answer 14

Random

Question 15

used when a specimen relatively free of microorganisms is required

Answer 15

Clean catch or Midstream specimen

Question 16

required for accurate measurement of the kidney’s excretion of substances that the kidney does not excrete at the same rate throughout the day

Answer 16

24 Hour specimen

Question 17

Used to collect sterile urine if patient is unable to void or already has a catheter in place

Answer 17

Specimen from a catheter

Question 18

Removal of catheter…

Answer 18

1) delay in voiding for a few hours because the bladder is empty
2) need to save first voided urine for measurement
3) need to increase fluid intake
4) not uncommon to experience some dribbling of urine

Question 19

painful urination

Answer 19

Dsyuria

Question 20

formation and excessive amounts of urine

Answer 20

Polyuria

Question 21

formation and excretion of decreased amounts of urine; urinary output of less than 500 mL in 24 hours

Answer 21

Oliguria

Question 22

formation and excretion of less than 100 mL of urine in 24 hours

Answer 22

Anuria

Question 23

subjective feeling of being unable to delay voiding voluntarily

Answer 23

Urgency

Question 24

occurs when a person voids more often than normal without a significant increase in fluid intake. Also known as overactive bladder

Answer 24

Frequency

Question 25

Voiding during normal sleeping hours

Answer 25

Nocturia

Question 26

Blood in the urine; Visible = frank/gross Not visible= occult

Answer 26

Hematuria

Question 27

Urine contains pus

Answer 27

Pyuria

Question 28

inability to empty the bladder of urine; the person in unable to perceive the feeling of bladder fullness or unable to relax the bladder to pass urine from the body

Answer 28

Urinary Retention

Question 29

Factors affecting bowel elimination…

Answer 29

Nutrition, Fluid Intake, Activity and Exercise, Body Position, ignoring the urge to defecate, Lifestyle, Pregnancy, Medications, Diagnostic procedures, Surgery and Fecal Diversion

Question 30

Nursing diagnosis for bowel elimination…

Answer 30

Constipation, Diarrhea, Perceived constipation and Incontinence

Question 31

Rectal Medication Adminstration

Answer 31

Patient should be in a side lying position
Insert past the internal sphincter or at the end of nurse’s index finger
Aim slightly in a upward direction toward the umbilicus

Question 32

Enema Administration

Answer 32

Position patient on their left side
Insert the lubricated tip of the tubing approximately 4 inches for an adult, aiming towards the umbilicus and slowly instill the solution into the patients rectum
The average adult needs to tolerate approximately 350 mL to 500 mL of solution instilled before expelling the enema
A large enema can be repeated up to three times in succession