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118 - INP > Class 7 - Urinary and Bowel Elimination > Flashcards

Class 7 - Urinary and Bowel Elimination Flashcards

1
Q

UTI

A

urinary tract infection

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2
Q

bypassing

A

a new pathway which is created for the transport of substances in the body

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3
Q

diuresis

A

increased or accessible production of urine

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4
Q

dysuria

A

patients with lower UTI’s may experience pain or burning sensation during urination

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5
Q

urgency

A

sudden and compelling urge to void that cannot be postponed

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6
Q

hematuria

A

blood in urine

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7
Q

feces

A

waste matter discharged from bowels after food has been digested

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8
Q

peristalsis

A

waves of involuntary contraction passing along the walls of the intestines and forcing content onwards

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9
Q

frequency

A

voiding more than 8 times in 24 hrs

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10
Q

hesitancy

A

difficulty initiating urination

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11
Q

how much water do you need per day

A

2 L

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12
Q

residual urine

A

urine is left in bladder after voiding

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13
Q

incontinence

A

involuntary loss of urine

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14
Q

voiding/micturition

A

urination

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15
Q

oliguria

A

a urine output of less than 400 mL in 24 hrs

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16
Q

flatus

A

gas in or from stomach or intestines, produced by swallowing air or by bacteria fermentation

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17
Q

sims position

A

for rectal exams, treatments or enemas. patient lays on their left side, left hip and lower extremity straight, and right hip and knee bent

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18
Q

nocturia

A

getting up at night to void one or more times

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19
Q

polyuria

A

voiding large amounts of urine

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20
Q

fibre

A

the indigestible residue in the diet, provides bulk of fecal matter

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21
Q

impaction

A

results from unrelieved constipation and can lead to overflow incontinence

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22
Q

stool

A

feces

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23
Q

laxatives

A

products that stimulate evacuation of the formed stool from the rectum

24
Q

factors that influence elimination

A
  • age
  • diet
  • position
  • pregnancy
  • Dx. tests
  • fluid intake
  • activity
  • psychological factors
  • personal habits
  • pain
  • medications
  • surgery+anesthesia
25
Q

toileting

A
  • commode
  • bedpans (regular or slipper/fracture)
  • urinals
  • ensure call bell within reach
  • maintain privacy
  • check on client frequently
  • always wear gloves
26
Q

rectal check/examination

A

to assess if stool is in rectum

27
Q

disimpaction

A

manual removal of stool

-within LPN scope with additional practice, depends on facilities rules

28
Q

vagal nerve stimulation

A

anytime there is a disruption in the GI tract. can drop HR and BP, can be fatal

29
Q

administering rectal suppositories

A
  • wash hands and assemble equipment (suppository, gloves, lubricant, TP, paper towel, toilet/commode/bedpan)
  • explain procedure and provide privacy
  • sims position, exposing buttocks only
  • put on gloves, lubricate suppository, index finger of dominant hand, and anal sphincter
  • put toilet tissue in non-dominant hand and lift butt
  • instruct client to breath in deeply
  • gently insert suppository as client exhales as far lubricated finger will go so it is against rectal wall
  • apply pressure to anus for a few seconds
  • ask client to try to hold for 15-30 mins
  • remove gloves, wash hands
  • ensure safe and comfortable
  • assist with toileting
  • report and record procedure and results
30
Q

glycerine suppository

A
  • contains no medication
  • osmotic laxative (pulling fluid from body into bowel)
  • mild action, does not cause irritation
  • takes 15-20 mins
31
Q

dulcolax (bisacodyl) suppository

A
  • contains medication
  • increase peristalsis by irritating the rectum (stimulant)
  • promotes fluid accumulation in the rectum (osmotic)
  • takes 15-60 mins
32
Q

sodium phosphate “fleet” enema

A

all the same steps as rectal suppository administration.

  • gloves and supplies, wash hands and assemble equipment
  • enema, gloves, lubricant, TP, paper towel, under pad, bath blanket, toilet/bedpan/commode
  • explain procedure + privacy
  • sims position
  • remove enema cap and expel air, lube nozzle and anal sphincter
  • TP in non dominant hand
  • insert nozzle as far as it will go as client exhales
  • slowly and firmly squeeze entire contents into rectum
  • stop for a few seconds if client experiences discomfort or if fluid is leaking (DONT REMOVE)
  • with-drawl nozzle when completely instilled and apply pressure to anus for a few seconds
  • remove gloves and dispose of equipment
  • ask client to hold enema as long as possible
  • ensure safe and comfortable
  • assist with toileting
  • report and record procedure and results
33
Q

Hx

A

history

34
Q

Ca

A

Cancer

35
Q

microlax enema

A
  • must do rectal check first as it only works if there is stool in the rectum
  • causes stool to break into smaller pieces; does not irritate bowel wall.
  • maintain pressure on the container as you remove
  • works in 5-20 mins
36
Q

what can a nurse diagnosis for bowel care

A

bowel incontinence, constipation, diarrhea

37
Q

how much can the bladder hold

A

up to 1500 mL

38
Q

how much urine is regular to void every hour

A

30 mL

39
Q

what can a nurse diagnosis for bladder care

A

urinary incontinence, urinary elimination

40
Q

factors that affect urination

A
  • urge to void @ 150-200 mL
  • growth and development
  • socio-cultural
  • psychological
  • personal habits
  • muscle tone
  • pathological
  • surgical procedures
  • medications
  • Dx. exams
41
Q

straight catheter

A

inserted through the urethra, drains bladder and then is removed

42
Q

indwelling/foley catheter

A

inserted through urethra balloon inflated to prevent catheter from slipping out - left in bladder - connected to drainage bag

43
Q

suprapubic catheter

A

surgically inserted through abdomen above the pubic bone into the bladder

44
Q

catherization: indications

A
  • before, during and after surgery to keep bladder empty
  • observe hourly output with very ill person
  • last resort for incontinence to protect skin
  • client is too weak to used bedpan, commode, toilet
  • collect sterile urine specimen, measure residual urine
45
Q

closed drainage system

A
  • used for indwelling catheters and suprapubic catheter
  • the urinary system must remain STERILE in order to avoid infection
  • a UTI is one of the most common causes of delirium in the elderly
46
Q

catheter care

A

medical asepsis, standard precautions

  • do not allow bag to touch floor
  • urine must flow freely - avoid kinks in tubing, ensure client does not lay on it
  • keep drainage bag below bladder
  • attach drainage bag to bed frame, not rail
  • tubing should not loop below drainage bag
47
Q

guidelines for catheter care

A
  • secure tubing on leg and linen
  • check for leaks
  • ensure tubing slack when moving client
  • move bag to side of bed that client will be turned toward before turning resident
  • drainage system remains closed except to change bag
48
Q

catheter assessment

A
  • colour, amount, quality (odour, sediment, blood)
  • taped in place
  • pain, burning, urge to urinate, red irritation of meatus
49
Q

catheter pericare

A
  • morning, hs, after BM
  • treat catheter as a urethral extension (cleanse from clean to dirty)
  • wash and rinse urinary meatus first
  • wash, rinse and dry around catheter away from meatus down catheter tubing for 10cm
  • proceed with normal pericare
50
Q

catheter drainage bag emptying

A
  • wash hands and gather supplies
  • clean gloves, paper towel, graduated cylinder
  • explain procedure and privacy
  • put paper towel under measuring cup on floor
  • apply gloves
  • open drain, allow urine to drain into cup
  • dont let drain touch cup
  • close clamp
  • assess urine, empty into toilet, clean cylinder
  • remove gloves, wash hands, document
51
Q

switching day/night or night/day catheter

A
  • wash hands and assemble equipment
  • leg bag/long sock or night bag, gloves, alcohol swabs, bag caps, specimen container
  • explain and give privacy
  • apply leg bag below knee and oversock
  • ensure drainage cap is closed
  • apply disposable gloves
  • use alcohol swab and wipe connecting tubing for 30 seconds between the catheter and old drainage bag and the connection to the new bag
  • disconnect catheter from old bag tubing
  • do not touch ends of any tubes to each other
  • place cap on old bag, remove cap from new bag
  • connect catheter, cleanse cap with alcohol and store in specimen container. secure catheter to leg (day bag)
52
Q

cleaning urinary drainage bag

A
  • wash hands and assemble equipment
  • disposable gloves, alcohol swabs, detergent, vinegar,
  • apply clean gloves
  • take drainage to the bathroom
  • drain urine into toilet
  • re-clamp drainage bag
  • remove cap from drainage tubing and place in specimen container
  • pour solution into drainage tubing (2 drops of detergent with tuberculin syringe, draw up one week supply in syringe, add tap water so bag is half full- swish together)
  • open drain at bottom of bag to drain into toilet
  • rinse with tap water until soap is gone
53
Q

disinfecting the catheter bag

A
  • pour mixture of 1 part vinegar, 4 parts H2O in drainage bag
  • swish, rub together
  • drain disinfectant but do not rinse
  • clean cap and end of tubing with alcohol - recap drainage tubing
  • hang up the drainage bag in residents washroom or cloth bag at bedside according to facility policy
  • remove gloves, wash hands
54
Q

external condom catheter

A
  • rubber sheath with a short tube for attaching drainage tubing
  • not a sterile procedure
  • non invasive
  • used by men with incontinence
  • promotes comfort and decreases skin irritation
55
Q

external condom catheter application

A
  • wash hands and assemble equipment
  • condom and foam tape; urine collection bag/leg beg and strap (sock to apply, leg bag over), disposable gloves, peri-care supplies
  • explain procedure and privacy
  • resident in supine position, only penis exposed
  • apply gloves, provide peri-care, assess penis
  • roll condom over entire length of penis (leave 2-3 cm slack at head of penis)
  • apply foam adhesive tape in a spiral motion toward the body
  • do not overlap tape or tape head of penis/pubic hair
  • connect drainage bag and tubing to end of condom
  • remove gloves and wash hands
  • at night connect tubing to a larger urine collection bag “night bag”
  • throw condoms away after each use
  • clean urine bag and tubing daily and discard once a week as per agency policy
56
Q

removal condom catheter

A
  • wash hands and assemble equipment
  • explain procedure and privacy
  • apply gloves
  • break foam tape in several places
  • roll condom off, place cap on drainage tube connector
  • wrap condom in paper towel, dispose
  • provide peri-care and assess penis
  • clean drainage bag

118 - INP (16 decks)

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