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BSNC 2000 > Elimination > Flashcards

Elimination Flashcards

1
Q

Melena

A

black stools d/t gi bleeding

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2
Q

Hematochezia

A

red blood in stool

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3
Q

Normal Bristol stool

A

3-4

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4
Q

Constipated Bristol stool

A

1-2

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5
Q

Diarrhea Bristol stool

A

5-7

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6
Q

Types of Incontinence

A 
Urge
Stress
Overflow
Functional 
Mixed
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7
Q

Location of Micturition Reflex

A

Sacral region

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8
Q

Location of Sympathetic Nerves

A

Thoracolumbar

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9
Q

Location of Parasympathetic Nerves

A

Cranial/Cervical, Sacral

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10
Q

Definition & Causes of Urge Incontinence

A

sudden, intense need to void

neurogenic bladder

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11
Q

Definition & Cause of Stress Incontinence

A

small increase in intraabdominal pressure –> voiding
multiple vaginal births
weak pelvic floor muscles

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12
Q

Definition & Causes of Overflow Incontinence

A

overdistended bladder leads to small leakage throughout the day
benign prostatic hyperplasia

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13
Q

Functional Incontinence

A

caused by a functional impairment that prevents someone getting to the bathroom in time

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14
Q

Bladder anatomy

A

body = stores urine
neck = continuous with urethra
trigone area = triangular area of ureteral openings & urethra

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15
Q

Parasympathetic receptors

A

muscarinic (M)

nicotinic (N)

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16
Q

N receptors

A

located in the synapses of SNS/PNS neurons at the motor end plate of striated muscle fibers @ the external sphincter or pelvic floor

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17
Q

M receptors

A

located in the post-ganglionic parasympathetic endings of detrusor muscle

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18
Q

A-1 receptors

A

sympathetic receptor located in the trigone area

contraction = prevent bladder emptying

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19
Q

B-2 receptor

A

located in the detrusor muscle

increase relaxation = increase storage capacity

20
Q

Vesicoutereal reflux

A

when urine backflows from bladder to kidneys via the ureters

21
Q

Ureter anatomy

A

do not have valves

enter the bladder posteriorly @ an oblique angle. bladder expansion occludes the ureter preventing backflow

22
Q

Etiology of bladder obstruction

A 
BPH
Gonorrhea/STI's
bladder tumors
constipation, fecal impaction 
poor pelvic floor support
23
Q

Bladder diverticulae

A

outpouchings that form when inner layers of the bladder herniate through the serosa
lack muscle fibers –> noncontractile
contribute to urinary stasis and infection

24
Q

Excretion definition

A

excretion of waste (urine/stool) from the body

25
Q

Parasympathetic innervation

A

controls contraction of the detrusor muscle and internal sphincter
promotes urination

26
Q

Sympathetic innervation

A

promotes relaxation of the detrusor muscle and trigone area

promotes bladder retention

27
Q

Somatic innervation

A

controls relaxation/contraction of the external sphincter

28
Q

Pontine Storage center

A

located in the brainstem

receives afferent stimuli from bladder

29
Q

Pelvic nerve

A

innervates detrusor muscle

30
Q

Pudendal nerve

A

innervates external sphincter

31
Q

Bladder volumes

A

150 mL = sensation of needing to go (can be delayed)
400-500 mL = full bladder
700 mL = painful. may cause overflow

32
Q

Determinants of urinary elimination

A 
intake/output of fluids
renal perfusion (determines GFR)
GFR 
nephron function
bladder capacity 
unobstructed flow
functional bladder, sphincters, pelvic floor muscles
intact neurological function
33
Q

Aging & Urinary elimination

A 
decreased nerve function 
muscular atrophy --> weak pelvic floor muscles
altered fluid intake
polypharmacy
co-morbidities
BPH (men)
decreased kidney function (decreased GFR)
decreased mobility/cognition
34
Q

Post residual volume

A

volume remaining in bladder post-void
usually <50 mL
increases with age

35
Q

DIAPPERS acronym

A 
causes of urinary incontinence
D
I
A
P
P
E
R
S
36
Q

Oxybutynin MOA

A

anticholinergic drug. inhibits action of acetylcholine @ post-ganglionic receptors.
used to treat neurogenic/overactive bladder by inhibiting contraction of GU smooth muscle.

37
Q

Oxybutynin therapeutic effects

A

increased bladder capacity
delayed desire to void (decreases sensory input)
decreased urge incontinence, urinary urgency, frequency

38
Q

Neurogenic bladder

A

disruption in the neural pathways can cause either

1) overactive bladder (increased spasticity –> urge incontinence)
2) areflexic bladder (lack of contractions –> overflow incontinence)

39
Q

Loperamide MOA

A

aka Imodium
antidiarrheal. inhibits nervous stimulation of GI wall decreasing peristalsis, prolonging GI transit time & increasing absorption.

40
Q

Loperamide Therapeutic fx

A

decreased diarrhea
decreased fecal volume
decreased loss of fluid & electrolytes

41
Q

Normal urinary findings

A 
SG: 1.010-1.025
pH: 4.5-6.5 (acidic)
straw color
output: 30 mL/hr 
no bacteria, protein, RBCs, glucose
42
Q

Urinary Incontinence Interventions

A

voiding diary
limit fluids 2-3 hrs before bed/outings
limit caffeine, alcohol, carbonated drinks (diuretics)
time/prompted voiding
bladder retraining
biofeedback –> electrical stimulation of pelvic area
kegel exercies/physiotherapy

43
Q

Fecal Incontinence Interventions

A 
limit caffeine, alcohol (diuretics)
limit fatty foods, dairy, spicy food (if diarrheic) 
increase fiber intake 
kegel exercises
timed voiding
44
Q

Geriatric absorption

A

increased gastric pH
decrease in absorption, GI secretions, motility
decreased peripheral perfusion

45
Q

Geriatric distribution

A

decreased CO, peripheral perfusion –> decreased distribution
decrease in muscle mass, increase fatty tissue
reduced plasma albumin levels –> enhanced drug fx

46
Q

Geriatric metabolism

A

decreased hepatic & renal function

reduced first-pass metabolism

47
Q

Geriatric excretion

A

decreased renal function –> decreased excretion

BSNC 2000 (9 decks)

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