Elimination Flashcards by Deleted Deleted

Nutrient absorption and digestion occurs in the ______

Upper GI tract, specifically the small intestine

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The stomach secretes _____

Digestive juices

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The _____ produces bile and the _____ stores the bile.

The liver and the gallbladder

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The lower GI’s function is to:

Absorb water and electrolytes (800-1,000 mL/day)

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3 facts about peristalsis:

1) occurs every 3-12 minutes
2) mass peristaltic movement occur 1-4 times/24 hours
3) 1/3 - 1/2 of ingested food is excreted in 24 hours, the rest within 48 hours

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Opioids effect on elimination:

Decrease G.I. motility, leading to constipation

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Diuretics effect on elimination:

Dry, hard, less frequent stool

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What 2 medications causes loose and frequent stools?

1) antibiotics
2) laxatives

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Stress incontinence:

Leakage of small amounts of urine during physical movement (coughing, laughing, exercising)

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Urge incontinence

Leakage of large amounts of urine at unexpected times, including sleeping

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Overactive bladder

Urinary frequency and urgency, with or without urge incontinence

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Functional incontinence

Prevention of reaching the bathroom, due to physical disability or cognitive problems

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Overflow incontinence

Unexpected leakage of small amounts of urine because of a full bladder

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Retention issues can arise from:

• Obstructions
• Inflammation
• Ineffective, neuromuscular activation within the G.I. tract
• Medication’s

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Fight or flight effects defecation how?

Blood is shunted from the GI tract and movement/peristalsis is slowed down

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Antacids cause the stool to be:

White

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Anticoagulants and aspirin cause the stool to be:

Pink or black due to GI bleeding

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Antibiotics cause the stool to be:

Green or grey; impaired digestion

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Laxatives promote excretion by promoting ______

Peristalsis

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Inhibited peristalsis caused by opioids or antidiarrheals can cause too much what in the large intestine?

Absorption; causing dry stool, and further constipation

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Which medicines can cause diarrhea (excluding assisted excretion from laxatives)

Antibiotics; amoxicillin, antacids, metformin (diabetes med)

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Age of identifying the urge to defecate:

18-24 mo

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Daytime bowel control is gained by:

30 mo

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Infants have around __-__ stools a day

2 - 10

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Why are pregnant women constipated?

• decreased peristalsis • iron prenatal vitamins

What is important to assess during an elimination assessment?

COGNITION

Focused elimination exam/assessment includes asking about what 4 things:

• elimination aids • artificial orifice (colostomy) • recent changes; blood, color • patterns (characteristics of stool)

What does flat contour on the abdomen mean?

Diarrhea

What does a distended or protruded abdomin mean:

Constipation

What quadrant do you listen to first?

Lower Right- and move counterclockwise moving to the Right Upper next

Order of physical abdominal assessment:

1) inspect 2) auscultation 3) palpate

Hypoactive abdominal sounds indicate:

Diminished rate; • abdominal surgery • late bowel obstruction

Hyperactive bowel sounds indicate:

Intense with increased frequency; • diarrhea • early, partial bowel obstruction

Interventions if bowel sounds are inaudible:

Immediate attention; CONTACT PROVIDER

Significant findings for abdominal assessment:

Absent sounds (2+ minutes)

Types of laxatives are:

Bulk forming Osmotic Stimulant Stool softeners Lubricant

Bulk forming laxatives:

Make the stool bigger and softer by absorbing water

Osmotic laxatives:

Increase motility by pulling fluids into intestines and washing things down Example: miraLAX, milk & molasses

Stimulant laxative:

Stimulates nerves in intestines Ex: dulcolax, Senna

Stool softeners:

Decreases the tension between water and fat, lubricating the stool

Lubricant laxative:

Coating still with fat or water to slow down absorption Ex: colace, mineral oil

Examples of antidiarrheals:

Imodium & pepto-bismol

Reasons for an ordered enema:

• prevent involuntary escape during surgery • radiograph or instrument exam in colon • establishing normal routine during bowel training program • acute pain • constipation

Contraindications for enemas:

1) bowel obstruction (you can worsen it) 2) surgery on bowel, prostate or colon; intentional injury- enema could irritate 3) bowel inflammation/infection 4) severe abdominal pain

Why is the patients LOC or dizziness important when assessing prior to enema administration?

The stimulation of the vagal nerve in the anus increases effects of the parasympathetic system; REDUCES HEART RATE- bad if patient is already dizzy

Hypotonic enema

Tap water 500-1,000mL 15 min

Isotonic enema is:

Normal saline solution; not for children

The small volume enema is:

Hypertonic solution, but avoid where Na+ retention can occur to prevent dehydration

Which enema is held in for 30-60 minutes?

Oil retention enema

Which enema should NOT be used on children?

Isotonic, can lead to electrolyte imbalance

Diagnostic tests for elimination issues:

• occult blood • stool culture • biopsy • CT scan • MRI • X-ray

Which imaging test gives a more detailed image of the soft tissues?

MRI- it uses magnetic waves, giving images not just of the bones but the soft tissue

What two procedures require informed consent and why?

1) sigmoidoscopy 2) colonoscopy Informed consent by a doctor because of the anesthesia

3 surgical procedures involving the GI include:

1) hemmorhoidectomy 2) rectal prolapse repair 3) fecal collection systems

Do you need informed consent from a doctor for an upper endoscopy / EGD?

True or false, there can be fecal impact ion and diarrhea occurring together?

True, increase fluids and fiber (30g/day)

Laxatives for constipation:

• bulk forming • stool softening

What is urinalysis used to detect?

Acidity or pH Urine concentration Presence of protein, ketones, blood, pus

Urine culture

Used to detect the presence of bacteria and yeast that may cause a UTI

Specimens required for a urine culture:

Clean specimen; ensuring the genitalia are wiped so they don’t contaminate the sterile urine specimen container. Pee, stop, pee into cup, stop, pull cup away, continue.

24 hour urine collection

• Urine collected over a 24 hour period of time • collected in a special container • refrigerated • determines kidneys function

Clean catch

Used for: • urinalysis and/or urine culture (UTIs) • pee, stop, pee into cup, method

What technique does catheterization require?

Sterile technique to avoid infection

Abnormal constituents in urine:

• blood • pus • protein (albumin) • glucose • ketone • bile • bacteria (gross amounts) • casts

If both BUN and creatinine levels are elevated, that could mean what two things:

1) renal damage 2) heart failure

Pus in urine

Pyuria