Exam 2 - Elimination Flashcards
what system wants to store urine?
sympathetic
what system wants to eliminate urine?
parasympathetic
what does acH do to the urinary sphincters?
relaxes them
what is the equation for adequate output per hour
0.5 to 1.0 ml per kg
use pt weight
what is the average output per hour
30 ml
what percent of long term care residents have urinary incontinence?
50 - 75%
what percent of the community have urinary incontinence?
20% (38% women)
how does age effect urinary incontinence
worsening bladder innervation
sphincter control loss
decreased bladder elasticity
what are the different types of urinary incontinence?
stress urge mix functional overflow reflex
what is stress incontinence
inadequate sphincter control
caused by coughing and sneezing
what is urge incontinence
overactive bladder
uncontrollable detrusor contractions
what is mixed incontinence
urge and stress together
what is overflow incontinence
incomplete bladder emptying
no urge, just happens
what is reflex incontinence
muscle spasms and leaks urine with no urgency
what is functional incontinence
inability to reach bathroom on time
treatment of urge incontinence
detrol, ditropan
anticholergenics that reduce bladder spasm
treatment of overflow incontinence for men
proscar
flomax
TURP
what is proscars action
reduce prostate size
androgen inhibitor
what is flowmax action
peripheral anti androgenics
reduce the contraction of smooth muscle
TURP
trans uretheral resection of the prostate
treatment of overflow incontinence in women
kegal
pessary
surgery
treatment of stress incontinence
botox
estrogen
duloxetine
what does duloxetine do?
increase sphincteral contraction
what are diagnostic reasons to insert a catheter
specimen collection
strict output measurements
what are therapeutic reasons to insert a catheter
urinary retention comfort care for those terminally ill wound healing surgery immobility
what are some urinary incontinence complications
skin breakdown poor wound healing falls dehydration institutionalizing decreased social interaction poor adherence depression
what are the different types of catheters
straight foley/indwelling coude condom suprapubic
risks with catherization
infection
trauma to urethra
bladder retraining
what is the normal pH of a urinalysis
between 4.6 and 8.0
what type of laxative would be appropriate for a patient who you wouldn’t want to strain, such as someone who has had an MI.
stool softener such as colace or metamucil
which laxative is used to prep for a colonoscopy?
colyte
what type of laxative allows mass to be added to stool and used in watery diarrhea
metamucil
what laxative allows you to have it at night and have results in the morning?
dulcolax (bisacodyl)
which laxative is least harmful when used for a while
metamucil because it just adds fiber
which laxative gives a lot of stimulus to initiate peristalsis
dulcolax
sinnacot (sennosides)
stimulant laxatives
which laxative should be avoided for renal failure
magnesium ones
which laxative causes a gelatinous mass to form and lodge into the esophagus if it is not taken with enough water
metamucil
follow up with another glass or water
which laxative may decrease absorption of antibiotics
any except stool softeners
which laxative causes dependence
the stimulants
which laxative and which route allows for quickest results?
dulcolax suppository
what happens if you give a stimulant laxative on an empty stomach
it will work faster
name a laxative that can be given rectally and PO
dulcolax
docusate
what type of laxative may cause electrolyte imbalance?
milk of magnesia
what type of laxative requires you to not eat at least 2 hours before?
osmotic - golytely and colyte
how does aging effect the GI system?
slowing peristalsis slowing motility slowing gastric secretions decreased sensation to defecate reduced strength in pelvic muscles
what type of blood tests are run to look at urinary system function?
BUN creatine electrolytes GFR TSH Ca Glucose
what does the BUN test tell you?
how much urea nitrogen is in the blood
indicates how the kidneys and liver are functioning
what is the TSH test tell you?
how the thyroid is working
what is the creatine blood test telling you?
kidney function
what does the bladder scanner and postvoidal residual tell us?
how much urine is left in the bladder
what does uroflowmetry tell us
urine speed and volume
what does cystometric tell us
quantity of urine in bladder and pressure in the bladder
what does cystoscopy tell us
visual examination of urethra and bladder with scope
what does voiding cysturethragram (VCUG) show
able to visualize urthravesicular angle
what does intravenous pyleogram (IVP) show us?
X-rays of kidney and bladder using contrast
what are the types of enemas
tap or soap saline fleets lubricants return flow
what position should the patient be in for an enema
left lateral sims position
how far should the tip go in for an enema
3-4 inches
how many ml should be administered in an enema
750 to 1000
why should a tap water enema not be administered repeatedly?
in fear or toxicity or circulatory overload
what do soapsud enemas do?
cause intestinal irritation
what are the precautions for a soapsud enema?
it can lead to electrolyte imbalance and damaged in pregnant and elders
what is a safer alternative to a soapsud enema?
normal saline
what enemas relieve flatulence and abdominal distension
return flow
carminative
what type of medicated enemas are there?
neomyocin
why do we give medicated enemas?
reduce bacteria in the bowel
what is a fleet enema?
slows absorption of water from the stool
what causes hemorrhoids
extreme pressure on veins that cause them to swell
what is a rectocele
weakening of area between ass and vagina
prolapsed rectum
falling out butthole
what does a guaic stool test fo
blood in the feces
abdominal xray
obstruction
labs
thyroid function
electrolytes
cbc
