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Essentials of Nursing > Exam 3 > Flashcards

Exam 3 Flashcards

November 25th

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1
Q

Nursing interventions for acute urinary problems

A

keep elimination habits similar
medication to stimulate detrusor muscle contractions
catheterization

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2
Q

How can medications influence urination

A

diuretics (increase urine)
sedatives (incontinence)
can change urine color

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3
Q

Types of catheter lumen materials

A

plastic- intermittent only
latex- 3 weeks max
silicon/teflon- long term (2-3 mos)

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4
Q

What does nil per os mean

A

nothing by mouth; NPO patients

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5
Q

How often do you perform mouth and nares care for NG tube

A

every 2 hours

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6
Q

What are indications for an intermittent catheter used

A

one time use
to relieve bladder distention to if clean catch sample is not a possibility
assess residual urine (if no bladder scan)

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7
Q

What type of urine specimen collection cannot be delegated

A

sterile specimen (catheter)

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8
Q

What are delegated tasks related to catheterization

A

report if pt has pain, leakage, or abnormal urine
empty drainage bag
perineal care

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9
Q

What are some ways to prevent CAUTI

A

keep closed drainage system
empty urine bag when 1/2 full
clean spigot
perineal care every 8hrs

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10
Q

Salem Sump characteristics

A

double lumen
air vent “pigtail”
for decompression/ lavage
decreased risk of gastric mucosa damage
main lumen connects to suction

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11
Q

Characteristics of elderly bowel movements

A

-decreased peristalsis, weakened anal sphincters, esophageal emptying slows
-decreased ability to thoroughly chew food

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12
Q

When would you start over a 24 hours urine collection

A

if contaminated or missed collection

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13
Q

When might NPO diet be necessary

A

after surgery, blockage, bleeding

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14
Q

Why is it critical to change ostomy bag?

A

for skin integrity (ileostomy enzymes/acids)
assess stoma
prevent odors
increase self esteem/comfort

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15
Q

Part of small intestines that absorbs water, fat, iron, and bile

A

ileum

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16
Q

What is a urostomy

A

continuously drains urine into collection pouch
urine drains from ureter –> intestine –> stoma

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17
Q

What are restorative care interventions for urinary problems

A

pelvic floor muscle training
lifestyle changes
voiding schedule
bladder retraining (mentally)

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18
Q

Nursing interventions for impaired bowel movements

A

establish toileting routine
encourage fluid intake
review dietary intake (need fiber)
enema to promote bowel cleansing

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19
Q

Why might a patient have a disturbed body image r/t bowel movements

A

bowel divisions (colostomy)
refusal to learn how to use it

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20
Q

What are some possible consequences of a catheter irrigation

A

irrigation solution doesn’t return
bright red blood (notify provider)
pain from clots of kinked tube

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21
Q

What are catheter irrigations

A

after bladder surgery
flush that remove clots/sediment from entering catheter
continuous or intermittent
must have closed catheter system to prevent infection
keeps catheter patent

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22
Q

Part of GI tract that allow storage, mixing, and emptying

A

stomach

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23
Q

Nursing diagnosis for diarrhea and cause

A

malabsorption. bloating, cramping, loose stools
r/t antibiotics, antidepressants, antacids, oral hypoglycemics

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24
Q

What are nursing interventions for urge urinary incontinence

A

limit nighttime intake, avoid bladder irritants, strengthen pelvic floor

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25
Q

What are some sociocultural factors that influence urination

A

Gender (men w/ enlarged prostates & women w/ pelvic prolapse)
Bathroom privacy and school/work environment

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26
Q

Type of hemorrhoid with visible purple thrombosis

A

external hemorrhoid

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27
Q

Type of hemorrhoid in anal canal with inflammation or distention

A

internal hemorrhoid

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28
Q

What are complications of NG tube placements

A

resistance= move steadily
vomiting= clear airway
gag=withdraw slightly on insertion
respiratory distress= remove tube to back nasopharynx

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29
Q

Purpose and steps to Kegel exercises

A

strengthens pelvic floor muscles
1) stop urination midstream
2) tighten muscles as if lifting a marble (don’t hold breath)

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30
Q

Process of an enema

A

for diagnostic tests or constipation
doesn’t require sterile technique
pt lays on left side/right knee flexed (Sim’s)
use warm solution

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31
Q

What part of catheter irrigations can be delegated

A

pain, discomfort, change in urine, leakage

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32
Q

How is urinary issues related to a nursing diagnosis of impaired skin integrity

A

constant moisture from incontinence can lead to skin breakdown/irritation

becomes an infection risk

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33
Q

How can medications influence bowel movements

A

opioids slow peristalsis
antibiotics decrease intestinal bacteria=diarrhea
laxatives promote defecation
cathartics control diarrhea

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34
Q

What type of procedure is classified as a urinary diversion

A

urostomy

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35
Q

What type of patients might require an intermittent catheter

A

spinal injury
neuromuscular degeneration
incompetent bladder

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36
Q

What should you do if the irrigation solution doesn’t return

A

reposition patient
check for kinks
use a new syringe to passively return/empty

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37
Q

Nephrostomy

A

tubes go through skin to the renal pelvis (on back)
drains renal pelvis if ureters are obstructed

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38
Q

Reasons that constipation may occur

A

improper diet
reduced fluid intake
meds
lack of exercise

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39
Q

Term for unformed stool than can lead to skin breakdown

A

diarrhea

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40
Q

What is effluent?

A

fecal material

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41
Q

What type of ostomy has less odor and a liquid consistency

A

ileostomy

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42
Q

Term for unrelieved constipation; stool cannot be expelled in rectum

A

Impaction

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43
Q

What can bowel impaction turn to if left untreated

A

intestinal obstruction

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44
Q

Coudé catheter characteristics

A

single lumen
stiffer
curved tip, easier to guide, less traumatic

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45
Q

How do you verify NG tube placement

A

ask patient to talk
X-ray confirmation
aspirate syringe for gastric contents (<5 pH)

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46
Q

What are nutrition changes for an ostomy

A

low fiber at first
eat slow/chew completely
10-12 water glasses daily
avoid gassy foods

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47
Q

Term for temporary or permanent abdominal wall opening

A

bowel diversion
(stoma and ostomy)

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48
Q

Urge incontinence

A

overactive urge to pee; muscles will contract and urine won’t stop once it begins (nocturia)

49
Q

What is a suprapubic catheter

A

surgically inserted if flow blockage through urethra
long term intervention

50
Q

Double Lumen NG Tube characteristics

A

large bore; 12+ French
for gastric decompression or removing gastric secretions
Salem sump

51
Q

Functional incontinence

A

incontinence not related to urinary tract issues
mobility issues, cognitive impairment, environmental barriers

52
Q

What are symptoms of bowel impaction

A

oozing liquid stool seeping around mass
loss of appetite
distention
cramping

53
Q

How does growth and development influence urination

A

gain voluntary bladder control @ 18-24 months
decreased bladder capacity in elderly

54
Q

Single Lumen NG Tube characteristics

A

fine/small bore
for med and enteral feedings

55
Q

Characteristics of infants bowel movements

A

-infants have a smaller stomach capacity, less enzymes, faster peristalsis
-can’t control defecation until 2-3 yrs

56
Q

Part of small intestines that absorbs carbs, proteins, electrolytes

A

jejunum

57
Q

What type of urine specimen collection can be delegated

A

midstream specimen

58
Q

How do you document I’s and O’s for NG tube

A

Intake: irrigation solution
Outtake: gastric drainage

59
Q

What are nursing interventions for stress urinary incontinence

A

Kegel exercises, stop smoking (prevents coughs), empty bladder completely

60
Q

What type of ostomy increased risk of electrolyte imbalance

A

ileostomy

61
Q

What is the process of discontinuing a NG tube

A

assess for bowel sounds (disconnect suction)
standard precaution
pt takes deep breath, kink tubing, steadily remove
After: assess abdomen tenderness, N/V, nostrils

62
Q

Ways to maintain an NG tube

A

mouth care every 2hrs
NPO
maintain patency= turn frequently

63
Q

What is collected during 24 hour urine sample

A

hour 0 (1st void) not collected
all in between collected
hour 24 collect last sample

64
Q

What are some nursing urinary interventions for elderly

A

educate on making a void schedule
adequate hydration
empty bladder before/after meals
limit fluids 2 hrs before bed

65
Q

Part of small intestines the gets fluid from the stomach

A

duodenum

66
Q

How do diagnostic tests influence bowel movements

A

colonoscopies require laxatives to fully empty bowel
will have increased gas and soft stool

67
Q

Acute urinary retention

A

sudden onset
from an infection or post surgical (anesthesia/meds)

68
Q

Stress incontinence

A

urine leaks because of an incompetent urethral sphincter
high intra abdominal pressure during coughing, laughing, exercise

69
Q

What is another name for intermittent catheters

A

straight catheter
single lumen

70
Q

What is post void residual and how is it measured

A

urine left in the bladder after voiding
can be seen with a bladder scan

71
Q

How can fluid and diet intake influence bowel movements

A

fiber absorbs fluid=softer stool
whole grains, fruits, veggies are high fiber foods
may produce gas which increases colon motility

72
Q

How can psychological factors influence bowel movements

A

emotional stress increases peristalsis
possible diarrhea and gas distention
depression slows peristalsis= constipation

73
Q

Overflow incontinence

A

bladder is overdistended/ full but cannot fully empty (retention) due to a urethral blockage

74
Q

What are possible complications of NG tube removal

A

abdominal pain
sore throat
aspiration

75
Q

Nursing diagnosis for constipation and cause

A

no stool for several days, hypoactive bowels, firm abdomen
r/t pain meds, decreased fluids, decreased mobility

76
Q

How to place in patient

A

place patient in High Fowler’s
start titling their head back
then tilt forward
swallow so epiglottis blocks trachea

77
Q

Term for involuntary urine leakage

A

urinary incontinence

78
Q

Term for dilated/engorged veins

A

hemorrhoids

79
Q

Term for inability to completely empty bladder

A

urinary retention

80
Q

How does pain influence bowel movements

A

hemorrhoids, rectal surgery, and fissures= defecation discomfort

81
Q

Pathological factors that influence urination

A

spinal cord injury, enlarged prostate, neurological deficits

82
Q

Levin Tube characteristics

A

single lumen
no pigtail air vent
for meds, tube feeding, decompression

83
Q

Who Is ask risk for bowel impaction

A

debilitated, confused, unconscious patients

84
Q

What are nursing interventions for UTI/infection prevention

A

educate on proper hygiene/UTI symptoms
promote voiding at regular intervals

85
Q

How can physical activity influence bowel movements

A

increases peristalsis
maintain muscle tone= able to increase intrabdominal pressure to open sphincter

86
Q

When would a coudé be beneficial

A

enlarged prostate

87
Q

Term for inability to control feces/gas

A

incontinence

88
Q

What can lead to increased risk of hemorrhoids

A

straining, pregnancy, heart failure, chronic liver disease

89
Q

How does positioning during defecation influence bowel movement

A

difficult to go if supine
lean forward, extra intrabdominal pressure, gluteal muscles contract

90
Q

Purpose of NG tube

A

decompress GI tract (obstruction)
enteral feeding
GI bleed
lavage (poisoning)

91
Q

Indications for short-term indwelling catheter

A

2 weeks or less
urine obstruction (ex. prostate enlargement)
after bladder or urethral surgery
prevent obstruction from blood clots after genitourinary surgery
measure urine output of critically ill

92
Q

How are UTI’s related to iatrogenic procedures

A

(in hospital procedure)
catheter (CAUTI) or invasive diagnostic procedure due to break in sterile procedure

93
Q

How does fluid intake influence urination

A

caffeine and alcohol= diuretic effects

94
Q

How does pregnancy influence bowel movements

A

fetus increases= increased rectal pressure
peristalsis slows in 3rd trimester
hemorrhoids from straining

95
Q

Understand the process of digital removal of stool

A

if enema fails; used for impaction
liquid stool oozes/abdominal distention
can possibly stimulate vagal n. = bradycardia/hypotension

96
Q

Who would benefit from a condom catheter

A

patients with spontaneous bladder emptying (incontinence/nocturia)

97
Q

How does surgery and anesthesia influence bowel movements

A

anesthetics temporarily shuts down peristalsis

98
Q

What type of ostomy is odorous due to bacteria and semi liquid/solid

A

colostomy

99
Q

Part of GI tract that digests using chyme and absorbs nutrients

A

small intestines

100
Q

Term for when gas accumulates in intestines causing fullness, pain, and cramping

A

Flatulence

101
Q

What are the physiological steps of elimination

A

intestinal contents trigger peristalsis
stool in rectum causes distention
sphincter relaxed
abdominal muscles contract

102
Q

How do you measure the NG tube

A

tip of nose –> earlobe –> xiphoid process

103
Q

How does the French sizing work for catheters

A

the larger the number the larger the lumen and tube circumference

104
Q

Indications for long-term indwelling catheter

A

1 month or more
severe urinary retention & UTIs
skin rashes, ulcers, wounds that are irritated by urine
comfort for terminal illness

105
Q

What part of the GI tract blocks airway when food enters

A

epiglottis

106
Q

What are physical/bodily factors that influence urination

A

pregnancy
overweight/obese (increased abdominal pressure)

107
Q

Process of NG tube irrigation

A

aseptic technique
confirm tube placement
saline syringe into irrigation tube/install
If resistance: check for kinks, pt on left side
aspirate fluid
reattach to suction

108
Q

Chronic urinary retention

A

from medication
a progressive blockage (prostate)
neural pathway interruption (stroke, MS, trauma)

109
Q

Term for bowel diversion of large intestines

A

colostomy

110
Q

How does surgery influence urination

A

pelvic surgery or anesthesia inhibit micturition reflex

111
Q

Term for bowel diversion of small intestines

A

ileostomy

112
Q

Contraindications for NG tube

A
  • head/neck trauma (can lead to intracranial insertion)
  • nasal surgery
  • Hx of alcoholism (esophageal varices)
113
Q

What are the benefits of Kegel exercises for men/women

A

Men: improve fecal/urinary incontinence & erectile dysfunction
Women: improve fecal/urinary incontinence & painful sex

114
Q

what part of the large intestines absorbs, secrete, and eliminates food blouses

A

colon

115
Q

Orthotropic neobladder

A

creation of a new bladder from part of the intestines
used if there is disease in the bladder or cystectomy

116
Q

What are possible causes of bowel incontinence

A

cognitive impairments
C. Diff
food intolerance

117
Q

What are the components of a triple lumen catheter

A

urinary drain connected to collection bag
balloon connector
irrigation/instillation

118
Q

Pathway of the NG tube in the body

A

enter nares
pass nasopharynx
pass through esophagus
goes to stomach

119
Q

How can personal habits affect bowel movements

A

busy schedules don’y allow regular elimination habits

Essentials of Nursing (2 decks)

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