Exam 3- Urinary/Bowel Elimination

Question 1

What are other terms used for urination?

Answer 1

Micturition, Voiding (conscious control process)

Question 2

What is an alarming amount of urine output (cc) and what is pt at risk for?

Answer 2

If pt output is LESS THAN 50 cc/hr call Dr. The normal is 125 cc/hr. Risk b/c if <50 cc/hr pt may be going under RENAL FAILURE

Question 3

How many times are neonates urinating and what is their urine like?

Answer 3

25 x per day, VERY LOW sp. gr (1.008), dilute urine- clear, light, watery, prod. 8-10 saturated diapers/day

Question 4

What is a common thing toddlers do in regards to urination?

Answer 4

ENURESIS- bed wetting episodes are common, even after TT has been established.

Question 5

When should toddler begin to control bladder during the day?

Answer 5

24 mo-3 years. learning to control micturation. Be sure not to punish child.

Question 6

When should a toddler have full control of bladder?

Answer 6

3-5 years old. By age 6, FULL CONTROL of urination.

Question 7

What are urinary changes in older adults?

Answer 7

1. Decreased kidney functioning
2. Polyuria- urgency and frequency
3. Loss of bladder elasticity & muscle tone- leads to nocturia, incontinence & incomplete emptying of bladder
4. Enlargement of prostate

Question 8

What are the different types of UI or involuntary leakage of urine/loss of bladder control?

Answer 8

1. Transient UI- arrives suddenly, lasts 6 mo or less.
2. Stress
3. Urge
4. Reflex
5. Retention w/overflow- bladder can only stretch so much therefore body will push urine out
6. Functional Incontinence

Question 9

What are 4 common effects of altered urinary elimination?

Answer 9

1. Urinary retention
2. Bladder distension
3. Urinary Incontinence
4. UTI

Question 10

What does a pt with urinary retention look like?

Answer 10

restless, uncomfortable, diaphoresis. The bladder may be distended r/t obstruction in urethra or med and pt c/n urinate

Question 11

When can a nurse palpate the bladder?

Answer 11

When the bladder is distended because it is then raised over the pubic symphysis

Question 12

Why should you encourage fluids?

Answer 12

h20, cranberry juice, and foods that acidify urine are essential to reduce risk of UTIs or the formation of Ca+ based kidney stones

Question 13

What makes up 40% of all nosocomial hospital acquired infections?

Answer 13

UTI’s. Most due to catheterization.

Question 14

How much residual urine is normal?

Answer 14

The amount of urine remaining in bladder after urination is: 50-100 cc

Question 15

What are S and Sx in a pt acquired UTI?

Answer 15

1. Dysuria
2. Polyuria
3. wants to but c/n= hesitation
4. MALAISE- don’t feel well
5. Hematuria- blood in urine
6. Can spread from bladder-ureters-kidneys= tenderness in kidneys, flank pain, fever, tenderness, chills
7. CONFUSION in elderly wome

Question 16

What is the most common type of Urinary incontinence?

Answer 16

STRESS INCONTINENCE- weakening of pelvic floor muscles therefore with pressure, laughing, sneezing, couging, excretes urine without control.
PATIENT TEACH: KEGEL/PME- 10x, 3 x a day. Do before any activity that increases intra-abdominal pressure

Question 17

What is the average amount adults should urinate?

Answer 17

5-6x per day

Question 18

What is the first stool in a baby called and what does it look like?

Answer 18

MECONIUM- green, black, tarry lasts 24-48 hrs

Question 19

Breast fed stool versus formula stool?

Answer 19

Breast fed- golden yellow, curdled, liquidy and more frequent
Formula- tan colored, 1-3x per day

Question 20

What should you teach a patient 3 days before they need a fecal occult blood test?

Answer 20

That certain foods and vitamins can cause faulty results.

1. Vitamin C- 250 mg
2. Red meat- beef, lamb, liver, and processed meat
3. Raw veg or fruits- radishes, turnips, horseradish, melons
4. Certain meds that irritate the gastric mucosa and cause bleeding (aspirin or other nonsteroidal anti-flam., drugs, steroids, and anticoagulants)

Question 21

What is the difference between occult blood and Frank’s blood?

Answer 21

most frequent performed fecal analysis, hidden blood. Frank’s is visually able to see in feces.

Question 22

What are 6 alterations to a BM?

Answer 22

1. Diarrhea- most common, liquidy/watery
2. Constipation- hard, dry feces
3. Fecal Impaction- unrelieved constipation with liquids/food around it (oooze)
4. Bowel Incontinence- involuntary passage of stool
5. Flatulence- bloating, distension, and passage of gas
6. Hemorroids

Question 23

What age groups are at risk for diarrhea and dehydration?

Answer 23

Babies and the Elderly

Question 24

If pt has diarrhea, what kind of diet is a BRAT diet to help?

Answer 24

Bananas, Rice, Applesauce, Toast

Question 25

When would you not digital examine a pt?

Answer 25

If pt has CD or CV history because may stimulate Vagus nerve. If examining, give pain med 30 min prior to examination

Question 26

Which blood count do you use to check for iron deficiency to prevent anemia?

Answer 26

Hemoglobin

Question 27

What is hematocrit?

Answer 27

Amount of cells that indicate Iron stores, % of RBCs