Exam 3- Urinary/Bowel Elimination Flashcards
What are other terms used for urination?
Micturition, Voiding (conscious control process)
What is an alarming amount of urine output (cc) and what is pt at risk for?
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
How many times are neonates urinating and what is their urine like?
25 x per day, VERY LOW sp. gr (1.008), dilute urine- clear, light, watery, prod. 8-10 saturated diapers/day
What is a common thing toddlers do in regards to urination?
ENURESIS- bed wetting episodes are common, even after TT has been established.
When should toddler begin to control bladder during the day?
24 mo-3 years. learning to control micturation. Be sure not to punish child.
When should a toddler have full control of bladder?
3-5 years old. By age 6, FULL CONTROL of urination.
What are urinary changes in older adults?
- Decreased kidney functioning
- Polyuria- urgency and frequency
- Loss of bladder elasticity & muscle tone- leads to nocturia, incontinence & incomplete emptying of bladder
- Enlargement of prostate
What are the different types of UI or involuntary leakage of urine/loss of bladder control?
- Transient UI- arrives suddenly, lasts 6 mo or less.
- Stress
- Urge
- Reflex
- Retention w/overflow- bladder can only stretch so much therefore body will push urine out
- Functional Incontinence
What are 4 common effects of altered urinary elimination?
- Urinary retention
- Bladder distension
- Urinary Incontinence
- UTI
What does a pt with urinary retention look like?
restless, uncomfortable, diaphoresis. The bladder may be distended r/t obstruction in urethra or med and pt c/n urinate
When can a nurse palpate the bladder?
When the bladder is distended because it is then raised over the pubic symphysis
Why should you encourage fluids?
h20, cranberry juice, and foods that acidify urine are essential to reduce risk of UTIs or the formation of Ca+ based kidney stones
What makes up 40% of all nosocomial hospital acquired infections?
UTI’s. Most due to catheterization.
How much residual urine is normal?
The amount of urine remaining in bladder after urination is: 50-100 cc
What are S and Sx in a pt acquired UTI?
- Dysuria
- Polyuria
- wants to but c/n= hesitation
- MALAISE- don’t feel well
- Hematuria- blood in urine
- Can spread from bladder-ureters-kidneys= tenderness in kidneys, flank pain, fever, tenderness, chills
- CONFUSION in elderly wome
What is the most common type of Urinary incontinence?
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
What is the average amount adults should urinate?
5-6x per day
What is the first stool in a baby called and what does it look like?
MECONIUM- green, black, tarry lasts 24-48 hrs
Breast fed stool versus formula stool?
Breast fed- golden yellow, curdled, liquidy and more frequent
Formula- tan colored, 1-3x per day
What should you teach a patient 3 days before they need a fecal occult blood test?
That certain foods and vitamins can cause faulty results.
- Vitamin C- 250 mg
- Red meat- beef, lamb, liver, and processed meat
- Raw veg or fruits- radishes, turnips, horseradish, melons
- Certain meds that irritate the gastric mucosa and cause bleeding (aspirin or other nonsteroidal anti-flam., drugs, steroids, and anticoagulants)
What is the difference between occult blood and Frank’s blood?
most frequent performed fecal analysis, hidden blood. Frank’s is visually able to see in feces.
What are 6 alterations to a BM?
- Diarrhea- most common, liquidy/watery
- Constipation- hard, dry feces
- Fecal Impaction- unrelieved constipation with liquids/food around it (oooze)
- Bowel Incontinence- involuntary passage of stool
- Flatulence- bloating, distension, and passage of gas
- Hemorroids
What age groups are at risk for diarrhea and dehydration?
Babies and the Elderly
If pt has diarrhea, what kind of diet is a BRAT diet to help?
Bananas, Rice, Applesauce, Toast
When would you not digital examine a pt?
If pt has CD or CV history because may stimulate Vagus nerve. If examining, give pain med 30 min prior to examination
Which blood count do you use to check for iron deficiency to prevent anemia?
Hemoglobin
What is hematocrit?
Amount of cells that indicate Iron stores, % of RBCs
