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3323 Advanced Assessment > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

reasons for urinary catheterization

A

relieve urinary retention; obtain sterile urine specimen; accurate measurement of urinary output in critically ill pt; comfort/end of life care; assisting in healing sacral or perineal wounds in incontinent pts; need for empty bladder related to surgical procedure

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2
Q

difference between hard rectangle catheter collection bag and soft circular

A

hard rectangular capture device is more accurate when measuring urine output; soft catheter collection bag needs to be poured out to be measured accurately

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3
Q

the spout on the catheter is…

A

clean not sterile

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4
Q

CAUTIs

A

catheter associated UTI; most common hospital acquired infection; avoid catheterization whenever possible; remove catheters as soon as possible; duration of catheter use is biggest risk factor for developing UTI

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5
Q

catheter is not to be placed for what reason

A

if pt is incontinent only; try comode or toileting time prior

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6
Q

types of urinary catheters

A

robinson 1 way/straight cath, robinson silicon 2 way catheter, coude latex 2 way catheter with rigid curved tip for those who may have obstruction like BPH; robinson latex 3 way catheter

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7
Q

in men when inserting catheter…

A

insert all the way to the biforcation then inflate balloon

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8
Q

if pain when inflating balloon of catheter…

A

deflate and insert further then re-inflate; pain d/t inflation in urethra

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9
Q

coude catheter

A

curved tip usually used in males; insert with curve up

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10
Q

suprapubic catheter

A

surgically inserted catheter; used for long term; anchored in place with a balloon; decreased risk for fecal contamination; used in situations where cannot enter urethra d/t blockage or trauma; cannula exits from bladder through abdomen

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11
Q

positions for catheter insertion

A

men are supine; women are dorsal recombinant (first choice) or sims or lateral position

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12
Q

common sizes of catheters used

A

16-20 french; larger number is larger size unlike catheter

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13
Q

green port on side of catheter connected to drainage tube

A

used for collecting sterile urine specimen

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14
Q

components of 3 way catheter

A

balloon port, drainage port with urine specimen capturing port, and irrigation port used to administer fluid to remove clots blood and debris

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15
Q
A
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16
Q

ileal conduit urinary diversion

A

used as an incontinent urinary diversion; ureters attached to a channel instead of bladder that travel to stoma and out into collection bag; channel usually made out of small intestine

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17
Q

collection bag for ileal conduit urinary diversion

A

empty bag at 1/3 to 1/2 fullness; used long term; can be used for short term but is hard to reverse once created; want 1/8 of skin around stoma exposed

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18
Q

urinary retention reservoir

A

also known as continent cutaneous reservoir; can control release of urine via straight cath through stoma; stoma is attached to a created bladder (knock pouch) that functions like a normal bladder would (kidneys transport urine through ureters to create (bladder); no need to worry about kin breakdown as there is no collection bag or adhesive

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19
Q

orthotopic neobladder

A

continent diversion to urethra; new bladder still connected to urethra and ureters; can still urinate like normal; used in situations where individuals have cancer

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20
Q

bowel diversion/ostomy

A

diversion from bowel to stoma; mucosal intestine brought out of abdominal wall; can be permanent or temporary; temporary used to allow bowel to rest

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21
Q

temporary ostomy

A

might be used to allow bowel to rest and repair itself related to inflammatory disease like crohns or after certain types of intestinal surgery or after injury; once issue has resolved then patient goes back for second surgery to reverse ostomy or bowel diversion

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22
Q

permanent ostomy

A

performed for debilitating intestinal diseases or cancer of colon/rectum; patients have these for life

23
Q

sigmoid colostomy

A

stoma placed right at end or sigmoid colon before the rectum; bypasses rectum; hard formed fecies

24
Q

descending colosotomy

A

stoma placed at the end of descending colon before sigmoid colon curve; bypasses sigmoid colon; less hard fecies than sigmoid colostomy

25
Q

transverse colosotmy

A

stoma placed in middle of transverse colon; bypasses half of colon;large intestine; fecies is softer/liquid than descending colostomy

26
Q

ascending colostomy

A

stoma placed in beginning of ascending colostomy; bypasses majority of large intestine; more liquid fecies

27
Q

ileosotmy

A

stoma placed at end of small intestine where ileum ends; bypasses entire colon/large intestine; liquid fecies (no water able to be reabsorbed by colon)

28
Q

ideal time to empty colostomy

A

1/3 is ideal but 1/2 is still alright

29
Q

colosotmy/ileostomyinspection

A

want bright beefy red stoma; want 1/8 inch of skin exposure around stoma and under dressing/bag seal; can have a ring dressing to clip bag onto

30
Q

swollen stoma

A

common right after surgery; bleeding can occur following surgery

31
Q

flush stoma

A

result of fluctuating weight or erosion of skin causing stoma to seep into itself; could be due to tissue used to create stoma

32
Q

colostomy/ileostomy care

A

measure intake in output; peristalsis may be absent or minimal after surgery; check for stool or gas formation; air/stool present once peristalsis returns; pt teaching on ostomy as ADL is important; depression and altered body image can result with stoma

33
Q

if gas occurs in colostomy/ileostomy bag…

A

need to burp the bag

34
Q

reasons for peristalsis…

A

can result from pt being NPO or result from anesthesia decreasing bowel motility

35
Q

when changing ostomy bag

A

clean around stoma with moist gauze; check for breakdown; may need to expose more than 1/8inch of skin under dressing if skin breakdown present (dont want to place adhesive on broken down skin)

36
Q

physiologic changes in middle adult

A

changes occur overtime; hormonal changes result in physiological changes like fatty tissue redistribution, abdominal fat in men, thicker middle in females, dry skin, wrinkles develop, loss/gray hair, decrease in cardiac output, muscle mass decreases, strength and agility decreases, calcium decreases (especially in perimenopausal), visual and hearing decrease, increased fatigue, menopause (women) andropause (men)

37
Q

middle aged adult

A

40-65 years old; changes occur overtime; not much cognitive change; psychosocially can be time of increased personal freedom and economic stability

38
Q

older adult

A

65 and older

39
Q

older adult changes

A

living longer with chronic illness; health disparity becomes magnified in older adults

40
Q

psychosocial changes in middle adults

A

increased personal freedom, economic stability, changes in relationships or partners, caring for children and aging parents (sandwich generation), career changes, returning to school for employment/education/skill development

41
Q

menopause causes…

A

decrease in estrogen, progesterone, and ovarian functioning leading to hot flashes, mod swings, fatigue, sleep disturbances, cessation of menstruation; decrease in estrogen increases risk for osteoporosis and heart disease

42
Q

andropause causes…

A

decrease in testosterone causing loss of muscle mass, decreased libido (still capable of reproduction)

43
Q

physiological changes of older adult

A

all organs undergo some decline and become less efficient, wrinkles, dryness or sagging of skin, baldness in males, thinning of hair in females, increase in moles, nails thicken, increased brusiing, decreased weight, decrease in muscle mass/strength, brittle/porous bones (increased FX risk), stiffening of joints, mobility/flexibility decreases; more likely to develope complications and heal slowly

44
Q

cognitive changes in older adults

A

cognitive and behavioral responses slow, reflex response decreases, balance difficulties, coordination decreases, fine motor decreases, spatial orientation decreases, increased risk of falls, sleep disturbances, short term memory decline, ma experience dementia or alzheimers or depression, long term memory usually stays

45
Q

psychosocial changes in older adults

A

loss of relationships due to illness or death, isolation due to illness and inability to drive, retirement and reduced income, change of living environment, nursing homes, assisted living, changes in role in family

46
Q

health promotion of adults

A

screenings, physical exams, digital rectal exams, eye exam, oral cancer screening, tetanus shot every 10 years, pneumococcal/shingles vaccine, exams of: skin eyes dental physical; diet- low fat high protein with colorful fruits and vegetables; exercise- encourage movement

47
Q

female specific screenings

A

mammogram beginning at 40 and every year until 55 then every 2 years until 75 unless findng or fam HX; pap smear for cervical cancer every year from 21-29 and then every 5 years from 30-65; colonoscopy beginning at 45 and done every 10 years unless finding or fam HX

48
Q

male specific screenings

A

prostate exams beginning at 45 or 40 if Af. Am. or have PMH; digital exam every year; colonoscopy beginning at 45 done every 10 years unless findings or fam HX

49
Q

life expectancy

A

males- 83.2 and females 85.8; factors such as socioeconomic, race/ethnicity, behaviors, metabolic risks, and health care factors all play into this statistic

50
Q

myths of old age aka ageism

A

old age begins at 65; most older adults are in long-term care facilities; older adults are sick and mental detioration occurs; older adults are not interested in sex; older adults do not care how they look and are lonely; bladder problems are problem of aging; older adults do not deserve aggressive treatment for illnesses; older adults cannot learn new things

51
Q

causes of accidental injuries in adults

A

changes in vision and hearing; loss of mass and muscle strength; slower reflexes and reaction times; decreased sensory ability; effects of chronic illnesses and medications; economic factors

52
Q

elder abuse

A

1/10 older adults in community-dwelling over than 60 years of age experience it; factors that increase risk are environmental, social, financial, educational, employment based inequalities; rates of worldwide abuse increased during covid; abuse consists of physical, sexual, psychological, emotional, financial, and neglect; men have higher rates of death by homicide and nonfatal assaults

53
Q

nursing actions to promote health in older adults

A

physiologic function, cognitive function, psychosocial needs, nutrition, sleep and rest, elimination, activity and exercise, sexuality, meeting developmental needs

3323 Advanced Assessment (4 decks)

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