Food and Fluid

Question 1

Normal Elimination

Answer 1

Easy passage of feces without straining or incomplete evacuation

Question 2

Constipation Reflects…

Answer 2

Poor habits
Postponed passage
Meds
Colonic dysmotility/CNS lesions

Question 3

Constipation leads to:

Answer 3

Impaired sensation, need for high volume to stimulate

Megacolon

Question 4

Valsalva’s maneuver can lead to

Answer 4

Transient ischemic attacks

Syncope

Question 5

Why suppositories don’t work

Answer 5

Their action is blocked by size and volume of stool

Question 6

Who is at risk for constipation?

Answer 6

• Hypotonic colon function
• Immobile
• Impaired cognition
• Those with CNS lesions

Question 7

Signs of constipation

Answer 7

• may not be infrequency
• Straining
• Incomplete defecation
• Hard lumpy stool

Question 8

Medications likely to cause constipation

Answer 8

1) CNS regulation
2) Nerve conduction
3) Smooth muscle function

Question 9

Non Pharm. interventions for constipation

Answer 9

• Fluid/fibre reg
• Exercise
• Environmental manipulation
• Combo

Question 10

When is fibre not advised?

Answer 10

suspicion of megacolon ore colonic dilation

Question 11

When are laxatives used?

Answer 11

Diet and lifestyle are not effective

Question 12

Gastro-colic reflex

Answer 12

Occurs ofter meals, can be enhanced by a warm drink

Question 13

Feeding tube positioning

Answer 13

Head of bed>30 degrees, up to 30min after eating

Question 14

How much should those 85+ drink?

Answer 14

1500=2000ml/day

Question 15

What is used to indicate dehydration?

Answer 15

Elevated serum osmolality

Question 16

Common reason for hydration in OA

Answer 16

Decreased thirst and increased fluid loss

Question 17

D E H Y D R A T I O N

Answer 17

Drugs
End of life
High fever
Yellow urine turns dark
Reduced oral intake
Axilla dry
Tachycardia
Incontinence (fear of)
Oral problems
Neurological impairment
Sunken eyes

Question 18

General rule of fluid replacement

Answer 18

Return 50% in 12hr

Question 19

What is micturition?

Answer 19

Urination

Question 20

Transient incontinence

Answer 20

Acute, sudden onset, <6 months, usually due to treatable causes

Question 21

Urge incontinence

Answer 21

Overactive bladder. Felt soon after urge, inability to suppress, sudden.

Question 22

Stress incontinence

Answer 22

Outlet. Involuntary loss of 50ml during actions that cause intra-abdominal pressure

Question 23

Urge/stress with high postvoid residual incontinence

Answer 23

When bladder does not empty normally and becomes over distended

Question 24

Functional incontinence

Answer 24

Lower urinary tract is intact but the individual is unable to reach a toilet bc of environmental barriers, physical limitations, severe cog. impairment

Question 25

Mixed incontinence

Answer 25

Combo | Usually stress + urge

Question 26

Behavioural Interventions for incontinence

Answer 26

``` Scheduled voiding Prompted voiding Bladder training Biofeedback Vaginal weight training pelvic floor ex. ```

Question 27

Lifestyle changes for incontinence

Answer 27

``` Dietary actions Weight reduction Smoking cessation Bowel management Physical gravity ```

Question 28

Absorbent products

Answer 28

Protective undergarment Adult briefs Used in addition to toileting regimes

Question 29

External catheters

Answer 29

Used for males with incontinence, can't be toileted

Question 30

intermittent catheterizations

Answer 30

Used with persons with urinary retention due to diabetic neuropathy, blockage, reflex incontinence

Question 31

Fecal incontinence

Answer 31

continuous or recurrent uncontrolled passage of fecal material for at least one month

Question 32

FANSCAPES

Answer 32

``` * Used for assessing frail older persons Fluids Aeration Nutrition Communication Activity Pain Elimination Socialization ```

Question 33

Environmental and safety assessment

Answer 33

1) Potential and status of dangers 2) Suggestions or opportunities for reducing dangers 3) fires, poisoning, fires, temp

Question 34

SPICES

Answer 34

``` Overall assessment Sleep disorders Problems with eating/feeding Incontinence Confusion Evidence of falls Skin breakdown ```

Question 35

Bulking agents

Answer 35

- first used - Absorb water, bulk stool - don't use with obstruction or compromised peristalsis

Question 36

Stool softeners

Answer 36

- Lubricate & soften - Limited to persons experiencing straining, painful def, high risk - little effect with those who are immobile

Question 37

Osmotic/saline laxatives

Answer 37

- increase in intraluminary pressure/volume Stimulate motility - Added if bulk isn't effective Effective for those on opiates - DON"T USE for those with poor renal/heart function

Question 38

Stimulant laxatives

Answer 38

Stimulate nervus plexus - Cause rythmic contractions - Effective for those. using opiates - Should not be used with obstruction