GI Flashcards
1
Q
FUNCTION OF THE KIDNEYS
how much cardiac output circulates through the kidneys per min?
A
- remove waste products
- balance body fluids
- release hormones (renin)
- produce RBC (erythropoietin –> bone marrow)
- 20-25% of cardiac output
2
Q
WHAT IS URINATION? HOW MUCH DO ADULTS VOID? WHATS THE MINIMUM? HOW MUCH CAN THE BLADDER HOLD. WHEN DO WE GAIN CONTROL?
A
- also called micturition or voiding
- complex neural response (brain, spine, peripheral nervous system, neurotransmitters)
- adults normally voids 1500-1600 ml/day
- bladder can hold 500ml and will void 5-7 times per day
- output is a minimum of 30ml/hr
- full control by age 4-5, older adults often experience noctuira
3
Q
COMMON ALTERATIONS IN URINARY ELIMINATION
A
- disturbances in act of micturition, faliure to store urine, faliure to empty or both
- UTI
- nocturia
- urinary retension (accumulates in bladder), or diversions (cancer of bladder)
- renal faliure (cannot excrete)
- urinary incontinence
4
Q
URINARY INCONTINENCE NURSING INTERVENTIONS
A
- perineal care and skin integridy
- lifestyle modifications
- pelvic floor muscle exercises
- bladder training
- prompted voiding, timed toileting and habit retraining
- double voiding (try again). limit caffeine
5
Q
DEFINITIONS
- frequency
- nocturia/nycturia
- urgency
- dysuria
- hematuria
- cystisis
- polyuria
- diuresis
- polydipsia
-oliguria
-anuria
A
- voiding at frequent intervals
- increased frequency at night
- sudden desire to pass urine
- pain, burning or discomfort when voiding
- blood in urine
- inflammation of bladder, usually bc of infection
- urine excretion volume over 24 hours is noticably larger than previous excretion
- increased production or passage of urine
-excessive thirst associated with diuresis - decreased urine output (< 400ml/day)
- lack of urine production or small amount ( < 100 ml/day)
6
Q
SUBJECTIVE DATA FOR URINARY ASSESSMENT
A
- common concerns, history, family history
- OPQRSTUV
- current elimination pattern
- lifestyle and health practices
- food and fluid intake
- medictions
- exercise and activity
- phsysiological activity
7
Q
OBJECTIVE DATA FOR URINARY ASSESSMENT
A
- skin and mucosal membranes
- kidneys
- bladder: inspect, palpate, percuss
- bladder scanner
8
Q
ASSESSMENTS FOR URINE
A
- amount: intake and output (urine hat, bedpan, urometer)
- colour: pale straw to amber
- clarity: transparent, cloudy if standing
- odour: characteristic, concentrated has strongest odour
9
Q
COMMON URINE DIAGNOSTICS
A
- urinalysis (ph, blood, ketones, glucose, WBC, bacteria, casts)
- specific gravity (how concentrated)
- urine culture (random (clean cup), mid-stream (sterile cup), catheder, timed)
10
Q
WHAT IS A CATHEDER? WHAT ARE RISKS ASSOCIATED WITH IT
A
- narrow tube tunning through urethra to bladder
- risks include UTI, blockage, trauma to urethra
- intermittent or indwelling
11
Q
URINARY CATHEDER CARE
A
- drainage back never above level of bladder, no kink
- increase fluid intake
- prevent infection through hand hyegine and closed system
- perineal hyigeine atleast twice a day
12
Q
WHAT ARE UTI’S?
A
- bacteria entering urinary tract via, utethera
- common pathogen responsible is E.coli
- upper UTI (kidney): chills, flank,fever
- lower UTI (bladder): dysuria, hematuria, cloudly urine, frequency, urgency, incontinence
13
Q
NURSING INTERVENTIONS FOR URINARY ELIMINAITON
A
- perineal care atleast 2 times a day and hand hygeine
- double voiding
- position for voiding
- regular voiding, bowel movements, diet rich in fiber
- education (hyegine, tobacco, fluid amount and type)
- enhance self-care and routine practices
14
Q
HOW WOULD YOU DO PERINEAL CARE FOR A FEMALE PATIENT
A
- privacy
- dorsal recumbent position
- wrap bath blanket around legs
- wash labia majora, whiping front to back
- wash labia minora, clitoris, vaginal orifice (catheder)
always go from clean to dirty
15
Q
HOW WOULD YOU DO PERINEAL CARE FOR A MALE PATIENT
A
- privacy
- supine position, place towel under penis
- if circumsized, retract foreskin
- wash tip of penis at urethral meatus in circular motions then return the foreskin (rinse/dry)
- wash shaft of penis and scrotum (rinse/dry)
16
Q
HOW DO YOU CALCULATE 24 HOUR FLUID BALANCE, WHAT DO RESULTS MEAN?
A
intake - output
- if output is higher than input, it creates a negative number, hinting towards diabetes
17
Q
WHAT IS THE PURPOSE OF THE GI TRACT
A
- injest food
- breandown food
-
absorb fluid and nutrients
prepare food for absorption and use by body cells and be a temporary storage site for feces
18
Q
definitions
IMPACTION
FECES
PERISTALSIS
FLATUS
FLATULANCE
HEMORRHOIDS
VALSAVA MANOEUVRE
A
- collection of hardend feces in rectum
-waste product also called stool - muscle contractions that occur in colon
- gas
- accumulation of gas, bowel wall expands
- dilated engorged veins in rectum
- voluntary contraction of muscles and diaphragm while maintaining forces expiration
19
Q
EXPLAIN THE PROCESS OF DEFECATION
A
- should be painless with soft stool
- contractions begin at left colon moving towards anus
- when stool reaches rectum, distension signals need to defecate
- relaxation of external sphincter and contraction of abdominal muscles leads to defecation
20
Q
WHAT SHOULD BE THE POSITION WHEN DEFECATING
A
- squatting (normal)
- knees higher than hips
- lean forward elbows on knees
- buldge out abdomen and straighten spine
21
Q
WHAT FACTORS ALTER ELIMINATION PATTERNS?
A
- diet and fluid intake
- physical activity
- personal habits
- privacy
- medical conditions/meds
- age
22
Q
SUBJECTIVE DATA FOR GI
A
- usual bowel movement elimination pattern (BEP)
- routines used to promote normal BEP
- use of meds
- cognitive abilities, emotional state
- changes in appetite, diet history, fluid intake
- history of surgery or illness
- history of exercise and mobility
- pain
- description of usual stool characteristics (bristol stool scale)
23
Q
OBJECTIVE DATA FOR GI
A
stool characteristics
- colour
- odour
- consistency
- frequency
- shape
- constituents
24
Q
NURSING INTERVENTIONS FOR CONSTIPATION
A
- fluids and fiber
- activity
- positioning, habit training
- reminders, cues
- psychosocial, privacy
- meds: laxatives
25
NURSING INTERVENTIONS FOR GENERAL GI
- fiber, fluids, activity, meds
- bowel retraining
- maintaining skin integridy
- proper positioning- bedpans, urinals, commode chairs
26
WHY DO WE DO DRUG CALCULATIONS?
- height/weight
- medication dosage
- IV drip rate
- Drug titrations
- patient caloric intake and output
