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Module 1 (Intro To Basics) > GI Elimination > Flashcards

GI Elimination Flashcards

1
Q

Elimination

A

excretion of waste products from kidneys and intestines

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2
Q

Defecation

A

process of elimination of waste

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3
Q

Feces

A

semisolid mass of fiber, undigested food, inorganic matters

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4
Q

Incontinence

A

inability to control urine or feces

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5
Q

Void, Micturate

A

to urinate

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6
Q

Dysuria

A

painful or difficult urination

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7
Q

hematuria

A

blood in urine

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8
Q

Nocturia

A

frequent night urination

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9
Q

T/F: Feces should only be in the rectum when ready to void.

A

True

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10
Q

Polyuria

A

large amounts of urine
-do not use a diuretic or drink large amounts

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11
Q

T/F: Nocturia is frequent in patients with heart issues.

A

True

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12
Q

Urinary frequency

A

voiding at frequent intervals

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13
Q

Urinary urgency

A

need to void

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14
Q

Valsalva Manuever

A

increase the pressure while bearing down
-straining the abdominal muscles and closing their airway

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15
Q

Pts we don’t want to Valsalva maneuver

A

mother’s after C-section
pt after abdominal surgery
at risk pt (aneurysm, stroke with blood thinner)

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16
Q

Proteinuria

A

presence of large protein in urine

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17
Q

Hesitancy

A

difficulty initiating urination

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18
Q

Dribbling

A

leakage of urine despite voluntary control of urination

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19
Q

Retention

A

accumulation of urine in bladder without the ability to completely empty

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20
Q

Residual

A

urine remaining post void greater than 100 mL

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21
Q

Bowel Elimination Process

A

-fecal material reaches the rectum (causes distention)
- stretch receptors initiate contraction of sigmoid colon/rectal muscles
-internal anal sphincter relaxes
-sensory impulses cause voluntary “bearing down” (diaphragmatic and abdominal muscles to increase downward pressure
-external sphincter relaxes

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22
Q

Hemorrhoids

A

occur due to pressure on uterus and increased blood volume

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23
Q

Factors Affecting Bowel Elimination

A

Developmental stage: young and old
Personal factors: privacy, time, job speed
Sociocultural: stress
Nutrition/Hydration: regular schedules, high fiber, fluid intake
Activity
Medications: oral meds
Surgery and Procedures: NG Tube, paralytic ileus
Pregnancy
Pathological conditions

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24
Q

A fecal transplant can be used if the pt has

A

C. diff

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25
Q

If the signal to defecate is ignored, the reflexive contractions

A

ease for a few minutes, until mass peristalsis occurs again

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26
Q

What developmental stages change bowel elimination patterns?

A

Young and the old

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27
Q

When you ignore the need to defecate, it promotes

A

bowel dysfunction
- no privacy, significant time
- fast-paced jobs ignore the need

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28
Q

Sociocultural factors affecting bowel elimination

A

stress has a major influence
- cause diarrhea or constipation
- risk development of IBS

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29
Q

IBS

A

Irritable Bowel Syndrome
-stress is a primary risk factor in the development
- associated with bloating, pain, and altered bowel function

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30
Q

Nutrition/Hydration factors affecting bowel elimination

A
  • regular intake of food promotes peristalsis
  • regular intake schedule
  • irregular schedule = irregularity
  • high fiber
  • fluid intake
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31
Q

High fiber promotes

A

peristalsis and defecation by increasing bulk, bulky foods absorb fluids and increase stool mass

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32
Q

Proper Fluid Intake

A

6 to 8 oz. glasses of water a day

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33
Q

Inadequate Fluid Intake can lead to

A

dry, hard stools that are difficult to pass

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34
Q

Nutrition has _________, _______ meals tend to work better, regular schedule promoting regular elimination.

A

several, small

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35
Q

Activity can stimulate

A

peristalsis

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36
Q

Sedentary people have _______ abdominal muscles.

A

weaker

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37
Q

Patients with limited activity often have what type of bowel movements?

A

constipation

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38
Q

What types of medications have the potential to affect the function of the GI Tract? Symptoms?

A

All oral meds
-Symptoms: N/V/D, constipation

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39
Q

Surgery/Procedures affecting bowel elimination

A
  • bowel manipulation leads to paralytic ileus
  • NG tube on low or intermittent suction
40
Q

How does pregnancy affect bowel elimination?

A
  • morning sickness at any time
  • Growing uterus crowds and displaces intestines
    -slowing of intestinal motility
  • increase in progesterone
  • often experience constipation, decreased appetite, irregular food intake
  • risk of hemorrhoids from the pressure of the uterus and increased blood volume
41
Q

Paralytic ileus

A

no bowel peristalsis, the bowel continues to produce secretions that remain stagnant causing distension and discomfort

42
Q

NG Tube removes secretions until

A

peristalsis

43
Q

Pathological factors affecting bowel elimination

A
  • neurological disorders affect the innervation of the lower GI Tract
  • cognitive conditions limit the ability to sense “the urge” = incontinence
  • Pain or immobility leads to sluggish peristalsis
44
Q

General Overall Goal is for pt to have

A

soft, formed, regular BM
- no N/V, bloating

45
Q

Promoting Regular Defecation

A
  • privacy
  • correct position: seated upright
  • timing: after meals, may need assistance
46
Q

What is the proper diet?

A

fresh fruits, veggies, whole grains, fiber

47
Q

Proper Exercise

A
  • 3-5 times a week
  • ROM for pts on bed rest
  • Positioning
  • Encourage exercise
48
Q

Bristol Stool Chart ( Type 1-7 )

A

1) Severe constipation: hard lumps
2) Mild constipation: lump and sausage like
3) Ideal: sausage shape with cracks
4) Ideal: smooth, soft sausage
5) Lacking fiber: soft blobs with clear edges
6) Mild diarrhea: mushy consistency
7) Severe diarrhea: liquid consistency

49
Q

Flexi-seal rectal tube process

A
  • inserted into the rectum with
    -inflate the retention balloon easily by filling it with tap water or saline
  • connected to a collection bag
50
Q

Flexi-seal rectal tube used for

A

severe incontinence (C. diff, severe diarrhea, and to prevent breakdown)

51
Q

What candies represent all 7 on the Bristol scale?

A

1) Raisenets
2) Baby Ruth
3) Twix/Snickers
4) Swiss Cake Rolls
5) Marshmallows
6) Pudding
7) YooHoo milk aka Big Summer

52
Q

Severe Constipation (1) caused by

A

immobile, inadequate diet, not enough fluid, too much fiber

53
Q

Mild Constipation (2) caused by

A

dehydration, side effect of medications, stress, too much fiber

54
Q

Ideal (3&4) is caused by

A

active, good fluid intake, low stress

55
Q

Lacking fiber (5) is caused by

A

no fiber, poor nutrition, too much fluid

56
Q

Mild diarrhea (6) is caused by

A

stress, no fiber, laxative abuse, Celiac disease

57
Q

Severe diarrhea (7) is caused by

A

Big Summer Blowout
- stress, no fiber, laxative abuse, rotavirus infections

58
Q

Fluid Balance

A

= kidneys maintaining the volume and composition of extracellular and to a lesser extent
= intracellular fluid by continuously exchanging water and solutes

59
Q

Interstitial fluid components and flow

A

Sodium and potassium change places
Water follows sodium

60
Q

What do the kidneys do to maintain fluid balance?

A

regulate the amount of makeup of the fluids inside and around the cells
- partially controlled by hormones

61
Q

What 2 hormones are involved in fluid balance?

A

Antidiuretic hormone (ADH)
Aldosterone

62
Q

Fecal matter in Bowel Incontinence Devices

A

when a pt has diarrhea, the watery stool travels through the small and large bowels much faster than solid waste
-prevents the reabsorption of stomach acid which causes the fecal matter to be caustic to the skin increasing the risk of skin breakdown

63
Q

Antidiuretic hormone is produced by

A

pituitary gland

64
Q

Antidiuretic hormone if high

A

causes more water to be absorbed creating a high concentration but small volume of urine

65
Q

Antidiuretic hormone if low

A

causes more water to be excreted creating a larger volume of urine

66
Q

Aldosterone produced by

A

adrenal gland

67
Q

Aldosterone

A

regulates water reabsorption and changes urine concentration by increasing sodium reabsorption
- helps control of secretion of potassium

68
Q

Normal Urinary Patterns

A

kidneys produce ~ 50-60mL/hr or 1500 mL/day
= normal voiding is ~ 5-6 times per day depending on fluid intake

69
Q

Characteristics of Normal Urine

A
  • Specific Gravity (1.002 - 1.003)
  • Color
70
Q

Specific Gravity

A

a measure of dissolved solutes in a solution

71
Q

Increased specific gravity means increased

A

urine solutes

72
Q

Fluid intake increases urine and becomes

A

more diluted and lighter in color

73
Q

Fluid intake decreases urine becomes

A

darker and specific gravity rises

74
Q

Abnormal Urine Meaning
Dark Yellow

A

less water, more waste, dehydration

75
Q

Abnormal Urine Meaning
Red/Pink

A

blood in urine

76
Q

Abnormal Urine Meaning
Brown

A

liver conditions, gallbladder (bile), fava beans, rhubarb

77
Q

Abnormal Urine Meaning
Orange

A

TB drug, carrots (beta-carotene)

78
Q

Abnormal Urine Meaning
Milky White

A

WBCs, purine rich foods like anchovies, herring, red meat

79
Q

Abnormal Urine Meaning
Blue

A

methylene blue (dye in diagnostic tests)

80
Q

Abnormal Urine Meaning
Green

A

drugs (Tagament, Elavil)

81
Q

Abnormal Urine Meaning
Purple

A

“Purple Urine Bag Syndrome”
- colonized bacteria in catheter or collection bag

82
Q

Condom catheter

A

applied to the tip of the penis and attached to a collection bag (looks like a flower)
- only on males
- low risk except for the potential for skin tears

83
Q

PureWick catheter

A

lays between the labia and attached to a suction device (looks like hot dog)
- only for women
- low risk
- may not stay in place if the patient moves around too much

84
Q

Foley catheter

A

inserted into the bladder and attached to a collection bag
- both genders
- not to be used for incontinence alone, use briefs instead
- if not clean can introduce pathogens into the GU tract

85
Q

A Three-way urinary catheter is used for

A

bladder irrigation

86
Q

Coude tip catheter is used for

A

passage past enlarged prostate

87
Q

Promoting Normal Urination

A
  • provide privacy
  • assist with positioning: men standing, women upright seating or squatting
  • facilitating toileting routines
  • promote adequate fluids and nutrition
  • assist with hygiene as needed
88
Q

Normal Urine color, clarity, and odor

A

pale yellow, clear, and w/o smell

89
Q

Urine color

A

indicate some form of intake or lack of fluid

90
Q

Urine clarity

A

appear cloudy if pathogen is present

91
Q

Urine Odor

A

pathogens can change odor as well as intake
-asparagus smells

92
Q

Specimen Collection devices

A

urinal, hat, bedpan, bedside commode

93
Q

Record ALL Fluid - Intake

A

semi-liquid foods, ice chips, fluids, IV fluids, tube feeding, and irrigations instilled and not immediately removed

94
Q

Record ALL Fluids - Output

A

fluid loss via emesis, urine output, diarrhea, drainage from suction or wounds

95
Q

Accuracy of I&O

A

teach pt and family members
used measured collection devices to get accurate counts

Module 1 (Intro To Basics) (32 decks)

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