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NSG 102 > GI/GU Alterations > Flashcards

GI/GU Alterations Flashcards

1
Q

high fiber foods

A

whole grains, fruits, bran, vegetables

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2
Q

average functional capacity of bladder

A

300-500ml

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3
Q

why are females more prone to UTIs?

A

urethra is shorter - bacteria has less distance to travel

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4
Q

normal hourly urine output

A

minimum of 30mL

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5
Q

anuria

A

no urine output
less than 50 mLs in 24 hours

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6
Q

dysuria

A

painful or difficult urination

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7
Q

frequency

A

needing to void frequently

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8
Q

nocturia

A

need to wake up at night just to void

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9
Q

oliguria

A

diminished urine output
less than 400 mLs in 24 hrs

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10
Q

polyuria

A

excessive urine output

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11
Q

pyuria

A

pus in the urine

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12
Q

urinary incontinence

A

involuntary voiding of urine

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13
Q

foods high in sodium can cause a pt to:

A

retain water

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14
Q

alcohol & foods high in water have a:

A

diuretic effect

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15
Q

How do diuretics affect urination

A

increased production of urine

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16
Q

What does dark amber urine indicate?

A

concentrated urine - need more water

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17
Q

What does clear or very pale urine indicate?

A

diluted urine - too much water

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18
Q

what does red urine indicate?

A

hematuria

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19
Q

what does brown urine indicate?

A

hematuria or increased bilirubin

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20
Q

what does cloudy urine indicate

A

infection, sediment, high urine protein

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21
Q

what does foul smelling urine indicate?

A

indication, drugs, dehydration, ingestion of certain foods (asparagus)

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22
Q

post-void residual

A

amount of urine left in the bladder after you void, should be close to 0

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23
Q

costovertebral angle tenderness

A

could indicate kidney inflammation

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24
Q

BUN

A

waste product filtered out of the blood by the kidneys
should be 10-20

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25
Q

creatinine

A

waste product produced in the muscles, filtered out by the kidneys
should be 0.8-1.4

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26
Q

is increased RBC ever normal?

A

only with catheterization or menses

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27
Q

possible reasons for increased RBCs

A

tumor, kidney stones, trauma, cystitis, UTI, bleeding disorders

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28
Q

crystals

A

indicate urine has been sitting for a while - not a usable specimen

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29
Q

why is it important to transport urine samples quickly?

A

room temperature can alter things, more bacteria will grow

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30
Q

how to perform a routine urine specimen

A

have pt urinate into a clean collection container - make sure there’s no feces, note if they’re on their period

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31
Q

how to preform a midstream urine collection

A

cleanse meatus, have them void a small amount, then collect 3-5mLs, then have them finish emptying their bladder

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32
Q

how to preform a sterile urine collection

A

cleanse port, clamp it for no longer than 30 minutes, collect 10 mLs, remember to unclamp!!

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33
Q

why is it important to not leave the catheter clamped?

A

urine will backflow and cause a UTI

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34
Q

how to preform a 24 hour urine collection

A

discard the first urine, record start time, collect all urine for 24 hours straight
store on ice

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35
Q

what is a KUB x-ray?

A

kidneys, ureters, bladder x-ray, depicts size, shape, and position

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36
Q

what is a bladder scan

A

ultrasound that measures bladder volume

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37
Q

urinary retention

A

inability to partially or completely empty the bladder

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38
Q

s/s of acute retention

A

discomfort, feelings of pressure, pain in pelvic region, restlessness, Abd. distention

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39
Q

overflow incontinence

A

bladder is so full that some involuntarily escapes/dribbles out

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40
Q

interventions for urinary retention

A

give them privacy, get them in the bathroom in natural position if possible, encourage normal voiding patterns, treat underlying cause, catheterization is last resort to decompress the bladder

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41
Q

single-lumen cath

A

one tube, straight cath

42
Q

double-lumen catheter

A

indwelling, has two tubes - one with a balloon to hold it in place, one for urine to exit through

43
Q

triple-lumen catheter

A

indwelling, three tubes - one with a balloon to hold it in place, one for urine to exit through, one that allows fluids to enter the bladder - for irrigation/instilling saline

44
Q

why is it important to use the smallest fr cath possible?

A

minimizes trauma & risk of infection

45
Q

appropriate indications for an indwelling cath

A

acute retention, accurate I&Os for critically ill pts, some surgeries, healing of open sacral/perineal wounds, prolonged immobility, end of life care

46
Q

NEVER an indication for an indwelling cath

A

incontinence, for you or the patient’s convenience

47
Q

what position should females be in for cath insertion

A

dorsal recumbent position - on back with knees to the side

48
Q

why do we not test the foley balloon?

A

can cause the tubing to wrinkle - can harm/tear them

49
Q

sterile drapes

A

block off rectum/anus

50
Q

fenestrated drapes

A

over the pelvic region

51
Q

how many inches should you lubricate the cath for females?

A

2-3 inches

52
Q

how many inches should you lubricate the cath for males?

A

5-8 inches

53
Q

correct sterile cleaning method for women before cath insertion

A

one swab on the side, one swab for the other side, one for the middle ALWAYS LAST

54
Q

what should you do if you encounter resistance when inserting a cath ?

A

don’t force it, ask them to relax or bear down

55
Q

how do you properly cleanse the penis for catheterization

A

use a circular motion, clean from meatus down

56
Q

suprapubic catheterization

A

surgically inserted into the bladder through the abdominal wall - either sutured to the skin or has a balloon

57
Q

indications for a suprapubic catheter

A

long term only; tumor in the way of normal urination, meatus damaged by past cath

58
Q

indications for external catheters

A

incontinence, immobility

59
Q

how often to change a condom cath?

A

change every 24 hours or if contaminated in some way - changing too often can cause skin breakdown

60
Q

how often to change ext. female caths?

A

every 8-12 hours or if contaminated

61
Q

UTI s/s

A

pelvic pain, dysuria, burning urination, frequency, urgency, nocturia, possible back pain if it gets into kidneys

62
Q

urinalysis findings w a UTI

A

bacteria, sediment, WBC, RBC, positive leukocyte esterase

63
Q

older adult manifestations of a UTI

A

confusion, incontinence, loss of appetite, nocturia, dysuria, urgency, frequency, sense of being “unwell”

64
Q

pelvic muscle exercises

A

strengthen muscles that allow the bladder to contract; have them alternate between holding their urine for 5 to 10 seconds and urinating for 5 to 10 seconds

65
Q

urinary diversions

A

surgical procedures that divert urine outside of the body though a stoma

66
Q

urinary diversion indications

A

when pt has an obstruction/tumor blocking part of the urinary tract

67
Q

what should a urinary diversion stoma look like

A

protrudes 1-3 cm, should be dark pink/red and moist

68
Q

what does a pale stoma indicate

A

anemia

69
Q

what does a dark purple/bluish stoma indicate

A

ischemia

70
Q

interventions for urinary diversion

A

regularly inspect stoma, keep peristomal area clean & dry, measure I&Os, empty when 1/3-1/2 full, change bag every 3-7 days

71
Q

expected fluid intake per day

A

1.5-2L

72
Q

how do laxatives affect the GI tract?

A

soften stool, promote peristalsis

73
Q

how do antidiarrheals affect the GI tract

A

inhibit peristalsis

74
Q

how do opiates affect the GI tract

A

decrease peristalsis, cause constipation

75
Q

how do antibiotics affect the GI tract

A

decrease normal flora and potentially cause diarrhea
maybe even C Diff

76
Q

what do stool tests look for?

A

consistency, color, occult bleeding, fat content, different food substances

77
Q

what is bowel training?

A

having them go the bathroom on a schedule

78
Q

fecal impaction

A

palpable on digital exam - mass of dry, hard feces that cannot be expelled
can cause leakage of liquid stool, fecal matter can cause ulcers if it sits there too long

79
Q

if a normally continent patient now has diarrhea that they are incontinent to, what should you check for?

A

fecal impaction - could be leakage

80
Q

enema contraindications

A

bleeding risk, has thrombocytopenia, rectal irritation, low WBCs, immunocompromised, blood disorder, on chemo

81
Q

how do enemas work?

A

increase peristalsis, stretches the intestines, irritate the intestinal lining, soften stool

81
Q

how to give a large volume enema

A

warm the solution, keep it elevated 18 inches about anus, lubricate tube 2-3 inches, gently insert over 4-5 inches, slowly introduce solution over 5-10 minutes, gently remove

81
Q

when giving a large volume enema, remember to…

A

do not let go of the tubing at any point, never force entry, remove gently, give it 10-15 minutes to work

82
Q

specific hypertonic enema contraindications

A

sodium/water retention, renal impairment, on dialysis

83
Q

how to administer a hypertonic enema

A

slowly insert 4-5 inches (tip is pre-lubricated); instill solution by gently squeezing the bottle

84
Q

diarrhea can cause…

A

dehydration, F&E imbalances

85
Q

diarrhea typically comes with…

A

cramping, nausea, vomitting

86
Q

causes of diarrhea

A

intestinal infections, food allergies/intolerances, tube feedings, IBS, surgical alterations, anxiety, on antibiotics or laxatives

87
Q

diarrhea interventions

A

identify & eliminate cause, replace lost fluid, monitor I&Os, educate on hand hygiene, frequent toileting, skin care, educate on nutrition, food safety, and hand hygiene

88
Q

bowel incontinence

A

loss of voluntary control of defection

89
Q

potential causes of bowel incontinence

A

loss of sphincter tone, inflammation, neurological conditions

90
Q

bowel incontinence interventions

A

frequent toileting, skin care, ensure linen is clean, bowel training

91
Q

fecal management system

A

tube inserted into rectum that directs loose stool in to a collection bag

92
Q

fecal management system indications

A

end of life care, confined to bed/immobilized, continuous liquid stool,

93
Q

disadvantages of a fecal management system

A

can leak, they’re uncomfortable, can cause skin damage & rectal tissue damage

94
Q

alternative to fecal management system

A

bag on the outside of their anus - attached with adhesive

95
Q

bowel diversions

A

a surgical procedure where part of the intestine is brought through the abdominal wall for elimination

96
Q

ileostomy

A

originates in ileum
liquid contents
output in about 24 hours

97
Q

colostomy

A

originates in the colon, formed contents, output in 2-5 days

98
Q

if someone has a high output ostomy, what should you monitor?

A

F&E

99
Q

what foods to avoid with an ostomy

A

nuts, popcorn, mushrooms, corn, stringy vegetables like celery, foods with skins or casings like sausage - anything that could get stuck, odorous foods
in initial post-op period, avoid high fiber foods

100
Q

ostomy interventions

A

inspect stoma, keep peristomal area clean & dry, I&Os, empty when 1/2 full, educate pt on how to care for it themselves

NSG 102 (11 decks)

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