GI + GU Systems Flashcards
Incontinence Definition
Inability to control urination / bowel movement
Anuria
Absence of urine, very low urine output under 50 mL a day
Oliguria
Urine output less than 300 mL a day
Hematuria
Blood in urine
Peristalsis
Contraction of intestines to push stool out
Cystitis
Inflammation of the bladder usually caused by bacterial infection.
Flatus
Air that moves from the digestive tract through the mouth
Causes of incontinence (5)
Traumatic (surgery)
Neurological (dementia, MS)
Inflammatory (e-coli infection, IBS)
Pelvic foor dysfunction (child birth)
Functional (physical mobility issues, aware but unable)
Management for bowel incontinence
Educate: wipe front to back, peri care after bowel movement
Keep skin clean and dry
Commode at bedside or bed pan
Bowel training program (regular bowel schedule)
Constipation
Decrease in frequency of bowel movement
When fecal mass remains in rectal cavity for long time, more water is absorbed causing small, hard, dry, painful to pass stool
Causes of constipation
Medication
Low fiber intake
Low fluid intake
Aging process
Metabolic \ neurologic conditions
Decreased mobility
Constipation S+S
Abdominal pain / distention
Indigestion
Rectal pressure
Dry hard stool
Barium enema
Like an X-Ray, very clear image of structure
Detects obstruction of colon
Barium liquid injected into large intestine through anus
Colonoscopy
Colonoscope inserted into anus through colon
Examines entire colon and colon walls
Can collect tissue
Lots of fluid taken before procedure to cleanse colon out
What diagnostic studies are used for constipation?
Abdominal X-Ray
Colonoscopy
Barium enema
Physical examination (1st)
Fecal impaction
Severe constipation, inability to pass stool even with use of suppositories and enemas
Digital removal is required (disimpaction)
What should you monitor after manually performing disimpaction?
Heart rate and blood pressure
Hesitancy urine
Difficulty starting a stream of urine or keeping it flowing ( may stop before bladder is empty )
Urethritis
Inflammation of the urethra
Pyelonephritis
Infection of one or both kidneys
intermittency urine
Urinary stream that is not continuous (starts and stops)
Dysuria
Painful or difficult urination
Nocturia
Excessive urination at night time
Nocturnal enuresis
“Bed wetting” at night time, involuntary urination during the night.
Leukocytosis
Increased white blood cells in urine and blood
Urine retention
Inability to empty all urine from bladder
UTI Risk factors
Incomplete emptying of bladder
Contamination
Instruments / tubes inserted in urinary meatus
Previous UTI
Aging
Stress
Stasis / retention
Female anatomic
S+S of UTI
Voiding urgency
Dysuria
Cloudy, foul smelling urine
Fever
Decreased mental status
What tests are used for UTI assessment
Dipstick urinalysis
If obstruction is suspected, Intravenous pyelogram / CT scan
GU assessment, inspection and palpation
What does the dipstick urinalysis identify, and what tests follow it?
First to identify presence of nitrates, white blood cells and leukocyte esterase (enzyme in WBC’s)
If test is positive it is followed by a urine culture and sensitivity test
What are the different types of incontinence?
Stress
Urge
Functional
Overflow
Total
Transient
Reflex
Teaching interventions for UTI
-Increase water intake and cranberry juice
-Void as soon as urge occurs
-Wipe front to back
-Avoid perfumed products
-Void after sexual intercourse to flush bacteria
-Teach signs and symptoms
Teaching interventions for urinary incontinence
Kegal exercises
Encourage fluid intake 2-3L
Avoid alcohol and caffeine
Discuss use of peripads
void at regular patterns
Don’t hold urine
