Module 7A dIN

Question 1

Nurse/Physician Initiated Interventions. - - Constipation

Answer 1

• Laxatives/Enema (only if needed)
• Increase fiber
• Encourage fluid intake (Warm beverages)
• Exercise regularly
• Establish a regular time to defecate (Don’t delay urges)
- Fetal Impaction
• Laxatives/Enema
• Digital Removal of Stool (Noted clay-colored stool)

Question 2

Nurse/Physician Initiated Interventions
- Diarrhea
•

Answer 2

Anti-diarrheal agents
(Contra-indicated for infectious diarrhea)
• Flagyl, Vancomycin & Dificid with C-diff infection)
(Rarely used to treat acute diarrhea)
• Oral Glucose & Electrolytes
• Endoscopy & Colonoscopy
- Flatulence
• Decrease use of straw
• Change diet

Question 3

NO ppts for Dino watch his videos!

Question 4

Identify factors affecting bowel elimination

Answer 4

Age
Diet
Exercise
Medication

Question 5

Discuss bowel elimination changes related to older adults

Answer 5

Muscle tone in the bowel and abdominal muscles weaken
Prostate problems for men
Malabsorption
Slower metabolism can cause constipation

Question 6

Describe characteristics of normal and abnormal stool

Answer 6

Normal
Brown color
Pungent odor
Soft, formed consistency
Daily or 2-3x a week
150g/day
Resembles diameter of rectum shape
Abnormal 
White, clay, black, red or pale color 
Noxious odor
Liquid or hard consistency 
narrow/ pencil shaped 
Black/tarry stools are called Melena (mentioned in lecture recording)

Question 7

Create a care plan for a patient with constipation and diarrhea

Answer 7

For constipation
laxatives/enema
Increase fiber
Food high in fiber; cereals with raisin bran
Encourage fluid intake
Exercise regularly
Establish regular time to defecate 
digital removal of stool 
Anti-diarrheals
PO glucose and electrolytes
Endoscopy and colonoscopy
Change diet
Decrease use of straws

Question 8

For urinary incontinence

Assess

Answer 8

For urinary incontinence
Assess impairments that can hinder ability to get to the bathroom
Encourage avoiding caffeine, alcohol and carbonated drinks
Assess signs of infection
Assess bladder distention
Develop voiding schedule
Assess for skin breakdown
Monitor for signs of UTI
Lower: symptoms in bladder, cystitis, frequent urination with pain (dysuria), dark, cloudy tinged
Upper: pyelonephritis, fever- only in upper, N/V, CVA tenderness, systemic symptoms; high temperature i.e. fever, can see symptoms of lower UTI can be seen in upper UTI

Question 9

Create a care plan for a patient with impaired urinary elimination, urinary retention and urinary incontinence
For urinary retention

Answer 9

Create a care plan for a patient with impaired urinary elimination, urinary retention and urinary incontinence 
For urinary retention
Assess pt bladder fullness
Encourage fluids
Monitor Is and Os
Monitor for s/s of UTI
Lower: symptoms in bladder, cystitis, 
Upper: pyelonephritis, fever- only in upper, N/V, CVA tenderness, systemic symptoms - kidneys symptoms

Question 10

Describe characteristics of normal and abnormal urine

Answer 10

Normal
clear/ pale yellow color
Slightly aromatic/ ammonia odor
Specific gravity 1.001-1.035
Abnormal
red-red/brown color
Cloudy
Veggies can change smell 
acetone/fruity odor

Question 11

Discuss urinary elimination changes related to older adults

Bladder muscles weaken

Answer 11

For women, urethra shortens and becomes thinner

Prostate problems for men