NRSG200 > QUIZ 7 > Flashcards
QUIZ 7 Flashcards
o2
oxygen
o2 sat
oxygen saturation
OA
osteoarthritis
OB
obstetrics
OD
overdose
OG
orogastric
OOB
out of bed
O&P
ova and parasites
OR
operating room
ORIF
open reduction internal fixation
OT
occupational therapy
OTC
over the counter
q
every
qid
four times per day
RBC
red blood cell
RDA
recommended daily/dietary allowance
RLL
right lower lobe
RLQ
right lower quadrant
RML
right middle lobe
RN
registered nurse
R/O
rule out
ROM
range of motion
ROS
review of systems
RR
respiration rate
RT
respiratory therapist
RUL
right upper lobe
RUQ
right upper quadrant
RV
right ventricle
Rx
treatment
s
without
SaO2
arterial oxygen percent saturation
SBP
systolic blood pressure
SCD
sequential compression device
SCI
spinal cord injury
SICU
surgical intensive care unit
SL
sublingual
SLE
systemic lupus erythematosus
SNF
skilled nursing facility
SOB
shortness of breath
S/P
status post
sp. gr.
specific gravity
STAT
immdiately
Sub Q
subcutaneous
SVC
superior vena cava
SVR
systemic vascular resistance
Sx
symptom(s)
anuria
a lack of urine production.
blood urea nitrogen
urea, the end product of protein metabolism in the kidneys, is measured as blood urea nitrogen (BUN).
creatinine clearance
this test uses 24 hr urine and serum creatinine levels to determine the glomerular filtration rate, a sensitive indicator of renal function.
diuretics
ie chlorothiazide, furosemide
increase urine formation by preventing the reabsorption of water and electrolytes from tubules of kidney into bloodstream. some meds may alter color of urine.
dysuria
voiding is either painful or difficult.
can accompany a stricture (decrease in caliber) of urethra, urinary infections, and injury to bladder and urethra. often clients will say they have to push to void or that burning accompanies or follows voiding. burning may be described as severe, like a hot poker, or more subdued like a sunburn.
enuresis
defined as involuntary passing of urine when control should be established (about 5 yrs of age), can be a problem for some school age children. about 10% of all 6 yr olds experience difficulty controlling bladder.
ileal conduit
or ileal loop, is the most common incontinent urinary diversion.
a segment of ileum is removed and intestinal ends are reattached. one end of portion removed is closed with sutures to create a pouch, other end is brought out through abd wall to create a stoma. ureters are implanted into the ileal pouch. ileal stoma is more readily fitted with an appliance than ureterostomies because of its larger size. mucous membrane lining of ileum also provides some protection from ascending infection. urine drains continuously from ileal pouch.
nephrostomy
diverts urine from kidney via a catheter inserted into the renal pelvis to a nephrostomy tube and bag.
neurogenic bladder
impaired neurologic function can interfere with the normal mechanisms of urine elimination, resulting in neurogenic bladder.
client with neurogenic bladder does not perceive bladder fullness and is therefore unable to control the urinary sphincters. the bladder may become flaccid and distended or spastic, with frequent involuntary urination.
nocturia
voiding two or more times at night.
like frequency, it’s usually expressed in terms of number of times person gets out to void ie nocturia x 4.
polydipsia
excess thirst (despite drinking fluids)
polyuria
aka diuresis.
refers to the production of abnormally large amounts of urine by the kidneys, often several liters more than the client’s usual daily output. polyuria can follow excess fluid intake (polydipsia), or may be associated with diseases like DM, diabetes insipidus, chronic nephritis. can cause excessive fluid loss –> intense thirst –> dehydration –> weight loss
polydipsia
condition of excessive fluid intake
postvoid residual
(PVR)
urine remaining in the bladder following voiding. normally 50-100ml. a bladder outlet obstruction (enlargement of prostate) or loss of bladder muscle tone may interfere with complete emptying. manifestations of urine retention: frequent voiding of small amounts (less than 100ml for adults), urinary stasis, UTI.
pvr is measured to assess amount of retained urine and the need for interventions (ie meds to promote detrusor muscle contractions).
to measure: nurse catheterizes or bladder scans client after voiding. amount voided/obtained by catheterization or bladder scan are measured and recorded. indwelling cath may be inserted if PVR exceeds specified amount.
suprapubic catheter
inserted surgically thru abdominal wall above symphysis pubis into urinary bladder. may have a balloon or pigtail that holds it in bladder. inserted with local anesthesia by provider or during bladder/vaginal surgery. may be secured with sutures to reinforce security of cath and then attached to closed drainage system.
may be placed for temp bladder drainage until client resumes normal voiding (after urethral, bladder, or vaginal surgery), or permanent device (urethral or pelvic trauma).
assess their urine, fluid intake, comfort, maintain patent drainage, do skin care around insertion, do periodic clamping of catheter preparatory to removing if not a permanent appliance.
care for insertion site with sterile technique.
trigone
at the base of bladder.
is a triangular area marked by ureter openings at posterior corners and opening of urethra at anterior inferior corner.
urinary frequency
voiding at frequent intervals, more than 4-6x per day. increased intake of fluid causes some increase in frequency. conditions such as UTI, stress, pregnancy can cause frequent voiding of small quantities (50-100ml) of urine. total fluid intake/output may be normal.
urinary hesistancy
a delay and difficulty in initiating voiding.
often associated with dysuria.
urinary urgency
sudden, strong desire to void. may or may not be a great deal of urine in the bladder, but person feels need to void immediately. accompanies physiological stress and irritation of the trigone and urethra. also common in people who have poor external sphincter control and unstable bladder contractions. it is not a normal finding.
urinary retention
when emptying of the bladder is impaired, urine accumulates and the bladder becomes overdistended = urinary retention.
overdistention causes poor contractility of detrusor muscle, further impairing urination. common causes = prostatic hypertrophy, surgery, some meds.
acute urinary retention is most commmon complication in first 2-4 hours postop.
causes of chronic = paraplegia, quadriplegia, Multiple sclerosis, urethral or perineal trauma.
clients with retention may experience overflow incontinence, eliminating 25-50ml of urine at frequent intervals. bladder is firm and distended on palpating and may be displaced to one side of midline.
cathartics
drugs that induce defecation. they can have strong, purgative effect. a laxative is mild in comparison to a cathartic. produces soft or liquid stools that are sometimes accompanies by abd cramping. ex: castor oil, cascara, phenolphthaelin, bisacodyl.
carminatives
herbal oils known to act as agents that help expel gas from stomach and intestines.
colostomy
a type of ostomy (an opening for the GI, urinary, or respiratory tract onto the skin).
colsotomy opens into the colon (large bowel).
diverts and drains fecal material. often classified according to status as permanent or temporary, anatomic location, and construction a stoma.
constipation
fewer than 3 BM /wk. passage of dry, hard stool or passage of no stool. occurs when movement of feces thru large intestine is slow, allowing time for additional reabsorption of fluid from large intestine. difficult evacuation of stool and increased effort or straining of voluntary muscles of defecation.
may have feeling of incomplete stool evacuation after defecation.
important to define constipation in relation to person’s regular elimination pattern.
defecation
expulsion of feces from anus and rectum. aka bowel movement.
frequency is highly individual. several times per day to 2-3 times per wk.
amount also varies.
peristaltic waves move feces into sigmoid colon and rectum, sensory nerves in rectum are stimulated and individual becomes aware of need to defecate.
facilitated by thigh flexion, sitting position. ignoring reflex or consciously inhibiting by contracting external sphincter muscle will make urge to defecate disappear for a few hours. repeated inhibition can result in expansion of rectum to accommodate accumulation and eventual loss of sensitivity to the need to defecate. constipation can be ultimate result.
diarrhea
the passage of liquid feces and an increased frequency of defecation. opposite of constipation. results from rapid movement of fecal contents thru large intestine. rapid passage of chyme reduces time available for large intestine to reabsorb water/electrolytes. some ppl pass stool with inc frequency, but diarrhea is not present unless stool is relatively unformed and excessively liquid. person with diarrhea finds it difficult or impossible to control urge to defecate. often source of embarrassment. often find spasmodic cramps and increased bowel sounds.
persistent diarrhea>irritation of anal region extending to perineum and buttocks.
fatigue, weakness, malaise, and emaciation are results of prolonged diarrhea.
can be a protective flushing mechanism but also creates serious fluid and electrolyte losses in body (develop within frightening short periods of time in infants, small children, older adults.)
protect anal area clean and dry with zinc oxide or other ointment.
use fecal collector can.
diarrhea caused by stress, meds, antibiotics, allergy, intolerance to foods, diseases like Crohn’s, Iron
enema
solution introduced into rectum and large intestine. action of enema is to distend intestine and sometimes irritate intestinal mucosa, thereby increasing peristalsis and excretion of feces and flatus. enema should be at 37.7 celsius (100F) because solution thats too cold or too hot is uncomfortable and causes cramping. classed as cleansing, carminative, retention, or return-flow enemas.
fecal impaction
mass or collection of hardened feces in folds of rectum. impaction results from prolonged retention and accumulation of fecal material. in severe impactions the feces accumulate and extend well up into sigmoid colon and beyond. a client who has a fecal impaction will experience the passage of liquid fecal seepage (diarrhea) and no normal stool. liquid portion of feces seeps out around impacted mass. impaction can also be assessed by digital examination of the rectum, during which the hardened mass can often be palpated.
flatus
largely air and the by-products of digestion of carbohydrates. eventually eliminated thru anal canal
gastrocolic reflex
increased peristalsis of the colon after food has entered the stomach.
jejunostomy
a type of ostomy (an opening for the GI, urinary, or respiratory tract onto the skin).
jejunostomy opens thru the abd wall into the jejunum.
generally performed to provide an alternate feeding route.
ileostomy
a type of ostomy (an opening for the GI, urinary, or respiratory tract onto the skin).
ileostomy opens into the ileum (small bowel)
hemorrhoids
veins in the vertical folds of the rectum become distended with repeated pressure –> hemorrhoids.
laxatives
medications that stimulate bowel activity and so assist fecal elimination.
consistent use inhibits natural defecation reflexes and is thought to cause rather than cure constipation. eventually will require greater doses. may interfere w/body electrolyte balance and decrease absorption of certain vitamins.
peristalsis
wavelike movement produced by circular and longitudinal muscle fibers of intestinal walls; propels intestinal contents forward. colon peristalsis is very sluggish and thought to move chyme very little along large intestine. mass peristalsis is the third type of colonic movement, and involves a wave of powerful muscular contraction that moves over large areas of the colon. usually occurs after eating, stimulated by presence of food in stomach and small intestine(occurs few times a day only).
stoma
the opening created in the abdominal wall by an ostomy. generall red and moist. initially slight bleeding may occur when touched and this is normal. person does not feel stoma because there are no nerve endings in the stoma.
