Set 10 Flashcards

1
Q

How many mL of urinary output per day is considered normal?

A

1500 mL (1.5 L)

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2
Q

Alert the provider if urine is less than ___ mL/hr

A

30

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3
Q

Concentration of urine

A

Urine specific gravity

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4
Q

Normal range for urine specific gravity

A

1.005-1.030

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5
Q

Low specific gravity = __________ urine

A

Dilute

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6
Q

High specific gravity = _________ urine

A

Concentrated

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7
Q

Patient education for 24 hour urine collection

A

Discard the first void of the day; keep container refrigerated

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8
Q

Leakage of urine as a result of intra-abdominal pressure (coughing, sneezing, jumping, laughing)

A

Stress incontinence

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9
Q

Who is most at risk for stress incontinence?

A

Patients who have multiple pelvic surgeries or pregnancies/deliveries due to weakened pelvic floor

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10
Q

Type of incontinence characterized by inability to make it to the bathroom when there is an urge to urinate

A

Urge incontinence

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11
Q

Who is most at risk for urinary tract infections?

A

Females due to shorter urethra

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12
Q

S/S of UTI

A

Abdominal pain, dysuria (painful urination), frequency, urgency burning, malodorous urine

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13
Q

Key signs of UTI in older adults

A

Confusion and abdominal pain (may not present with classical symptoms)

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14
Q

Patient education for prevention of UTI

A
  • wipe front to back
  • wear cotton underwear
  • avoid bubble baths
  • empty bladder regularly
  • urinate after penetrative vaginal intercourse
  • increase fluid intake; cranberry juice
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15
Q

Placement of bladder scanner transducer

A

Approximately 1 in above the pubic symphysis pointed down towards bladder

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16
Q

Biggest concern for patients with indwelling (foley) catheter

A

Risk for catheter-associated UTI (CAUTI)

17
Q

Biggest risk associated with external catheters

A

Skin breakdown

18
Q

Indwelling catheter care

A
  • use STERILE technique during insertion
  • keep bag below bladder
  • assess for kinks/loops
  • remove as soon as appropriate
19
Q

The nurse should educate constipated patients to increase

A

Fluids, dietary fiber, activity

20
Q

BRAT diet for diarrhea

A

Bananas, rices, applesauce, toast

21
Q

Patients with diarrhea are at risk for

A

Fluid volume deficit (increase fluid intake), impaired skin integrity

22
Q

Surgical openings that divert the normal passage of the bowel

A

Ostomies

23
Q

Surgical opening created in the ileum of the small intestine

A

Ileostomy

24
Q

Describe output from an ileostomy

A

Frequent, liquidy stools

25
Q

Surgical opening created in the colon/large intestine

A

Colostomy

26
Q

Describe the output of colostomies depending on location

A

Output is going to be more formed the closer it is to the rectum:
- ascending colon — watery
- transverse colon — semisolid, pudding-like consistency
- sigmoid colon — formed stool

27
Q

When should ostomy bags be changed?

A

When it is 1/3 full or immediately if it is leaking

28
Q

Characteristics of a normal, healthy stomach

A

Red/pink in color, moist (indicates good blood supply)

29
Q

Stoma findings that should be reported to the provider

A

Pale, cool, dusky, blue (indicative of ischemia)

30
Q

Part of ostomy device that sticks to the patient’s skin

A

Wafer

31
Q

Patient education for cutting/fitting of ostomy wafer

A
  • measure stoma
  • cut opening less than or equal to 1/8 inch wider in diameter
32
Q

Insertion of rectal suppository

A
  • patient in sims position
  • insert suppository about 1 inch into rectum (past the internal sphincter)
33
Q

Enema solution should be less than or equal to ___ inches above the patient

A

18

34
Q

What should the nurse do if patient complains of cramping during instillation of enema?

A

Lower the bag (slows rate of delivery)

35
Q

The nurse should instruct the patient receiving an enema to resist the urge to toilet for approximately ___ minutes or as prescribed per order

A

10

36
Q

Testing for the presence of blood in the feces that is not seen

A

Fecal occult blood test

37
Q

For fecal occult blood testing, blood is present if the card turns __________ after developer is added

A

Blue (NOTE: no color change in the absence of blood)