Test #1 Flashcards
Urgency
Feeling of need to void immediately. Full bladder, bladder irritation, or inflammation from infection, overactive bladder, psychological stress
Dysuria
Painful or difficult urination. Bladder inflammation, trauma, or inflammation of urethral sphincter.
Frequency
Voiding at frequent intervals (less than 2 hours). Increased fluid intake, bladder inflammation, increased pressure on bladder (pregnancy), diuretic therapy
Hesitancy
Difficulty initiating urination. Prostate Enlargement, anxiety, urethral edema
Polyuria
Voiding large amounts of urine. Excess fluid intake, diabetes mellitus or insipidus, use of diuretics, postobstructive diuresis
Oliguria
Diminished urinary output relative to intake (usually 400 ml/24 hr). Dehydration, renal failure, UTI, Increased ADH secretion, heart failure
Nocturia
Voiding one or more times at night. Excessive fluid intake before bed (especially coffee or alcohol), Renal disease, aging process, prostate enlargement.
Dribbling
Leakage of urine despite voluntary control of urination. Stress incontinence, overflow from urinary retention (e.g. from BPH)
Incontinence
Involuntary loss of urine. Multiple factors: unstable urethra, loss of pelvic muscle tone, fecal impaction, neurological impairment, overactive bladder
Hematuria
Blood in urine. Neoplasms of kidney or bladder, glomerular disease, infection of kidney or bladder, trauma to urinary structures, calculi, bleeding disorders
Retention
Accumulation of urine in bladder, with inability of bladder to empty fully. Urethral obstruction (stricture) decreased sensory activity, neurogenic bladder, prostate enlargement, postanesthesia effects, side effects of medications. (e.g., anticholinergics, opioids)
Residual Urine
Volume of urine remaining after voiding (greater or equal to 100 mL). inflammation or irritation of bladder mucosa from infection, neurogenic bladder, prostate enlargement, trauama, or inflammation or urethra.
ADH
Antidiuretic hormone
BPH
Benign prostatic hyperplasia
BSC
Bedside Commode
FUNCTIONAL -Urinary Incontinence & Tx options
Loss of urine caused by factors outside the urinary tract that interfere with the ability to respond in a socially appropriate way to the urge to void. INTERVENTIONS: Clothing mods, Environ. Alterations, Scheduled toileting, Absorbent Products
STRESS - Urinary Incontinence & Tx options
Involuntary leakage of urine during increased abdominal pressure in the absence of bladder muscle contraction. (coughing, laughing, sneezing, or lifting with a full bladder) INTERVENTIONS: Pelvice Floor Exercises (kegel) Surgical Interventions Biofeedback Electrical Stimulation Absorbent Products
URGE - Urinary Incontinence & Tx options
Involuntary passage of urine after a strong sense of urgency to void. Urinary urgency, often with frequency (more than every 2 hours); bladder spasm or contraction. INTERVENTION: Antimuscarinic Agents Behavioral Interventions Biofeedback Bladder retraining Pelvic floor exercises Lifestyle modifications (smoking, cess, weight loss, fluid mods) Absorbent products
MIXED -Urinary Incontinence & Tx options
Combination of urge and stress urinary incontinence signs and symptoms or Combination of urge and stress symptoms
INTERVENTION:
Main Treatments usually based on symptoms that are most bothersome to patient
OVERFLOW INCONTINENCE -Urinary Incontinence & Tx options:
Involuntary loss of urine at intervals without sensation of urge to void
RELEVANT FACTORS:
Spinal Cord Dysfunction - loss of cerebral awareness or impairment of reflex arc
List Roles of a Professional Nurse
Protect, Promote & Optimize our pt’s health
Prevent illness & injury
Alleviate suffering through the diagnosis & tx of Human Responses
Advocate for the care of our pts
APRN
Advanced Practice RN, master’s degree
DNP
Doctor of nursing practice, doctoral degree
CNS
Certified Nursing Specialist, APRN in specialized area
NP
Nurse Practitioner; APRN in specialized area
CNM
Certified Nurse Midwife; provided care for pregnant women
CRNA
Certified RN anesthetist, APRN with specialization in anesthesia
Benner: Stages of nursing proficiency
Novice Advanced Beginner Competent Proficient Expert
Florence Nightingale
1st practicing epidemiologist;
1st Nursing school - helped sanitation in battlefield hospitals, her practices remain in nursing today.
Studied caring: a universal phenomenon that influences the way we think, feel & behave (reduced mortality from 45% to 2%)
Autonomy
Involves the initiation of independent nursing interventions w/o medical orders. Increased responsibility
Accountability
Means that you are responsible, professionally & legally, for the type and quality of nursing care provided. WE are accountable
Caregiver
Regain Health, find max level of independent function
Advocate
Protect human and legal rights of clients, help assert those rights when needed.
Educator
Informal and Formal teaching client, family, significant other, or support systems
Communicator (key)
Central to nurse-client relationship, helps you to know your pt’s strengths, weaknesses, needs and fears
Manager
Collaborates with others to establish outcomes, evaluate care, evaluate staff nurses
What are the standards of nursing?
They provide guidelines for implementing and evaluating nursing care (ADPIE)
Preventative
Primary care, focused on improved outcomes for an entire population, collaboration among healthcare professionals, lowers overall cost: health promotion is the key to quality healthcare
Secondary/Tertiary
Acute care, focused on diagnosis & tx of dz, dz management, 20% of people spend 80% of healthcare costs
Restorative
Helps pts recover from acute or chronic illness/disability; regain maximal function and quality of life, promotes pt independence and self-care; multidisciplinary approach. Ex: homecare, rehabilitation, extended care
Continuing Care
For people who are disabled, functionally dependent, or suffering a terminal diz. Available w/in institutional settings or in the home.
Ex: nursing centers/facilities, hospice, assisted living (5% over 65 live here), adult day care
METABOLIC - Discuss Hazards of Immobility
Endocrine, calcium absorption, GI function
CV - Discuss Hazards of Immobility
Orthostatic hypotension, thrombus (blood clot)
MS EFFECTS -Discuss Hazards of Immobility
Loss of ms mass, atrophy
URINARY - Discuss Hazards of Immobility
Urinary stasis, renal calculi, UTI
RESPIRATORY -Discuss Hazards of Immobility
Atelectasis (fluid in lungs causing cracking, wet sounds) hypostatis pneumonia
MUSCULOSKELETAL -Discuss Hazards of Immobility
Loss of endurance, decreased stability
SKELETAL -Discuss Hazards of Immobility
Imparied calcium absorption, joint abnormalities
INTEGUMENTARY -Discuss Hazards of Immobility
Pressure ulcer, ischemia, older adults at greater risk
PSYCHOSOCIAL -Discuss Hazards of Immobility
Emotional/Behavioral response: Hostility, giddiness, fear, sensory: altered sleep patterns - changes in coping: depression, sadness
METABOLIC - Nursing Implementations of Immobility
Provide high-protein/calorie diet with Vitamin B & C Supplements
RESPIRATORY - Nursing Implementations of Immobility
Cough & deep breathe every 1-2 hours, chest PT
CV - Nursing Implementations of Immobility
Progress from bed to chair ambulation; SCD’s (sequential compression device), TED hose, leg exercises
MUSCULOSKELETAL - Nursing Implementations of Immobility
PROM, CPM, AROM
INTEGUMENTARY - Nursing Implementations of Immobility
Reposition every 1-2 hours, provide skin care
ELIMINATION - Nursing Implementations of Immobility
Provide adequate hydration, serve diet rich in fluids, fruits, veggies and fiber.
Supported Fowler’s
pt is supine with head of bed raised/flexed to 30-45 degrees
Supine
pt lies flat facing up
Prone
pt lies facing down
Sims’
Pt lies on left side with left arm and shoulder are drawn back behind the body, body weight is primarily on the chest, right arm is flexed upward for support
Trendelenberg
Pt lies flat with head of bed flexed down 45 degrees
National Pt Safety Goals (NPSGs)
- Identify patients correctly
- Improved staff communication
- Use Medicines safely
- Use Alarms Safely
- Prevent infection
- Identify patient safety risks
- Prevent mistakes in surgery
- A pt safe environment: reduces the risk for injury & illness, decreases costs, improving a pt’s functional status, increasing a pt’s sense of well-being
QSEN (Quality & Safety Education for Nurses)
- Was developed to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the health care systems in which they work.
- minimizes risk of harm to patients and providers through system effectiveness and individual performance
Patient Safety Factors
Environmental Basic Needs Oxygen Nutrition Temp (65-75 deg) Disasters Pollution Physical Hazards MVAS Poison Falls Fire Transmission of pathogens
What is a serious reportable event?
Medication Error, Falls, IV infiltration - Fill out incident report
What is a never event?
Foreign object left in body after surgery, air embolism, blood compatibility, pressure ulcers stage 3 or 4, falls and trauma, electrical shock, UTI from catheters, DVT