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fundamentals of nursing > test 3 > Flashcards

test 3 Flashcards

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1
Q

where is blood filtered

A

nephrons

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2
Q

3 parts of the kidney

A

cortex, medulla, renal pelvis

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3
Q

what do nephrons do

A

filtrate, reabsorb, secrete

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4
Q

renal pyramids

A

bundles of collecting tubules
in medulla

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5
Q

what does renal pelvis do

A

receives urine from renal pyramids, stores until ready to go to bladder

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6
Q

outer layer of kidney

A

cortex. houses nephrons

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7
Q

inner layer

A

medulla. where renal pyramids are

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8
Q

filtrate is removed from blood

A

bowmans capsule

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9
Q

where reabsorption in kidney occurs

A

convoluted tubules

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10
Q

controls convuluted tubules

A

ADH- increase water absorption
aldosterone- increase sodium reabsorption

both cause less water= less urine

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11
Q

what percentage of urine is filtrate

A

1% is filtrate, the rest is water

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12
Q

transports urine from renal pelvis to urinary bladder

A

ureters

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13
Q

muscular sac like organ that holds averagely 500 mL urine

A

urinary bladder

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14
Q

where do most UTIs happen

A

urinary bladder

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15
Q

transports urine to exterior

A

urethra

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16
Q

why are females more prone to UTI

A

due to close proximity to anus, and the short urethra (1.5 inches approximately)

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17
Q

is the internal urethral sphincter involuntary or voluntary

A

involuntary

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18
Q

is the external urethral sphincter voluntary or involuntary

A

voluntary, if you are potty trained

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19
Q

normal kidneys produce how much urine for avg adult

A

50-60 mL/hr
1500 ml/day
avg person urinates 5-6 times daily

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20
Q

what can cause increased urination

A

diabetes, UTI, tumor, pregnancy

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21
Q

what can cause decreased urination

A

kidneys aren’t functioning, blockage, dehydration

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22
Q

urination in infants is based on

A

weight.
15-60mL per Kg
they dont have voluntary control

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23
Q

what is needed for toilet training

A

a mature neuromuscular system
adequate communication skills

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24
Q

when do most kids have full bladder control by

A

4-5 years of age

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25
Q

enuresis

A

unable to hold urine, usually from holding too long.

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26
Q

nocturnal enuresis

A

bed wetting

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27
Q

primary nocturnal enuresis

A

bed wetting in a child who hasnt yet learned to hold all night

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28
Q

secondary nocturnal enuresis

A

child had no issues with bed wetting but it randomly started occurring all of a sudden. usually related to something else such as some type of trauma, or diabetes.

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29
Q

what happens to kidneys as they age

A

nephrons decrease
kidney size decreases

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30
Q

common urinary issues in elderly

A

urgency and frequency occurs
kidney function decreases
loss of bladder elasticity

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31
Q

nocturia

A

getting up to pee in night

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32
Q

retention

A

bladder can’t fully empty

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33
Q

nutrition factors influencing urination

A

high salt intake holds onto water which causes less urine

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34
Q

surgical factors influencing urination

A

anesthesia can cause urinary retention

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35
Q

how does pregnancy affect urination

A

pelvic floor muscles weaken

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36
Q

pyridium

A

medication that makes urine bright orange. Numbs urethra

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37
Q

amitriptyline

A

medication that causes a blue/green urine

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38
Q

levodopa

A

medication that causes brown or black urine

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39
Q

what kind of medications can be nephrotoxic

A

antibiotics, NSAIDs, chemo drugs

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40
Q

med that prevents reabsorption of water

A

diuretics

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41
Q

why does decreased blood flow affect urine

A

less blood, less filtration

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42
Q

hypertrophy of prostate

A

prostate to big, urine cant pass. urinary retention

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43
Q

neuro problems with urination

A

cant sense bladder is full

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44
Q

urethritis

A

uti in urethra

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45
Q

cystitis

A

uti in bladder

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46
Q

pyelonephritis

A

uti in kidney

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47
Q

most common cause of uti

A

e. coli

found in human intestinal tract
- wiping front to back helps prevent

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48
Q

uti risk factors

A

enlarged prostate
females
frequent sex
menopause
uncircumcised males
indwelling catheters

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49
Q

uti symptoms, treatment and diagnostic

A

back pain, nausea, frequency, urgency, dysuria, hematuria, pyuria, fever, cloudy urine

treatment- antibiotics. cipro is most common
drink water
analgesic for pain

diagnosed by UA and CNS

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50
Q

should you be able to palpate empty bladder

A

no

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51
Q

what can cause urinary retention

A

muscle dysfunction
enlarged prostate
anesthesia
disease
injury
infection
obstruction
sensory impairment

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52
Q

urinary retention symptoms and treatment

A

abdominal pain, bladder distention, low urine output, residual urine, frequency, urgency

treatment- straight (intermittent) catheter, indwelling catheter, suprapubic catheter

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53
Q

stress incontinence

A

urinating when laughing, sneezing, etc

common in pregnancy

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54
Q

urgency incontinence

A

overactive detrusor muscle

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55
Q

overflow incontinence

A

bladder overfills and leaks

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56
Q

functional incontinence

A

inability to get to bathroom

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57
Q

total incontinence

A

involuntary

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58
Q

management of incontinence

A

kegel exercises (women)
bladder training- increase bladder volume
lifestyle modification
prevention of skin breakdown

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59
Q

urinary diversion

A

surgical opening for urine elimination. can be permanent or temporary

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60
Q

urostomy

A

ureter to surface

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61
Q

continent urinary reservoir

A

holding bag for urine

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62
Q

neobladder

A

alternate bladder

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63
Q

dialysis

A

when we need to take filtrate out because kidneys aren’t working properly
can:
- restore fluid and electrolytes
- control acid-base balance
- remove waste and toxic materials

from movement of high to low concent

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64
Q

peritoneal dialysis

A

in abdomen. dialysis fluid in body that pushes waste out
done at home, filtered thru peritoneum

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65
Q

hemodialysis

A

cleaning the blood. shunt in arm pulls blood out, runs thru dialysis machine and cleans blood and puts it back in thru other shunt
done at a clinic

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66
Q

CNS

A

urine culture and sensitivity
cultures what is growing and what antibiotics work for it

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67
Q

lab test and bedside tests of urine

A

UA
CNS
electrolytes
blood urea/creatinine- for dehydration
input and output
daily weights - if holding fluids, more weight

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68
Q

mastication

A

chewing

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69
Q

what is persistalsis

A

muscular movement that pushes food in stomach

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70
Q

where is cardiac sphincter

A

upper part of stomach

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71
Q

how long does food say in stomach on average

A

4 hours

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72
Q

what does pepsin and protease do

A

digests proteins

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73
Q

what does food leave stomach as

A

chyme

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74
Q

where are most things absorbed

A

small intestine

75
Q

why does fecal become more solid as it moves toward rectum

A

more absorption

76
Q

what does villi and microvilli allow for

A

maximum absorption

77
Q

main function of large intestine

A

water absorption

78
Q

internal anal sphincter

A

involuntary

79
Q

external anal sphincter

A

voluntary

80
Q

breaks down carbs

A

salivatory amylases

81
Q

how long in between peristalsis contractions

A

3-12 mins

82
Q

mass peristalsis movement that occurs 1-4 times a day averagely

A

bowel movement

83
Q

what helps prevent loose stools

A

fiber, it doesn’t digest so it helps harden and clean out the intestine

84
Q

what helps prevent constipation

A

fluids

85
Q

why do infants have watery stool

A

intestines aren’t mature yet

86
Q

biggest risk factor for IBS

A

stress

87
Q

foods that can cause constipation

A

lean meat, cheese, eggs , pasta

88
Q

laxative foods

A

dark chocolate, fruit, veggies, bran cereal, alcohol, coffee

89
Q

gas producing foods

A

onions, cabbage, broccoli, cauliflower, beans, sweet potatoe

90
Q

prolonged use of laxatives

A

decreases peristalsis

91
Q

what 2 most common medications cause diarrhea

A

iron and narcotics

92
Q

what does iron do to stool

A

make it black

93
Q

anesthesia relationship with stomach

A

it slows the movement and can result in paralytic ileus

94
Q

how to avoid paralytic ileus

A

stay on NPO and NG tube

95
Q

pregnancy relationship with bowels

A

fetus crowds and can cause constipation
elevated progesterone slows intestinal activity
iron supplement for anemia constipates

96
Q

what does antibiotics do to stool

A

can make it green or gray

97
Q

what could aspirin and anticoagulants do GI tract

A

possibly cause GI bleeding

98
Q

flatulence

A

passing gas

99
Q

hemmorrhoids

A

varicose vein in rectum

100
Q

diverticulosis

A

pouches in intestine. can turn into diverticulitis

101
Q

What is diarrhea

A

when the stool moves to quickly making it loose and watery.
this has to happen multiple times to be considered diarrhea

102
Q

fecal impactatin

A

dry hard stool that becomes lodged and cant be passed

may result in enema or digital removal

103
Q

diverticulosis risk factor

A

eating lots of red meat, low fiber, or obesity

104
Q

bowel diversion

A

surgically created opening that brings bowel to surface

105
Q

what causes diverticulitis

A

something getting stuck in diverticula

avoid small seeds and eat a high fiber diet

106
Q

how many gurgles should you hear a minute when auscultating stomach

A

3-15

107
Q

if there is no sound in bowel when auscultating for 3-5 mins, what should you do

A

notify provider
monitor blockage

108
Q

how much formed stool is needed for a sample

A

1 inch, or 2 tablespoons

109
Q

how much liquid stool is needed for sample

A

20-30 oz, or an ounce

110
Q

how does a occult blood test work

A

fecal is smeared and test looks for peroxidase which is a enzyme in blood

111
Q

where does a EDG look at

A

upper part of GI

112
Q

where does colonscopy look

A

begining of large intestine

113
Q

where does sigmoidoscopy look

A

end of colon near rectum

114
Q

what is barium

A

radioactive dye

115
Q

interventions for patients with diarrhea

A

dilute gatorade/pedialyte with water
BRAT diet
encourage clear liquids
anti diarrhea meds not recommended for acute cases

116
Q

why does depression effect bowels

A

it slows all body processes

117
Q

how long should enema be held

A

15 mins

118
Q

digital impaction

A

digital removal of stool

119
Q

stool softener

A

prevents straining
better than laxative

120
Q

what does NG tube do

A

drains stomach and keeps it empty. allows GI tract to rest

121
Q

what should stoma look like

A

beefy red or dark pink
shiny

122
Q

what to teach patient with stoma

A

when and how to change it
what it should/shouldn’t look like
body positivity

123
Q

the higher in tract the stoma…

A

the more liquidy it is and smelly

124
Q

TPN

A

total peripheral
all feeding is from vein

125
Q

PPN

A

parietal peripheral
only portion of feeding thru vein

126
Q

why thickeners in drinks for people with swallowing issues

A

to prevent aspiration

127
Q

3 main functions of skin

A

thermoregulation, protect, sensation

128
Q

superficial wound depth

A

epidermis

129
Q

partial thickness wound depth

A

dermis, epidermis

130
Q

full thickness wound depth

A

down to subcutaneous tissue. muscle,

131
Q

penetrating wound depth

A

organs

132
Q

older adult skin

A

less elastic, drier, reduced collagen, hyperpigmentation, more prone to injury

133
Q

why may tenting on elderly be normal

A

less elasticity

134
Q

exudate

A

drainage

135
Q

friction

A

rubbing together

136
Q

shearing

A

gravity with friction

137
Q

ischemia

A

decreased oxygenation

138
Q

how does protein help the skin

A

building block. helps maintain, repair and reserve intravascular volume

139
Q

what vitamins are associated with collagen formation

A

vitamin c, zinc, copper, vitamin A

140
Q

What are some meds that can effect skin

A

blood thinners, vitamin k, steroids (reduces inflammation, inflammation is skin response to injury to help heal)

141
Q

what’s maceration and what causes it

A

pruny skin, moisture

142
Q

how do fever affect skin healing

A

increased metabolic rate, making more work to reduce that rather then healing skin, and they create moisture

143
Q

examples of closed wound

A

hematoma (bleeding under skin), ecchymosis (bruising), redness

144
Q

induration

A

hard area, gives evidence that there may be problem under skin

145
Q

not breaking sterile technique in surgery

A

clean

146
Q

higher risk body surgery (GI, GU, resp) locations whose at risk for infection

A

clean contaminated

147
Q

pathogen growing, localized

A

contaminated

148
Q

systemic problem throughout whole body from contamination

A

infection

149
Q

serous exudate drainage

A

straw colored (clear to yellow), plasma, thin, watery

150
Q

sanguineous drainage

A

bloody drainage

151
Q

serosanguineous drainage

A

mix of bloody and straw colored fluid

152
Q

purulent drainage

A

yellow, pus, usually with foul odor

153
Q

regeneration

A

superficial, no scar

154
Q

primary intention

A

wound closed by surgery, edges are together

155
Q

secondary intention

A

letting wound heal from inside out, not completely closed in surgery

156
Q

tertiary intention “delayed primary”

A

wound is left open to start with, but will eventually be fully closed in surgery
usually cause of infection/contamination

157
Q

how to look for hemorrhage

A

Look for internal bleeding, low bp, high HR, hematoma in gravitational areas, mental status changes, low hematic hemoglobin levels

158
Q

whens a fever considered concerning

A

101F and above

159
Q

signs of infection

A

fever, elevated WBC, inflammation

160
Q

fistula formation

A

connection between 2 points that typically don’t have on. usually in GI or GU

161
Q

dehiscence

A

tissue pulls apart or splits

162
Q

evisceration

A

protrusion of organ thru incision

163
Q

what is braden scale based on

A

sensory perception, moisture, activity and mobility, nutrition, friction and shear

164
Q

braden scale scoring

A

best score=23
score that is at risk= 18 and under

165
Q

why does location change wound healing

A

places that are more vascular heal faster

166
Q

debriding

A

removing dead, dying, or useless tissue

167
Q

BEAMS acronym for debriding

A

B- biologic ex- maggots
E- enzymatic drug on dressing to liquefy junk on wound
A- autolysis letting the body do its own thing. Only thing we do is put dressing
M- mechanical wet to dry
S- sharp/surgical scalpel and cutting out

168
Q

why should some wounds be immobilized

A

to prevent reopening skin

169
Q

necrotic tissue that is yellow. only seen in stage 3&4 ulcers not 1&2.

A

slough

170
Q

dead tissue that’s black or brown. typically hard

A

eschar

171
Q

suspected deep tissue injury

A

Looks like stage one ulcer, but more purplish bruise looking, stage one is more pink tone

172
Q

how to find stage 1 ulcer on darker skin

A

Palpate for temp and induration

173
Q

unstageable ulcer

A

cant see 50% of wound bed

174
Q

what causes pressure injuries

A

decreased blood flow

175
Q

TIME acronym- assessing wounds

A

Tissue- what does it look like
Infection or inflammation
Moisture
Edge of wound- what does it look like

176
Q

wound bed curls under. signs of inadequate nutrition, not enough hydration to wound

A

epiable

177
Q

what to do if wound bed pink

A

protect, monitor blood flow.

178
Q

what to do if wound bed yellow

A

monitor for infection, clean and debride

179
Q

what to do if wound bed black

A

eschar, dead tissue, debride and monitor for circulation

180
Q

red wound bed

A

usually healthy, protect

181
Q

tells us about protein stores here and now

A

prealbumin

182
Q

tells us about protein stores over time (3 weeks or so)

A

albumin

183
Q

Phlebitis

A

Redness following path of vein
Purulent drainage, pain, edema

184
Q

Infiltration

A

Bubbling at the site
Skin blanched, bruised, swollen, pitting edema, numbness, cool to touch, pain

fundamentals of nursing (4 decks)

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