Test #4 study guide Flashcards
Elements of the pain experience:
- Transduction
- Transmission
- Perception of pain
- Modulation
Acute vs. chronic pain – symptoms :
Acute- rapid onset, no warning.
Chronic- (3 months) , gradual and ongoing.
Types of pain:
- somatic
- visceral
- nociceptive
- neuropathic: Pain from a lesion or disease of the central or peripheral nerves
- cutaneous
Factors that may affect a person’s pain experience:
- pain threshold
- adaptation
- modulation of pain
Non pharmacologic pain relief measures :
A distraction like the TV, relaxing techniques, playing a video game, humor, music, imagery, etc
Side effects of analgesics:
Euphoria, dysphoria, agitation, seizures, hallucinations. Lowered blood pressure and heart rate. Muscular rigidity and contractions. Nausea and vomiting. Non-allergic itching. Pupil constriction. Sexual dysfunction. Urinary retention.
Variables that influence urination
Pathologic and surgical conditions Privacy issues and embarrassment Medications Food and fluid intake Ambulatory ability Muscle tone The cause of enuresis (involuntary passing of urine) Developmental factors Psychosocial factors
Normal characteristics of urine:
Urine can be dilute or concentration
Normal urine is sterile
It contains fluids, salts, and waste products, but it is free of bacteria, viruses, and fungi.
Urine can be produced in small or large amounts (1.5 L per day)
DOES NOT HAVE protein, glucose (little to none), or ketones.
Diagnostic tests procedures r/t urinary elimination:
BUN and Creatinine
-measure kidney function
Creatinine
waste product from muscle breakdown
BUN
a measure of the urea level in the blood
Diagnostic tests procedures r/t urinary elimination: Urinalysis
Specific gravity, pH, protein, glucose, ketones, microscopic analysis
Screens for UTI, kidney disease, etc.
Diagnostic tests procedures r/t urinary elimination: 24-hour urine collection
First specimen is discarded and then the time starts for 24 hours.
Keep urine on ice
Diagnostic tests procedures r/t urinary elimination: Intravenous pyelography
X-ray of the kidneys, bladder, ureters, and urethra
Images show the size, shape, and position of the urinary tract.
Diagnostic tests procedures r/t urinary elimination: Computed tomography
Used to diagnose kidney stones, bladder stones, or blockage of the urinary tract.
With contrast
Diagnostic tests procedures r/t urinary elimination: Cystoscopy
Camera inserted into the urethra
Diagnostic tests procedures r/t urinary elimination:
Cystoscopy
Camera inserted into the urethra
Nursing diagnosis. (Urination)
Nursing diagnosis: Impaired urinary elimination Urge urinary incontinence Pain Ineffective coping Stress urinary incontinence Functional urinary incontinence Risk for infection
Implement and evaluate nursing care (urination)
- Nurse focuses on activities that will help the patient with compromised urinary elimination return of the NORMAL STATE OF FUNCTION OR TO ADAPT TO CHANGES IN THE STATE OF FUNCTION.
- Follow ups are needed to assure quality in the care provided and to determine need for further nursing interventions
Lab values: Auria, Oliguria, Polyuria
Auria: 50-100mls
Oliguria: 100-400mls
Polyuria: over 2,500 mls
Alteration in renal function. - renal, pre-renal, post-renal
Pre-renal: reduced blood flow to kidneys
Renal: Actual kidney damage
Post-renal: obstruction of urine flow
Types of incontinence:
- Stress
- Urge
- Mixed
- Functional
- Overflow
UTI prevention:
Avoid wearing tight-fitting clothing Drink at least 8 8oz glasses of water every day Urinate when the urge is felt Women and girls wipe “front to back” Urinate after sexual intercourse Showers are preferred over baths Good perineal hygiene is essential
Identify variables/factors that influence bowel elimination:
Developmental considerations Daily patterns Food and fluid intake Activity and muscle tone Lifestyle Psychological variables Pathologic conditions Medications Diagnostic studies Surgery and anesthesia
Stool collection for laboratory analysis: (guidelines for handling it)
- Medical aseptic technique is imperative. (not sterile)
- Hand hygiene, before and after glove use, is essential.
- Wear disposable gloves.
- Do not contaminate the outside of the container with stool.
- Obtain stool and package, label, and transport according to agency policy.
Stool collection for laboratory analysis: (Directions)
Void first so that urine is not in the stool sample.
Defecate into the container rather than the toilet bowl.
Do not place toilet tissue in the bedpan or specimen container.
Avoid contact with soaps, detergents, and disinfectants as these may affect test results.
Notify the nurse when the specimen is available.
Direct and indirect visualization studies of the gi tract and nursing care/teaching:
- Indirect visualization studies: RADIOGRAPHIC (NON INVASIVE) views of the GI tract, used to detect gallstones, fecal impaction, and distended bowel. Tests include Abdominal Flat Plate, Barium Enema (BE), Ultrasonography, CT scan, and MRI
- Direct visualization studies: used for diagnostic and treatment purposes only, ARE INVASIVE PROCEDURES conducted by a gastroenterologist who inserts various instruments to examine the interior of the GI tract. Tests include: esophagogastroduodenoscopy (EGD), sigmoidoscopy, fiberoptic colonoscopy
Nursing interventions to promote regular bowel habits and ease defecation:
- Timing, positioning, nutrition, privacy, exercise, and teaching clients when they should seek medical assistance. .
- Providing hydration and nutrition (More fiber and fluid intake, FRUIT).
Nursing diagnosis (Bowel)
- Constipation
- Diarrhea
- Bowel incontinence
- Self-care deficit
- Disturbed body image
Implement and evaluate nursing care involving bowel elimination:
- Evaluation of the goals and outcomes for the patient with bowel elimination problems is important to achieve the desired outcomes.
- Whether the goals include a return to normal bowel function or maintaining existing function within the parameters of the patient’s condition, it is important for the nurse to determine whether they have been met, and if not, why.
Common laxative types
- Bulk-forming
- Stimulant
- Osmotic: Draws water into the bowel
- Lubricant
- Stool softener: Brings liquid into the stool
Function and role of the respiratory and cardiovascular system:
Respiratory :
- Inspiration and expiration
- Pulmonary ventilation: movement of air into and out of the lungs
- Respiration: Intake of O2, release of CO2.
Cardiovascular
- Composed of the heart and blood vessels
- Transport blood all over the body
- Blood bring O2 around the body, and deoxygenated O2 back to the lungs
Care of patients with oxygenation problems:
Teach about a pollution-free environment Promote comfort Promote optimal function Promote proper breathing Manage chest tubes Promote and control coughing Perform chest physiotherapy Suction the airway Meet O2 needs w medications and teach patients about them
Factors that affect respiratory and cardiovascular function:
Level of health Developmental considerations Medication considerations Lifestyle considerations Environmental considerations Psychological health considerations
Diagnostic & lab studies and nursing care/teaching: Cardiac coronary catheterization
We put a probe through the femoral artery and it goes into the heart-
-they put a catheter in the heart valve or wherever to keep it open for blood flow, used especially when there is plaque build up.
Medications for oxygen?
- Bronchodilators
- Nebulizers
- Meter-dose inhalers: you get the same amount of medicine no matter what type of breath you take
- Dry-powder inhalers: have to take a deep breath to get the medicine
- Cough suppressants
- Expectorants: Facilitates the removal of the secretions
and liquifying the secretions more so it is easier to cough up - Lozenges: Contains a local anesthetic (benzocaine) like cough drops, throat spray, etc.
Electrolytes lab values:
Sodium : 135-145 mEq/L Potassium : 3.5-5.0 Chloride : 95-105 Calcium : 8.5-10.5 Phosphate : 1.7-2.6 Magnesium : 1.3-2.1
Respiratory and renal role in acid base balance:
Respiratory: Balance CO2 and O2 by either increasing respirations or decreasing them.
Renal: Can either keep hydrogen if we are going to be more basic, or let them go through the urinary tract if we are going more acidic.
Tingling of hands and feet
Hypocalcemia
