Unit 3 Flashcards
Urinary Elimination is also known as
Voiding
The inability to empty the bladder can result in
damage to bladder or rupture
- Temporary measure to empty the bladder: indwelling
(Foley) catheter
Oral medication typically given after 3 days of no bowel movement
Laxatives
Wax cone inserted into rectum after 4 days of no bowel movement
Suppositories
Injection of fluid into rectum after 5 days of no bowel movement
Enemas
Devices Used for bowel and urinary Elimination
-Bedpans-traditional and fracture
- Commodes-can be placed at bedside for resident
- Urinals-only ones for males are commonplace
- Commode hats-placed under seat of toilet or commode; can be used to measure output or specimen collection
Incontinence • Resident care:
-Toilet client or change incontinence garment every 2 hours
- Cleanse the perineal area with adult wipes
- Apply barrier cream to intact skin
- Monitor skin integrity closely
- Allow client to sit on toilet and attempt to void if they are able
- Remain with client during toileting if they are at risk of falls
- Promptly remove soiled incontinence garments from room
Incontinence • Resident care:
-Toilet client or change incontinence garment every 2 hours
- Cleanse the perineal area with adult wipes
- Apply barrier cream to intact skin
- Monitor skin integrity closely
- Allow client to sit on toilet and attempt to void if they are able
- Remain with client during toileting if they are at risk of falls
- Promptly remove soiled incontinence garments from room
Peri-Care for Incontinent Residents
• When performing peri-care:
- Act and speak in a professional manner
- Discourage rude jokes or remarks made by resident
- Wash from clean to dirty areas
- Avoid overexposure of resident
- Check skin for breakdown
Peri-care for a female resident:
-Open labia with nondominant hand
- Using adult wipes, start at top of labia and wipe downward toward anus
- Start at urethra and work toward outer aspect
- Wipe front to back at least three times
- Wipe until area is clean
- Use clean part of wipe with each pass
Peri-care for a male resident:
If resident is uncircumcised, pull foreskin back to clean head of penis
- Wipe, starting at tip of penis and moving downward to base
- Continue until penis is cleansed, using new part of wipe each pass
- Gently pull foreskin back in place
- If unable to retract foreskin, immediately inform nurse
To complete peri-care:
- Have resident roll onto his or her side
- Wipe buttocks with adult wipe
- Then wipe anal area from front to back
- Use clean part of wipe with each pass until area is clean
After performing peri-care:
- Place dirty wipes onto incontinence pad or directly into trash
- Apply barrier cream as directed
- Place clean incontinence pad under resident
- Remember to document
What is a Urostomy?
An artificial opening in the abdominal wall through which urine drains to the outside of the body.
When is a Urostomy required?
When the bladder no longer functions due to damage or disease
Where is urine collected in a person with a Urostomy?
In a bag outside of the body.
Where is urine collected in a person with a Urostomy?
In a bag outside of the body
When should the urostomy bag be emptied?
When it is 1/3 to 1/2 full and at the end of a shift.
What should be done after emptying the urostomy bag?
Measure and record the urinary output.
What is an ostomy?
A segment of bowel drawn to the outside of the body in the abdominal area.
What is the purpose of a stoma in an ostomy?
Stool is diverted through the stoma and empties into a collection bag.
What does PRN mean?
As needed
What is a colostomy?
An ostomy made from the large intestine.
What is an ileostomy?
An ostomy made from the small intestine
What are the key aspects of resident care for an ostomy?
• Empty and clean the ostomy bag.
• Clean the stoma and surrounding area when emptying the bag.
• Change the ostomy appliance according to facility protocol.
• Chart bowel movements.
What is occult blood in the stool?
Stool that looks black and tarry, is sticky or pasty, and may smell foul, indicating bleeding in the upper part of the digestive tract.
What does black and tarry stool suggest?
It suggests bleeding in the upper part of the digestive tract.
What is frank blood in the stool?
Red, obvious blood in the stool, indicating bleeding in the lower part of the digestive tract.
What might cause frank blood in the stool?
It may be due to hemorrhoids or bleeding in the lower part of the digestive tract.
What should you do if you notice any sign of bleeding in the stool?
Update the nurse with any sign of bleeding and do not flush the toilet.
Who initiates bowel and bladder training?
The nurse and the resident’s healthcare provider initiate bowel and bladder training.
What is the role of the nursing assistant in bowel and bladder retraining?
The nursing assistant reinforces the education done by the nurse, contributing to the team effort and maintaining consistency.
Why is emotional support important in bowel and bladder retraining?
Providing emotional support is crucial to help the resident feel comfortable and encouraged during the retraining process.
How should documentation be handled in bowel and bladder retraining?
Document according to facility protocol.
The most important goal of bladder training is to
a. decrease the cost of care
b. stop urinary incontinence
c. prevent embarrassment to staff members
d. reduce bed changes
stop urinary incontinence
A fracture-type bedpan is used for residents who
a. are in traction
b. have had hip surgery
c. have a back injury
d. have any of the above conditions
have any of the above conditions
What must the nursing assistant know about the manner and route of collection for specimens?
The correct manner and route of collection.
What must the nursing assistant know about the container and label for specimens?
The correct container and label to use.
What must the nursing assistant know about the amount of urine or feces required for a specimen?
The correct amount of urine or feces required.
What must the nursing assistant know about the specific time requirements for specimen collection?
The specific time requirements for collecting the specimen.
