Unit 3 Flashcards

1
Q

Urinary Elimination is also known as

A

Voiding

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2
Q

The inability to empty the bladder can result in

A

damage to bladder or rupture
- Temporary measure to empty the bladder: indwelling
(Foley) catheter

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3
Q

Oral medication typically given after 3 days of no bowel movement

A

Laxatives

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4
Q

Wax cone inserted into rectum after 4 days of no bowel movement

A

Suppositories

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5
Q

Injection of fluid into rectum after 5 days of no bowel movement

A

Enemas

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6
Q

Devices Used for bowel and urinary Elimination

A

-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

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7
Q

Incontinence • Resident care:

A

-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

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8
Q

Incontinence • Resident care:

A

-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

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9
Q

Peri-Care for Incontinent Residents
• When performing peri-care:

A
  • 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
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10
Q

Peri-care for a female resident:

A

-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

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11
Q

Peri-care for a male resident:

A

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

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12
Q

To complete peri-care:

A
  • 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
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13
Q

After performing peri-care:

A
  • Place dirty wipes onto incontinence pad or directly into trash
  • Apply barrier cream as directed
  • Place clean incontinence pad under resident
  • Remember to document
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14
Q

What is a Urostomy?

A

An artificial opening in the abdominal wall through which urine drains to the outside of the body.

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15
Q

When is a Urostomy required?

A

When the bladder no longer functions due to damage or disease

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16
Q

Where is urine collected in a person with a Urostomy?

A

In a bag outside of the body.

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17
Q

Where is urine collected in a person with a Urostomy?

A

In a bag outside of the body

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18
Q

When should the urostomy bag be emptied?

A

When it is 1/3 to 1/2 full and at the end of a shift.

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19
Q

What should be done after emptying the urostomy bag?

A

Measure and record the urinary output.

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20
Q

What is an ostomy?

A

A segment of bowel drawn to the outside of the body in the abdominal area.

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21
Q

What is the purpose of a stoma in an ostomy?

A

Stool is diverted through the stoma and empties into a collection bag.

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22
Q

What does PRN mean?

A

As needed

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23
Q

What is a colostomy?

A

An ostomy made from the large intestine.

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24
Q

What is an ileostomy?

A

An ostomy made from the small intestine

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25
Q

What are the key aspects of resident care for an ostomy?

A

• 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.

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26
Q

What is occult blood in the stool?

A

Stool that looks black and tarry, is sticky or pasty, and may smell foul, indicating bleeding in the upper part of the digestive tract.

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27
Q

What does black and tarry stool suggest?

A

It suggests bleeding in the upper part of the digestive tract.

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28
Q

What is frank blood in the stool?

A

Red, obvious blood in the stool, indicating bleeding in the lower part of the digestive tract.

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29
Q

What might cause frank blood in the stool?

A

It may be due to hemorrhoids or bleeding in the lower part of the digestive tract.

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30
Q

What should you do if you notice any sign of bleeding in the stool?

A

Update the nurse with any sign of bleeding and do not flush the toilet.

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31
Q

Who initiates bowel and bladder training?

A

The nurse and the resident’s healthcare provider initiate bowel and bladder training.

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32
Q

What is the role of the nursing assistant in bowel and bladder retraining?

A

The nursing assistant reinforces the education done by the nurse, contributing to the team effort and maintaining consistency.

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33
Q

Why is emotional support important in bowel and bladder retraining?

A

Providing emotional support is crucial to help the resident feel comfortable and encouraged during the retraining process.

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34
Q

How should documentation be handled in bowel and bladder retraining?

A

Document according to facility protocol.

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35
Q

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

A

stop urinary incontinence

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36
Q

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

A

have any of the above conditions

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37
Q

What must the nursing assistant know about the manner and route of collection for specimens?

A

The correct manner and route of collection.

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38
Q

What must the nursing assistant know about the container and label for specimens?

A

The correct container and label to use.

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39
Q

What must the nursing assistant know about the amount of urine or feces required for a specimen?

A

The correct amount of urine or feces required.

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40
Q

What must the nursing assistant know about the specific time requirements for specimen collection?

A

The specific time requirements for collecting the specimen.

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41
Q

What must the nursing assistant know about the storage of specimens?

A

The correct storage requirements for the specimen.

42
Q

What should be done before collecting a specimen?

A

Assemble supplies, don appropriate PPE, label either the container or the outside of the biohazard bag.

43
Q

What information should be included on the label of a specimen?

A

The date, time, resident’s name, and date of birth.

44
Q

What should be done after collecting a specimen if it will not be processed within 2 hours?

A

Refrigerate the sample.

45
Q

What should be done after collecting and handling the specimen?

A

Alert the nurse that the task is complete and document the collection of the specimen.

46
Q

What are the reasons for collecting a urine specimen?

A

To detect bacteria, determine kidney function, check for sugar, measure electrolytes, and check drug levels.

47
Q

How must a urine sample be obtained for urinalysis?

A

It must be obtained as a clean catch.

48
Q

Where may a resident not void when collecting a sample for urinalysis?

A

The resident may not void into a commode, commode hat, urinal, or bedpan.

49
Q

What should be attempted when collecting a sample from residents who are incontinent?

A

Attempt to collect the sample despite the resident’s incontinence.

50
Q

What should be done before the resident begins to void for a urinalysis sample?

A

Cleanse the perineal area with an antiseptic wipe.

51
Q

How should the perineal area be wiped before collecting a urinalysis sample?

A

Wipe the area 3 times, starting from the urethra and moving toward the anus.

52
Q

From which part of the urine stream should the sample for urinalysis be collected?

A

Collect the sample from the middle of the urine stream.

53
Q

How much urine should be collected in the collection cup for urinalysis?

A

How much urine should be collected in the collection cup for urinalysis?

54
Q

What should you avoid touching when handling the collection cup for urinalysis?

A

Do not touch the inside of the cup or lid.

55
Q

What should you do after collecting the urine sample?

A

Attend to the resident’s needs.

56
Q

Where should the collected urine sample be placed after collection?

A

Place the item in the designated storage area or give it directly to the nurse.

57
Q

How should you set up for collecting kidney stones?

A

Place a commode hat in the front half of the toilet or commode.

58
Q

What should you remind the resident to do with toilet paper when collecting kidney stones?

A

Remind the resident to place toilet paper in the wastebasket.

59
Q

How should the contents of the commode hat be processed to collect kidney stones?

A

Empty the contents of the commode hat through a strainer.

60
Q

What should you look for when straining urine for kidney stones?

A

Look carefully for stones in the strainer.

61
Q

What should be done with the found kidney stone?

A

Place the found stone in a labeled container.

62
Q

Where are the kidney stones sent after collection?

A

Stones are sent to the lab after collection.

63
Q

What might happen after the kidney stones are analyzed?

A

The doctor may give treatment recommendations after the analysis.

64
Q

What should be used to obtain a stool sample?

A

Use a clean commode hat or bedpan

65
Q

What should be avoided when obtaining a stool sample?

A

Avoid contamination with urine or toilet paper.

66
Q

What tools can be used to obtain a stool sample?

A

Use a wooden tongue blade or a plastic spoon.

67
Q

From how many different areas of the stool should the sample be taken?

A

Take the sample from 3 different areas of the stool.

68
Q

How should you obtain a stool sample for occult blood testing?

A

Obtain a small sample of stool with the wooden stick provided with the test.

69
Q

Where should the first stool sample be placed for occult blood testing?

A

Wipe the stool on the test card under window A and then close the flap.

70
Q

How should the second stool sample be collected for occult blood testing?

A

Take the second sample from a different area of the stool.

71
Q

Where should the second stool sample be placed for occult blood testing?

A

Place the second sample under window B and close the flap.

72
Q

What should be done after placing the stool samples on the test card?

A

Turn the card over and place 1 to 2 drops of developer over the window.

73
Q

What indicates a positive occult blood test result?

A

The window typically turns blue if the test is positive.

74
Q

What should be done with the test card after applying the developer?

A

Give the card to the nurse.

75
Q

What are other names for the occult blood stool test?

A

It may be referred to as stool guaiac, fecal occult blood test, Hemosure, or Hemoccult.

76
Q

What should be recorded for fluid intake?

A

Record all fluids taken in by mouth or IV, including snacks, meals, water at bedside, and food items that are liquid at room temperature.

77
Q

What should be recorded for fluid output?

A

Record all eliminated bodily fluids using a graduate or commode hat.

78
Q

What should residents avoid placing in the commode hat?

A

The resident should not place toilet paper in the commode hat.

79
Q

When should the total fluid intake and output be recorded?

A

Record the total at the end of the shift.

80
Q

How should intake and output be documented?

A

Document according to facility protocol.

81
Q

What are the basic types of linens used on a bed?

A

Bath blanket, fitted sheet, draw (or lift) sheet, incontinence pad/bed protector, top sheet, blanket, bedspread, and pillowcases.

82
Q

When collecting linens, what is used on regular hospital bed mattresses?

A

Reusable incontinence pads.

83
Q

What type of incontinence pads is used on alternating-pressure beds or mattress toppers?

A

Disposable incontinence pads.

84
Q

What should not be used on hospital bed mattresses?

A

Mattress pads.

85
Q

What can be used in lieu of a bath blanket?

A

A large towel, blanket, or top sheet.

86
Q

What should be done to limit the spread of infection before gathering clean linens?

A

Perform hand hygiene.

87
Q

How should clean linens be handled to prevent infection?

A

Keep all linens away from your body and place clean linens on a clean surface.

88
Q

What should be avoided to prevent the spread of infection when handling linens?

A

Avoid flicking or shaking linens.

89
Q

What should you do if clean linens fall to the floor?

A

Place them in the soiled linen bag.

90
Q

What should be done before putting clean linens on a bed to prevent infection?

A

Perform hand hygiene.

91
Q

What should be done to limit the spread of infection before gathering clean linens?

A

Perform hand hygiene

92
Q

How should clean linens be handled to prevent infection?

A

Keep all linens away from your body and place them on a clean surface.

93
Q

What should you avoid doing with linens to prevent the spread of infection?

A

Avoid flicking or shaking linens.

94
Q

What should be done if clean linens fall to the floor?

A

Place them in the soiled linen bag.

95
Q

What should be done before putting clean linens on a bed to prevent infection?

A

Perform hand hygiene

96
Q

What personal protective equipment should be worn when removing soiled linens from a bed?

A

Wear gloves

97
Q

What should be used if available to further limit the spread of infection?

A

Use pillow protectors.

98
Q

What should be done with collected linens that are not needed?

A

They should go into the soiled linen bag.

99
Q

Where should the linen bag not be placed?

A

Do not place the linen bag on the floor.

100
Q

What should you watch for when removing linens from a bed?

A

Watch for items accidentally left in bed by the resident.

101
Q

Can linens from one resident’s room be used for another resident?

A

No, do not take linens from one resident’s room to use for another.