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NURS 200 > Urinary & Bowel Elimination > Flashcards

Urinary & Bowel Elimination Flashcards

1
Q

describe URINARY ELIMINATION

A
  • type of BASIC HUMAN FUNCTION
  • can be compromised by illness & conditions
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2
Q

definition of MICTURITION

A

where the BRAIN gives the bladder permission to EMPTY & BLADDER BEGINS TO CONTRACT
- have the RELAXATION OF THE SPHICTER
- have the RELEASE OF URINE

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3
Q

what are the other names for MICTURITION?

A
  • urination
  • voiding
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4
Q

why are CATHETERS USED?

A
  • from SURGERIES
  • want to obtain a STERILE SAMPLE
  • patient has URINARY INCONTINENCE
  • patient has SPINAL CORD INJURIES
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5
Q

what is IMPORTANT TO CONSIDER within CATHETERS?

A
  • catheters are DIRECT PORTALS OF ENTRY–very susceptible to infection
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6
Q

what are some FACTORS THAT INFLUENCE URINATION?

A
  • person’s GROWTH & DEVELOPMENT
  • their OWN PERSONAL HABITS
  • pt.’s own FLUID INTAKE
  • type of MEDICATIONS
  • other medical conditions
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7
Q

what are the COMMON URINARY ELIMINATION PROBLEMS?

A
  • URINARY RETENTION
  • URINARY TRACT INFECTIONS (UTIs)
  • URINARY INCONTINENCE
  • URINARY DIVERSIONS (type of stomas – diversions of bladder)
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8
Q

what are some INTERVENTIONS to ensure within URINARY ELIMINATION PROBLEMS?

A
  • can check PVR (URINARY RETENTION)
  • UTIs; can be TREATED with ANTIBIOTICS
  • always WIPE FROM FRONT TO BACK
  • always VOID BEFORE & AFTER INTERCOURSE
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9
Q

definition of URINARY RETENTION

A

an accumulation of URINE due to the INABILITY of the BLADDER TO EMPTY

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10
Q

definition of URINARY TRACT INFECTION

A

often results from catheterization or procedure
- the 4th most common HAI
- CAUTI

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11
Q

definition of URINARY INCONTINENCE

A
  • involuntary leakage of URINE
  • often is from URGE or STRESS
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12
Q

what are some SYMPTOMS OF UTI?

A
  • DYSURIA
  • URGENCY
  • FREQUENCY
  • INCONTINENCE
  • SUPRAPUBIC TENDERNESS
  • FOUL ODOR
  • CLOUDY URINE
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13
Q

what are some NURSING CONSIDERATIONS?

A
  • INFECTION CONTROL & HYGIENE
  • GROWTH & DEVELOPMENT
    (infants&raquo_space; greater frequency of voiding)
    (pregnancy»frequency of voiding)
    (older adults»decreased bladder capacity/increased bladder irritability)
  • PSYCHOSOCIAL IMPLICATIONS
    (self concept & self esteem)
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14
Q

what are some factors to consider during the assessment?

A
  • how does the patient feel about the situation?
  • can the patient take care of themselves?
  • what are some cultural considerations to consider?
  • what is the PATIENT’s HISTORY?
  • their patterns of urination
  • symptoms of urinary alterations
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15
Q

what are some CHARACTERISTICS of URINE ASSESSMENT?

A
  • INTAKE & OUTPUT
  • URINE CHARACTERISTICS;
  • COLOR
  • CLARITY
  • ODOR
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16
Q

what are some factors in LABORATORY & DIAGNOSTIC TESTING?

A
  • LABELING ALL SPECIMENS
  • PRESERVATION according to LAB PROTOCOL
  • keeping proper INFECTION CONTROL POLICIES
  • want to also assess any MEDICATIONS
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17
Q

what are some LABS to do?

A
  • WBC
  • GFR (60 or above)
  • CREATINE
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18
Q

what are the APPROPRIATE NANDAS?

A
  • URINARY INCONTINENCE; FUNCTIONAL/OVERFLOW/REFLEX/STRESS/URGE
  • INFECTION
  • IMPAIRED SELF TOILETING
  • IMPAIRED SKIN INTEGRITY
  • URINARY RETENTION
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19
Q

what are some STRATEGIES FOR HEALTH PROMOTION?

A
  • want to always EDUCATE THE PATIENT
  • want to PROMOTE NORMAL MICTURITION
    (maintain good elimination habits & proper fluid intake)
  • want to PROMOTE COMPLETE BLADDER EMPTYING
  • want to PREVENT INFECTION
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20
Q

what is SUPRAPUBIC CATHETERIZATION? How is it different from EXTERBAL CATHETERS?

A
  • surgically placed type of catheter which is then connected to a collection bag

external catheters are PLACED ON THE OUTSIDE; often changed out on the regular;
ex. CONDOM CATHETERS

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21
Q

what are methods of CONTINUING AND RESTORATIVE CARE patients undergo regarding urinary elimination?

A
  • goes through more LIFESTYLE CHANGES
  • PELVIC FLOOR MUSCLE TRAINING; often seen in pregnant patients
  • BLADDER RESTRAINING EXERCISES
  • proper TOILET SCHEDULES
  • proper SKIN CARE around pelvic area
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22
Q

what are IMPORTANT ASPECTS TO CONSIDER when evaluating the patient?

A
  • how is the patien’s own personal view of themselves/regarding self image?
  • how is their voiding pattern?
  • does the caregiver/patient know the plan or scheduling regarding the proper interventions?
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23
Q

describe the KIDNEYS

A
  • filtration of waste products of metabolism
  • have their units of NEPHRONS that help with filtration
  • helps with BP CONTROL & production of ERYTHROPOIETIN; stimulates RBC production & bone marrow maturation
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24
Q

function of the URETERS

A

transports urine from kidneys to bladder

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25
Q

function of BLADDER

A

holds urine until urge to pass

26
Q

function of the URETHRA

A

pathway for the URINE TO LEAVE THE BODY
- allows for the TIGHTENING OR RELAXING OF THE SPHINCTER MUSCLES in order to retain or remove urine

27
Q

why is BOWEL ELIMINATION SO IMPORTANT?

A
  • pertains to the REGULAR REMOVAL OF WASTE
  • essential for NORMAL BODY FUNCTIONING
28
Q

how should the NORMAL DEFECATION PROCESS OCCUR?

A
  • should be painless with SOFT STOOL
  • no discomfort/regular brown color
29
Q

what are the FACTORS THAT INFLUENCE BOWEL ELIMINATION (12)?

A
  • AGE
  • DIET
  • FLUID INTAKE
  • PHYSICAL ACTIVITY
  • PSYCHOLOGICAL FACTORS
  • PERSONAL HABITS
  • POSITIONING
  • PAIN
  • PREGNANCY
  • SURGERY/ANESTHESIA
  • MEDICATIONS
  • DIAGNOSTIC TESTS
30
Q

what are some FOODS that can change BOWEL ELIMINATION?

A
  • **FIBER is a huge component for elimination
    (WHOLE GRAINS, FRESH FRUIT, VEGGIES)
    (BROCCOLI, CABBAGE, BEANS)
  • helps to INCREASE COLONIC MOBILITY & GAS)
31
Q

how does PHYSICAL ACTIVITY/PSYCHOLOGICAL FACTORS INFLUENCE BOWEL ELIMINATION?

A
  • more activity (ex. ambulation) = the more peristalsis within bowels
  • more stress = more diarrhea/difficulty with bowels
32
Q

what are SOME MEDICATIONS that can INFLUENCE BOWEL ELIMIINATION?

A
  • OPIOIDS (constipation)
  • ANTIBIOTICS (diarrhea)
  • LAXATIVES
  • STOOL SOFTENER
33
Q

what are some DIAGNOSTIC TESTS that can INFLUENCE BOWEL ELIMINATION?

A
  • ENEMAS
  • ENDOSCOPIES
  • COLONOSCOPIES
34
Q

definition of CONSTIPATION

A
  • is a SYMPTOM NOT A DISEASE
    • has many probable causes
      • medications
      • improper diet
      • lack of exercise
      • reduced fluids
      • spinal cord injuries/stroke
        • SIGNS:
          • infrequent bowel movements
          • hard & dry stools
35
Q

definition of DIARRHEA

A

increase in the NUMBER OF STOOLS and passage of LIQUID & UNFORMED DEVES

36
Q

what are some CAUSES OF DIARRHEA?

A
  • can also be caused by FOODBORNE PATHOGENS
  • can also be caused by FOOD INTOLERANCES
  • increased irritation of colon - increased secretion of mucus
  • risk of DEHYDRATION
  • risk of IRRITATION & SKIN BREAKDOWN
37
Q

definition of FECAL INCONTINENCE

A

the INABILITY to CONTROL THE PASSAGE OF FECES & GASES from anus

38
Q

definition of FLATULENCE

A
  • a common cause of ABDOMINAL FULLNESS, PAIN, & CRAMPING
  • gas accumulation in the intestines’ lumen
39
Q

definition of HEMORRHOIDS

A

DILATED or ENGORGED VEINS within the RECTUM LINING due to increased pressure
- ex. straining during bowel movements
- ex. chronic diarrhea/constipation
- ex. sitting for too long

40
Q

what are BOWEL DIVERSIONS? or aka OSTOMIES?

A

certain temporary or permanent openings (STOMA) that allow to bring part of the intestine out through the abdominal wall

41
Q

what is the difference between IELOSTOMY vs. COLOSTOMY

A

ILEOSTOMY
- connects to the SMALL INTESTINE (ILEUM)
- collects more of a LIQUID STOOL

COLOSTOMY
- connects to the COLON
- collects more of a SOLID STOOL

42
Q

what is an IILEOANAL POUCH ANASTOMOSIS?

A
  • surgical procedure for patients who need to have a colostomy for treatment of ulcerative colitis or familial adenopolyposis (FAP)
  • removal of colon - creation of POUCH at the end of the SI
    • this is then attached to the anus
43
Q

what are some IMPORTANT QUESTIONS TO ASK DURING ASSESSMENT?

A
  • how is the patient’s diet?
  • last bowel movement?
  • stool characteristics/patterns?
  • any pain during elimination?
  • diarrhea/constipation?
  • any medications?
44
Q

what are some DIAGNOSTIC EXAMINATIONS to factor in?

A
  • can take FECAL SPECIMENS
  • FOBT; FECAL OCCULT BLOOD TEST
    screening for blood in the feces
  • COLONOSCOPY
  • H & H; hemoglobin & hematocrit
45
Q

what about PHYSICAL ASSESSMENT?

A
  • important to INSPECT, AUSCULTATE, and PALPATE
  • looking at SYMMETRY, CONTOURS, and TENDERNESS, SHAPE
  • inspecting the mouth, abdomen etc…
46
Q

what are the APPROPRIATE NANDAS?

A
  • BOWEL INCONTINENCE
  • CONSTIPATION
  • RISK FOR CONSTIPATION
  • DIARRHEA
  • LACK OF KNOWLEDGE OF DIETARY REGIME
47
Q

what are IMPORTANT GOALS & OUTCOMES nurses want to reach regarding BOWEL ELIMINATION?

A
  • able to IMPLEMENT ELIMINATION HABITS OR ROUTINES
  • being able to REINFORCE THESE ROUTINES
  • able to see progress in LIFESTYLE CHANGES; within DIET, ACTIVITY, IRREGULAR BMS
48
Q

is it a POSSIBILITY PATIENTS CAN HAVE MULTIPLE DIAGNOSES?

A

YES!

  • patients OFTEN have multiple diagnoses
  • must be able to SET PRIORITIES of what needs to be taken care of
  • ex. patient can have pain, constipation, and impaired mobility
49
Q

who are other NURSES or PEOPLE that have to be within this process?

A
  • family members
  • dieticians
  • WOCN
50
Q

what are our HEALTH PROMOTION STRATEGIES?

A
  • PROMOTION OF NORMAL DEFECATION

ex. SITTING POSITION
ex. POSITIONING ON THE BEDPAN

51
Q

how can we have PROPER IMPLEMENTATION METHODS in ACUTE CARE?

A
  • ensure proper environment for the patient; giving PRIVACY
  • use of CATHARTICS and LAXATIVES
  • use of ANTIDIARRHEAL AGENTS
  • knowing the CAUSE OF DIARRHEA/CONSTIPATION
    ex. infection? inflammation?
52
Q

difference between CATHARTICS and LAXATIVES? difference between SUPPOSITORIES vs. ORAL MEDS

A

CATHARTICS - must more STRONG and RAPID compared to laxatives

SUPPOSITORIES - rectally placed; and ACT MORE QUICKLY vs. oral meds

53
Q

what type of CLEANSING ENEMAS do we use; what is the safest/most at risk?

A

CLEANSING ENEMAS help to STIMULATE PERISTALSIS with the instillation of liquid solution into the rectum

  • TAP WATER (hypotonic s.)
  • NORMAL SALINE (the MOST SAFE)
  • HYPERTONIC SOLUTIONS
  • SOAP SUDS (the MOST AT RISK–can IRRITATE INTESTINES)
54
Q

what to remember for ENEMA ADMINISTRATION?

A
  • sterile technique is not needed
  • always EXPLAIN the procedure/ positioning/precautions- can be an invasive or quite uncomfortable procedure for some patients
55
Q

how do we CARE FOR OSTOMIES?

A
  • always making sure to EMPTY THE POUCH ONCE its around 1/2-1/3 FULL
  • always want to ASSESS THE STOMA
  • always want to PROTECT THE SKIN/NO ODOR
56
Q

what are the MAIN FUNCTIONS OF THE STOMACH?

A
  1. STORAGE for SWALLOWED LIQUID & FOOD
  2. MIXING OF FOOD with digestive juices - CHYME
  3. REGULATION OF EMPTYING CONTENTS into SI
    - produces;
    • HYDROCHLORIC ACID (HCI) - protein
    • MUCUS - protects stomach mucosa
    • PEPSIN - protein
    • INTRINSIC FACTOR - absorption of vitamin B12
57
Q

what is the FUNCTION OF THE SMALL INTESTINE?

A
  • aids in both DIGESTION & ABSORPTION
  • introduced to CHYME + mixes chyme with DIGESTIVE ENZYMES (from the pancreas)
  • very important & efficient in RESORPTION
58
Q

what are the MAIN PARTS OF THE SI?

A
  • DUODENUM
    • processes fluid
  • JEJUNUM
    • absorbs carbs & proteins

[both duodenum & jejunum absorb the MOST NUTRIENTS & ELECTROLYTSE]

  • ILEUM
    • absorbs water, fats, & bile salts
    • absorbs vitamins, iron
59
Q

function of the LARGE INTESTINE

A

is the PRIMARY ORGAN OF BOWEL ELIMINATION

  • FUNCTIONS:
    • ABSORPTION
    • SECRETION
    • ELIMINATION
60
Q

functions of the RECTUM

A
  • empties fecal matter
  • has VERTICAL & TRANSVERSE FLODS to help control expulsion of fecal contents

NURS 200 (16 decks)

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