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foundations > waste elimination > Flashcards

waste elimination Flashcards

1
Q

urge to void at…

A

400-600 mL

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2
Q

bladder holds

A

600-1000mL

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3
Q

normal urination amt

A

30mL/hr

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4
Q

normal defecation

A

3 or more BM’s per week

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5
Q

where is the ileosecal valve

A

between small and large intestine

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6
Q

what is the bladder controlled by

A

brain and spinal cord

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7
Q

types of output

A

voiding
stools
emesis
gastric/wound drainage
significant diaphoresis
all measured in mL except stools and emesis/incontinence which are estimated

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8
Q

types of urine tests

A

urinalysis (cc or sterile)
urine drug screen
urine C&S (cc or sterile)

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9
Q

urinalysis pH nl

A

5-8

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10
Q

urinalysis specific gravity nl

A

1.010-1.030
lower= over hydration
higher = dehydration

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11
Q

urinalysis RBCs nl

A

negative
positive indicates glomerular injury

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12
Q

urinalysis protein nl

A

0-8 mg/dL but should be negative

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13
Q

urinalysis WBC

A

less than 1phpf but in women 1-5 is nl as well
presence of WBC indicates infection

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14
Q

urinalysis casts nl

A

negative
positive indicates renal disease

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15
Q

what pan would you use for a pt with hip injury

A

fracture pan

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16
Q

rinse bedpan with what

A

cold water

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17
Q

stool cultures

A

for C diff.

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18
Q

FOBT

A

fecal occult blood test
guaiac or hemoccult

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19
Q

ideals for hemoccult test

A
  • 3 different tests on 3 different days
  • stop eating red meat 3 days prior
  • stop taking NSAIDS 7 days prior (false positive)
  • stop taking vit. C and citrus 3 days prior (false neg.)
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20
Q

hemoccult turns what color when positive for blood

A

blue

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21
Q

nl on bristol stool form scale

A

types 4 and 5

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22
Q

urinary retention

A

inability to empty the bladder
severe= 2-3 L of urine retained
high post-void residuals

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23
Q

bladder scan

A

reads amount of urine in bladder
no radiation, non invasive

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24
Q

most common healthcare acquired infection

A

UTI

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25
Q

main causes of UTI

A

non steril catheter placement
improper maintenance of catheter
E coli entering urethra is most causative organism!!!!

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26
Q

S&S of UTI

A

dysuria
urinary frequency
urgency
hematuria

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27
Q

complications resulting from UTI

A

pyelonephritis, bacteremia (sepsis)

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28
Q

tx for UTI

A

antibiotics

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29
Q

random urine collection

A

from normal void or drainage bag
make sure its free from stool or TP but not worried about bacteria

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30
Q

collection methods for urine

A

random
clean catch/midstream
sterile

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31
Q

clean catch/midstream urine collection

A
  • clean urethra site
  • start voiding into the toilet, THEN stop, THEN void into the container
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32
Q

steril urine collection

A
  • from indwellling or straight cath
  • completely free from outside organisms
  • sample port on chamber of cath
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33
Q

how much is usually collected in a urine sample

A

30-60mL

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34
Q

what to label urine sample with

A

date/time/initials

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35
Q

24 hour urine collecting

A
  • usually looking for kidney problems
  • measuring protein, BUN, and creatine
  • start clock, first void discarded, THEN all is kept for 24 hours
  • keep in steril jug on ice or in refrigerator
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36
Q

functional urinary incontinence

A

decreased ability to toilet independently d/t issues outside of urinary tract

37
Q

transient urinary incontinence

A

caused by medical conditions, usually reversible

38
Q

overflow

A
  • over distended bladder and chronic retention of urine
  • tx: toileting schedule
39
Q

stress

A
  • involuntary leakage of urine d/t intra abdominal pressure exceeding the strength of urethral sphincter
  • seen in prostatectomies in men and pregnancy in women
  • tx: pelvic floor exercises (kegles)
40
Q

urge

A

overactive bladder

41
Q

reflex

A
  • d/t spinal cord damage between C1-S2
  • leaking urine d/t decreased awareness of bladder filling
  • toileting schedule or superpubic cath
42
Q

what effect does the backup of urine have on the body

A

cause bp and hr to go up d/t pressure on vagus nerve

43
Q

kegles

A
44
Q

ostomy

A

surgical procedure that changes the way that wastes exit the bod

45
Q

stoma

A

artificial opening of an ostomy

46
Q

nephrostomy

A
  • tube inserted into renal pelvis
  • directly from kidney to drain pouch
  • measure urine output
47
Q

urostomy (ileal conduit)

A
  • most common
  • done s/p cystectomy (bladder removal)
  • ureters rerouted to a portion of the ilium
  • no valve= incontinent
48
Q

Ureterosigmoidostomy

A
  • ureters connected to sigmoid colon
  • urine and stool eliminated via rectum
  • can be continent but sometimes isn’t
  • not preferred method
  • can end up with pH imbalance
49
Q

cutaneous ureterostomy

A
  • ureters rerouted to stomas created on abdomen
  • incontinent
  • typically to right side of abdomen
50
Q

continent urinary reservoir (kock pouch)

A

internal pouch created from colon and ilium
- ileocecal valve creates one way valve
- continent, must be catheterized
- have to be willing to catheterize 4-6 times per day

51
Q

risk factors of constipation

A
  • ignoring the urge to poop
  • old age
  • medications
  • low fiber diet
  • neurological conditions
  • immobilization and surgery
52
Q

tx for constipation

A
  • prevention: fluid, fiber, and stool softeners
  • laxatives
53
Q

msot abused substance in America

A

laxatives

54
Q

hemorrhoids

A

dilated engorged rectal veins d/t straining for bowel movements, pregnancy, HF, and liver disease

55
Q

fecal impaction

A

hardened feces that obstruct the rectum d/t unrelieved constipation

56
Q

risks of fecal impaction

A

prolonged immobility, confusion, unconsciousness, dehydration, meds

57
Q

S&S of fecal impaction

A
  • no BM for several days
  • leakage of small amounts of liquid stool
  • abd cramping
  • anorexia
  • possible urinary incontinence d/t pressure on bladder
58
Q

tx for fecal imp.

A

enemas
manual disimpaction

59
Q

warning with manual disimpaction

A

possible vagal stimulation (dysrhythmias), bowel perforation

60
Q

diarrhea risks

A

dehydration, electrolyte imbalance, skin breakdown

61
Q

ileostomy

A
  • incontinent
  • done after total colectomy
  • stoma is inner RLQ
  • output: watery and constant stool
62
Q

continent ileostomy

A
  • kock pouch
  • barnett continental intestinal reservoir (BCIR)
  • not common
63
Q

types of colostomies

A

end stoma
loop stoma
double barrel stoma

64
Q

end stoma

A
  • permanent colostomy
  • can be done anywhere inside the bowels
65
Q

loop stoma

A
  • temporary
  • 7-10 days
  • gives bowels a rest
  • proximal end of stoma drains stools
  • distal end drains mucus
66
Q

double barrel stoma

A
  • temporary
  • cut in half and sewn back together later
  • proximal end: stool
  • distal end: mucus
67
Q

ascending colostomy

A
  • rare
  • stoma in RLQ
  • output: constant liquid to semi-liquid stool
68
Q

transverse colostomy

A
  • loop or double barrel stomas
  • middle to RUQ
  • output: liquid to semi-formed stool (unpredictable)
69
Q

descending colostomy

A
  • outer LLQ
  • output: stemi-formed to formed stool
  • predictable
70
Q

sigmoid colostomy

A
  • most common
  • LLQ
  • output: normal formed stool (predictable)
71
Q

ostomy assessment

A

stoma location
type of devise (1 or 2 piece)
stoma appearance

72
Q

stoma appearance

A

red: good blood flow
moist: good moisture
budded: on top of skin, not below
peristomal skin (liquidy)
drainage: color, consistency, amount

73
Q

change ostomy bandage how often

A

q 3-4 days

74
Q

provide ostomy care when how full

A

half way

75
Q

how to make sure seal is good

A

measure stoma
mark and cut out wafer
apply to skin
flap should be able to come down to show stoma

76
Q

enema types

A

cleansing : for feces
Carminative : for gas

77
Q

types of cleansing enemas

A
  • NS
  • tap water (hypotonic)
  • hypertonic saline
  • soap suds
  • oil retention
78
Q

NS cleansing enema

A
  • safest
  • stimulates peristalsis
79
Q

tap water cleansing enema

A
  • hypotonic
  • causes fluid to leave the bowel
  • can cause water toxicity
80
Q

soap suds enema

A
  • castile soap in tap water
81
Q

oil retention enema

A
  • mineral oil
  • softens stool
82
Q

medicated enema

A
  • carminative
  • treats various px
83
Q

barium carminative enema

A

diagnostic procedure
- radioactive
- looks for cancer

84
Q

enema contraindications

A
  • N/V
  • appendicitis
  • abd pain
85
Q
A
86
Q
A
87
Q
A
88
Q
A

foundations (15 decks)

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