Week 4: GU/GI Flashcards
Projectile Vomiting
Forceful ejection of digested food and secretions
What to assess in projectile vomiting?
Frequency, content of emesis, fresh blood, coffee grounds
What does it mean if someone throws up coffee grounds?
Internal bleeding
When is vomiting a concern?
when present with:
- lethargy
- confusion
- decreased alertness
- severe abdominal pain
- vomiting with fever
- vomiting with diarrhea
- severe headache or stiff neck
What occurs if hepatocytes are not functioning?
Portal system is blocked and backed up, which can lead to esophageal vericose veins
Severe headache or stiff neck can be indicidaiton for what when related to vomiting?
Neurological, meningitis
What age group should we be concerned about with vomiting and nausea?
Older frail adults and younger children
With lethargy, confusion, decreased alertness can indicate what?
Hypovelemia
When vomiting and diarrhea are both present what can this indicate?
Hypovelemia
Vomiting a lot indicates?
Alkalosis
Down and out- a lot of diarrhea indicates what?
Acidosis
Average pH of blood
7.35-7.45
Average pH of blood
7.35-7.45
What blood gases are part of an ABG?
O2, CO2, HCO3
BRAT diet?
Bananas, rice, apple, toast
What important medication helps with nausea?
Gravol- dimenhydrinate
Difference between regurgitation and vomiting?
Regurgitation- partially digested food slowly brought up from
stomach
Projectile vomiting- forceful vomiting
What is Narrow Therapeutic Range?
Some drugs have a narrow therapeutic index, which means that there is only a small difference between the minimum effective concentrations and the minimum toxic concentrations in the blood.
Any drug that ends in PRIL is part of what drug category?
ACE inhibitor
What does furosemide (lasix) do?
Treats high blood pressure and oedema
What does atorvastatin do?
It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.
Any drug that ends in STATIN is used to treat what?
Hypercholesterolemia
Sodium normal lab values
(135-145) mmol/ L
Potassium normal lab values
(3.5-5) mmol/L
HCO3 normal lab values
(21-28) mmol/L
Chloride normal lab values
98-106 mmol/L
Blood, Uria, Nitrogen (BUN) and Creatnine relates to what organ?
Kidney’s
Why is bilirubin important?
Leads to jaundice, yellowing of sclera and body tissue. Can indicate issues with liver like liver failure
What is albumin?
main protein in blood. Where drugs are carried. Lose them as we age, as it is made in liver. Lower albumin, lower amount of drugs
Hypokelemia/low potassium can cause what? What diagnostic test would be used?
Can cause dysrythmias, therefore an ECG would be a good diagnostic test for pt.ba
What is the pH of urine?
4.5-8
Urinalysis Normal Findings?
ph- 4.6-8
Protein- none or up to 8mg/100ml
Glucose-none
Ketones-none
Blood- up to 2RBCS
Specific gravity- 1.010-1.025
WBS- 0-4
Bacteria- none
Casts-none (always abnormal)
Glomerular Filtration rate normal findings?
between 60-120
What number on Glomerular FIlrtation Rate indicates kidney failure?
0-15. Then youd need dyalisis
What is a culture and sensitivity test?
-culture the fluid and look for bacteria, virus, fungi, parasites and then see if there is an anti infective for a bacteria virus, fungi or parasite
How to prevent uti in patient with indwelling foley catheter
-avoid raising bag above bladder
- avoid prolonged clamping of tubing
- keep urine draining by positioning tubing
- empty bag at least every 8h
- tape and secure catheter appropriately
- remove catheter ASAP
- routine perineal care after each BM
What is c dif?
C. diff (also known as Clostridioides difficile or C. difficile) is a germ (bacterium) that causes diarrhea and colitis (an inflammation of the colon)
Importance of furosemide?
Given to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine.
What is the importance of potassium chloride?
It helps your nerves to function and muscles to contract. It helps your heartbeat stay regular.
80% of UTI’s are caused by what?
Escherichia Coli
Cystitis
Inflammation of the bladder
Upper urinary tract infection: What is urosepsis?
Bacteremia (bacteria in bloodstream) resulting from a uti
Which kidney is lower?
Right
What’s a normal adult urine output?
1-2L/ 24hr
How much mL / hr may indicate renal alterations?
30ml/hr
What is the capacity of the bladder?
500 mL
What are things that may occur with a LOWER UTI? With an older adult?
- Dysuria
- Frequency
- Urgency
- Suprapubic discomfort
- Hematuria
- Cloudy urine
Older adult may experience:
- delirium
- cognitive impairment
- falls
- non-localized abdominal discomfort
What are things that may occur with an UPPER UTI? With an older adult?
- Flank pain
- Chills
- Fever
Older adult may experience:
- fever less likely
- over 80 may have declined temperature
- non specific symptoms of fatigue/anorexia
What is pyleonephritis?
Infection spreads to kidneys
Urosepsis
Bacteremia (bacteria in bloodstream) resulting from UTI
How many mL/ hour of urine should be indication to worry?
30 mL/hour
Routine urinalysis normal findings
****
pH- normal (4.6-8)
- no protein
- no glucose
- no ketones
- up to 2 RBCS
- specific gravity (1.010-1.025)
- no bacteria
- no casts (always abnormal)
What are things to prevent infection and acidify urine?
Cranberry juice, vitamin C
What catheterization is used for obtaining sterile specimen, residual urine assesment and spinal cord injuries?
Intermittent catheter
How many cm in between tip of penis should you keep the condom catheter?
Allow 2.5-5cm in between tip of penis and end of condom
Different types of tests for urinenalaysis
…
What are fluids you want to avoid with a UTI?
Caffeine, alcohol, chocolate, spicy food
