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115 Cards in this Set
- Front
- Back
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what is reflex bladder
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loss of bladder control due to spinal chord injury
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what is urinary retentions
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hindered peeing due to obstruction of pathway, innability to empty
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prerenal dysfunction is caused when?
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when problems are occuring in systems before the blood to be filtered hits the kidneys, there could be decreased blood flow to the kidneys causing decrease in blood flow to the renal tissue. (oliguria, anuria)
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Renal dysfunction results from?
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factors causing direct injury to the glomeruli or renal tubule interfering with their normal filtering, reabsoptive, and secretory functions. (transfusions, diseased glomeruli)
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Postrenal dysfunction occurs when?
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obstruction to the flow of urine or urinary collecting duct system (blood clots, tumors, caliculi)
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oliguria
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diminished capacity to produce urine due to decrease in renal blood flow. (dehydration, hemorrhage, CHF)
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uremic syndrome includes the following characteristic signs
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increased nitrogenous waste in blood, altered regulatory functions, nausea, vomiting, headache, coma, convulsions
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peritoneal dialysis
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indirect method of cleaning blood of waste products using osmosis and diffusion. Functions as a semipermeable membrane and waste products are taken out via surgically placed cath
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Hemodialysis
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machine with semi permeable membrane (art. kidney) in which wastes and excess fluid from the blood are removed. Dialysate flued is pumpe through one side, and kidney pumps other.
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what are the three most common dysfunctions with the failure to store or empty urine?
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Urinary Retention
UTI's Incontinence |
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Retention with overflow
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progressed retention and the pressure in the bladder builds to a point where external urethral spincter is unable to hold urine back and patient voids several times and only small amounts.
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Functional incontinance
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urge to void causes loss of urine before wanted
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Overflow incontinance
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small dribbles to large amounts released from overdistended bladder
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Reflex Incontinance
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unawareness of bladder filling, lack of urge to void, due to spinal injuries
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Stress incontinance
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loss due to increased intrabdominal pressure and weak pelvic floor. (laughing)
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Urge incontinance
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frequent urinary urgency after voiding, lowered bladder capacity and infections
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what are three factor to be explored during a nursing history in regard to urinary elimination?
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pattern of urination
symptoms of urinary alterations factors affecting urination |
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assessment of urine involves what?
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measuring I & O / observations of urine characteristics
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roenterogram
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determines size, shape, symmetry and location of kidneys
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CT scan
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computerized xray to see detailed structure images on selected plane
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renal scan
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determines blood flow, anatomical structures, and excretory function
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ultrasound
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identifies gross structures and abnormalities
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three types of invasive procedures for urinary elimination
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endoscopy
anteriogram urodynamic testing |
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list four types fo foods tat increase urine acidity
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meat, eggs, whole grain breads, prunes, cranberry juice
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what are the goals of bladder retraining?
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increase interval between voiding, decrease voiding during the day and night, restore normal urinary pattern
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comfort measures for incontinant clients
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dry clothing
protective pad |
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comfort measures for dysuria clients
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analgesics
antibiotics/fluids |
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comfort measures for painful distenstion clients
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warm sitz bath
stimulate peeing |
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what is the normal specific gravity of urine?
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1.010 - 1.025
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List two diseases of the GI tract associated with stress
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colitis
Crohn's disease |
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Mineral oil has what effect on defecation?
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laxative, decrease fat soluble absorption
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Dicyclomine HCL (Bentyl) has what effect on defecation?
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decrease peristalsis and can decrease gastric emptying
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Narcotics cause what with defecation?
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slow peristalsis and segmentation leads to constipation
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Anticholinergics do what to defecation?
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inhibit gastric secretions and depress GI motility and cause constipation
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Antibiotics do what to defecation?
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diarrhea because normal flora disrupted and causes cramps
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HIstamines do what to defecation?
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decrease HCL, interfere with digestion, some and antagonists with food digestion.
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NSAIDS do what to defecation
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promote GI irritation, dyspepsia can cause irritation
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3 groups where constipation is a significant concern
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CVD history
glaucoma increased olecranial pressure |
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four conditions that cause hemmorhoids
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straining feces
pregnant heart failure liver disease |
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assessment of abdomen includes
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inspection, auscultation, palpation and percussion
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inspection of the abdomen
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not distension, shape size, symmetry, skin color of all quadrants, scars, peristaltic waves, stomas, lesions
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auscultation of the abdomen
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bowel sounds: character frequency, absent, hyperactive?
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palpation of the abdomen
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tenderness
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percussion of the abdomen
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detect lesions, fluid, gas, 5 notes, dull, hollow
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white or clay stool?
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absence of bile
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black or tarry melena stool
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iron ingestion, upper GI bleeding
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liquid consistancy of stool
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diarrhea, low absorption
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narrow pencil shaped stool?
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obstruction , rapid peristalsis
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tap water enema?
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hypotonic, water is absorped, have lower osmotic pressure than the fluid in the intersitial tissue, there is a net flow of water out of the bowel and into the tissues,give as much as tolerated
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normal saline/ milk of mag. enema?
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isotonic, equal concentrations on both sides of the colon, no net movement of fluids, stimulates peristalsis
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soapsuds/ fleet enema?
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hypertonic saline, higher concentration that intersitial fluid and net flow of water is into the colon, distention irritates mucosa and stimulates peristalsis
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maximum # of enema's given to fully clense?
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3
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constipation defined
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less than 3 bms a wk, straining, painful, hard, dry, ab pain
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maroon red feces?
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GI bleeders, smells horrible
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the F's of abdominal distension
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fluid, fat,feces, fetus, flatus, fibroid (tumor in uterus), full bladder, fatal tumor
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borborygmus
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stomach growling
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causes for ostomies
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cancer, ulcerative colitis, regional ileitis-crohns, trauma, intestinal obstruction , burth defects
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ileostomy
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opening between the ileum and ab wall
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drainage from a colostomy is called?
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effluent
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6 catergories of nutrients
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carbs, proteins, fats, vitamins, water, minerals
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1 gram carbs = ?
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4 kcalories
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what is the simplest form of protein?
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essential amino acids (cannot be synthesized)
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complete protein?
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contains all the essential aa's in sufficient quantity to support growht and maintain nitrogen balance
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complementary protein?
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pairs of incomplete proteins that when combined supply total smount of protein provided by complete protein sources
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1 gram fat =?
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9 kcal
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triglycerides
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3 fa's and glycerol backbone
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fatty acids
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chains of carbon and hydrogen atoms with acid group and methyl group on opposite ends. (saturated and unsaturated)
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deficiencies occur when fat intake falls below ? daily nutrition
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10%
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water composes how much of body weight?
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60-70%
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lean people vs. obese people and water weight
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lean people have more % water
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water soluble vitamins
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B & C
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Fat soluble vitamins
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ADEK
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macrominerals
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daily requirement is 100mg or more
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trace minerals
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daily requirement is less than 100mg
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k vitamin is synthsized where?
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colon
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the bodys main form of energy and storage unit
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fat and adipose tissue
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glycogenolysis
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catabolism of glycogen to glucose
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glycogenesis
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anabolism of gluose into glycogen for storage
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gluconeogensis
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catabolism of aa's and glycerol to glucose
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what do feces contain?
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cellulose and other non digestible substances, sloughed epi. cells from GI tract, degestive secretions, microbes
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Dietary Reference Intakes
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present evidenced based criteria for min and max amounts of vitamins and nutrients to avoid deficiencies or toxicities and to provide acceptable intake in place of absolute values.
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infants intake how many kcal/kg in the first half of infancy and the second?
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108, then 98
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a full term new born is able to digest>>
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simple carbs, proteins, some emulsifies fats
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infants need how much fluid?
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100-150ml/kg/day
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toddlers need increased...
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protein
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adolescent girls are deficient in.. and boys in..
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iron, calcium and vit B / kcals, protein, iron, B, folic acid and iodine
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pregant women become deficient in ..
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calcium, A,C, iron,
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adult women using contraceptives need extra
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vitamins
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what are the five components of nutritional assesment?
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anthopometry, lab tests, diet, health history, clinical observations, client expectations
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ovolactovegetarian
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avoids poultry, fish and meat but eats eggs and milk
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lactovegetarian
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drinks milk, no eggs
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zen macrobiotic
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brown rice, grain and herb tea diet
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anthropometry
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measurement system of size and make up of body
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polymeric formula
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milk based for the client that can digest whole nutrients
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modular formula
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single macronutrient added to other foods, incomplete itself, usually glucose, polymers, lipids or protein
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elemental formula
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predigested for dystunctional GI tract clients
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specialty formula
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designed for special illness to balance nutrition personally
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PEG
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inserted endoscopically
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multicultural influences in nutrition
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SPEC - social, psychological, economical, cultural
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Atrogenic effects on nutrition
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secondary effects due to pathology treatment
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ciliac disease
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highly allergic to gluten/ wheat products!
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BUN
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blood urea nitrogen- drops with malnourished clients
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decreased Potassium?
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GI cramping, increased cardiac problems
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Ketones in the urine
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diabetes, spilling sugars
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protein in the urine
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really bad,
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1 gram protein and 1 gram carbs = ?
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4 kcal
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minerals
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calcium, phosphorus, iron, zinc (nerve transmission, tissue metabolism)
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if you decrease your fat intake you are also decreasing?
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fat soluble vitamin absorption
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Micronutrients
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Water soluble vitamins: B : energy and metabolism / C : tisue integrity, healing and iron metabolism, antioxidant
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simple carbs provide
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fast energy
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monosaturated fat
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olive, peanut and canola oil
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polyunsaturated fat
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corn, and fish oil
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trans fats
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hydrogenated
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ldl / hdl
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bad / good cholesterol
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too much protein leads to ?
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nitrogen overload, and kidney damage
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