Adult 1 Test 2

Front 1

keeping cath drainage bag in the dependent position prevents?

Back 1

urinary reflux

Front 2

A client underwent total knee replacement and was placed on patient-controlled analgesia (PCA). The client has been activating the drug button an average of 4 times per hour. The nurse has assisted the client on and off the bedpan 2 or 3 times an hour for the past 2 hours. Urine output was about 50 ml with each void. The nurse now begins to suspect:

Back 2

retention overflow

Front 3

A client is scheduled for an intravenous pyelogram (IVP). Before the test the most important assessment the nurse performs is asking about:

Back 3

allergy to shellfish because allergy to iodine is suggested

Front 4

Elimination changes that result from obstruction to the flow of urine in the urinary collecting system may cause which of the following?

Back 4

UTI, retention, renal damage

Front 5

The nurse is teaching a group of young (20- to 25-year-old) women how to prevent urinary tract infections (UTIs). Which of the following foods does the nurse recommend consuming to reduce the incidence of UTIs? (Select all that apply.)

Back 5

prunes,cranberry juice, whole grain bread acidifys the urine

Front 6

bodys specific protective response against foreign agents and organisms

Back 6

IMMUNITY

Front 7

Name 5 functions of the kidneys(homeostasis)

Back 7

1filters and regulates blood contents 2 concentrations of electrolytes 3 acidity of blood ph 4 excretes metabolic waste 5 endocrine function

Front 8

what is the acidity of blood

Back 8

7.35-7.45

Front 9

Filtration occurs when substances and fluids are filtered from the ------ into -------

Back 9

tufts of cappilaries into bowman's capsule

Front 10

secretion is

Back 10

when substances are secreted from the blood into the renal tubules

Front 11

substances and fluids are reabsorbed from the renal tubules back into the blood (Na K)

Back 11

reabsorbtion

Front 12

how much water is filtered at glomerus

Back 12

180 liters

Front 13

name 8 factors influencing urination

Back 13

muscle tone--psychological--disease--sociocultural--fluid balance--surgical procedures--medications--diagnostic exams

Front 14

dysuria

Back 14

painful urination

Front 15

polyuria

Back 15

large amounts of urine--2.5 L over 24 hours

Front 16

less than 400ml a day

Back 16

Oliguria

Front 17

the need to get up at night and urinate

Back 17

nocturia

Front 18

urine that contains pus

Back 18

pyuria

Front 19

lack of ability to urinate

Back 19

retention

Front 20

involuntary leakage of urine

Back 20

incontinence

Front 21

anything that increases intraabdominal pressure like coughing sneezing jumping

Back 21

stress incontinence

Front 22

bedwetting

Back 22

Enuresis

Front 23

urinary retention

Back 23

Retention of urine in bladder retention with overflow 2000 to 3000 cc’s BPH

Front 24

Older individuals para and quadriplegics

Back 24

urinary incontinence

Front 25

ileal loop

Back 25

isolated ileal segment with ureters implanted in posterior portion of segment with protruding stoma on abdomen

Front 26

ureteosstomy

Back 26

left and right ureters tied together or separate

Front 27

most normal for urination

Back 27

5 times a day

Front 28

physical assessment

Back 28

Skin and mucous membranes Hydration = turgor mucous membranes Kidneys -Flank pain auscultation for bruits

Front 29

protein in urine is what range and be fine

Back 29

0-8mg or 100ml and is seen in people with renal failure

Front 30

glucose bilirubin and keytones are normally in the urine

Back 30

false

Front 31

what is the range of normal specific gravity

Back 31

1.010-1.025

Front 32

diluted has a ----- specific gravity

Back 32

low

Front 33

joe is dehydrated and his specific gravity of urine is

Back 33

high

Front 34

ph of urine can be what range

Back 34

4.6-8.0 and the higher then there is UTI or standing

Front 35

RBC

Back 35

0-4 and increased is caculi cystitis or trauma

Front 36

WBC

Back 36

0-5 and increased is UTI or pyuria

Front 37

pink or red urine urine indicates

Back 37

hemoglobin breakdown RBCs gross blood

Front 38

old red blood cells in urine

Back 38

brown to black urine

Front 39

when doing urinary diagnostic exams

Back 39

NPO bowel cleansing meds I/O and characteristics of urine

Front 40

KUB Film

Back 40

A KUB is a plain frontal supine radiograph of the abdomen. It is often supplemented by an upright PA view of the chest (to rule out air under the diaphragm or thoracic etiologies presenting as abdominal complaints) and a standing view of the abdomen (to differentiate obstruction from ileus by examining gastrointestinal air/water levels).

Front 41

IVP

Back 41

radiological procedure used to visualize abnormalities of the urinary system including the kidneys

Front 42

retrograde pyelogram

Back 42

a urologic procedure where the physician injects contrast into the ureter in order to visualize the ureter and kidney. The flow of contrast (up from the bladder to the kidney) is opposite the usual flow of urine hence the retrograde name. Reasons for performing a retrograde pyelogram include identification of filling defects (e.g. stones or tumors) as an adjunct during the placement of ureteral stents or ureteroscopy or to delineate renal anatomy in preparation for surgery. Retrograde pyelography is generally done when an intravenous excretory study (IVP or contrast CT scan) cannot be done because of renal disease or allergy to intravenous contrast.Relative contraindications include the presence of infected urine

Front 43

name 5 different diagnoses for urinary problems

Back 43

incontinence risk for infection impaired urinary elimination toileting self care deficit

Front 44

name 4 things to promote urinary health to client

Back 44

1 education 2 promote normal micturition stimulation of reflex and encourage fluid intake 3 promote complete bladder emptying 4 to prevent infection hygiene and acidify urine

Front 45

Computed Tomography Scan

Back 45

detailed images of structures within selected plane..looks for tumors and obstructions. assess for shellfish allergy if with contrast test is ordered

Front 46

Cystogram

Back 46

voiding cystogram is a functional study where contrast "dye" is injected through a catheter into the bladder. Under x-ray the radiologist asks the patient to void (usually young children) and will watch the contrast exiting the body on the x-ray monitor. This examines the child's bladder and lower urinary tract. Typically looking for vesicoureteral reflux, involving urine backflow up into the kidneys.

Front 47

Renal Arteriogram

Back 47

visualizes the renal arteries to detect narrowing or occlusion. a catheter is placed in the femoral artery and introduced up to the level of the renal arteries. assess for shellfish allergy

Front 48

urge incontinence

Back 48

involuntary passage of urine after a strong sense of urgency to void

Front 49

stress incontinence

Back 49

involuntary leakage of urine during increased abdominal pressure in the absence of bladder muscle contractions

Front 50

reflex incontinence

Back 50

loss of urine involuntary at intervals without sensation of urge to void. Spinal cord dysfunction

Front 51

overflow incontinence

Back 51

Overflow incontinence occurs when the patient's bladder is always full so that it frequently leaks urine. Weak bladder muscles, resulting in incomplete emptying of the bladder, or a blocked urethra can cause this type of incontinence. Autonomic neuropathy from diabetes or other diseases (e.g Multiple sclerosis) can decrease neural signals from the bladder (allowing for overfilling) and may also decrease the expulsion of urine by the detrusor muscle (allowing for urinary retention). Additionally, tumors and kidney stones can block the urethra. In men, benign prostatic hyperplasia (BPH) may also restrict the flow of urine. Overflow incontinence is rare in women, although sometimes it is caused by fibroid or ovarian tumors. Spinal cord injuries or nervous system disorders are additional causes of overflow incontinence. Also overflow incontinence in women can be from increased outlet resistance from advanced vaginal prolapse causing a "kink" in the urethra or after an anti-incontinence procedure which has overco

Front 52

functional incontinence

Back 52

loss of urine caused by factors outside urinary tract that interferes with the ability to respond in a socially appropriate way to the urge to void. sensory -cognitive-mobility issues

Front 53

name 3 nursing responsibilities associated with bowel elimination

Back 53

assessing bowel function- promoting normal bowel health- Intervening to manage alterations in bowel function

Front 54

name 3 functions of the intestine

Back 54

motility absorption defecation

Front 55

This aids in digestion and absorption and contracts and relaxes the smooth muscle alternating back and forth

Back 55

segmentation

Front 56

where are most fluids absorbed at

Back 56

large intestine

Front 57

where are most nutrients and electrolytes absorbed at

Back 57

small intestine

Front 58

what are the divisions of the large intestines

Back 58

ascending transverse descending sigmoid rectum and anus

Front 59

certain diseases cause conditions that prevent normal passage of feces through rectum so an artificial opening is made called what

Back 59

stoma in the abdominal wall

Front 60

Loop colostomy

Back 60

usually performed in emergency when they suspect closure of colostomy-temporary large stomas in the transverse colon-the loop has 2 openings through the one stoma -proximal end drains stool and distal drains mucous and external device is removed within 7-10 days

Front 61

end colostomy

Back 61

one stoma formed from the proximal end of the bowel with the distal portion removed or sewn-many people have these after correctal cancer--hartmans pouch

Front 62

double barrel colostomy

Back 62

bowel is surgically severed in a dbl barrel and the 2 ends are brought out onto the abdomen - 2 distinct stomas

Front 63

Ileoanal anastomosis

Back 63

this is used in clients who need to have a colectomy 4 treatment of ulcerative colitis or polps-colon is removed creates a pouch from end of the small intestine and attaches pouch to the anus

Front 64

kock continent ileostomy

Back 64

small intestine is used creating a spherical reservoir - pouch has a continent stoma and valve that is drained with catheter

Front 65

colostomy

Back 65

creates opening in abdomen for drainage of stool from large intestine

Front 66

colonoscopy

Back 66

an exam of the entire colon into the rectum-clear liquids the day before and bowel cleaner-light sedation and sometimes enemas until clear

Front 67

Flex sigmoidoscopy

Back 67

a flexible or rigid lighted tube examines the interior of the sigmoid colon and light sedation is required

Front 68

occult blood test

Back 68

also called guaiac test useful 4 screening 4 colon cancer-avoid red meat fish raw veggies asprin can be done at home or hospital ulcerative colitis can cause false positive

Front 69

when placing an enema in a patient

Back 69

lower container or clamp tubing if client complains of cramping or fluid escapes and slow it down

Front 70

when fitting a stoma

Back 70

the opening around the appliance should be no more than 1/16 larger than stoma

Front 71

ph on ng tube shoul be between

Back 71

1 - 4

Front 72

name 5 places an enteral feeding tube can be placed

Back 72

1 nasogatric 2 Esophogastomy 3 Gastrostomy 4 Jejunostomy 5 Nasoduedenal

Front 73

Using endoscopy

Back 73

a gastrostomy tube is inserted through the esophagus into the stomach and then pulled through a stab wound made in the abdominal wall. A retention disk and bumper secure the tube

Front 74

A firm and painful abdomen during or after enema administration could indicate perforation of the rectum

Back 74

true take vitals and call doctor

Front 75

Intact skin barriers without evidence of leakage can remain in place for 3 to 5 days

Back 75

How often should an ostomy pouch be changed?

Front 76

A client is diagnosed with colorectal cancer. Which type of ostomy is the client most likely to have after surgery?

Back 76

Loop colostomies are usually performed during emergency surgeries. End colostomies are more common as a result of surgical treatment of colorectal cancer.

Front 77

stress incontinence and how it is repaired

Back 77

kegals-surgery-biofeedback-electrical stimulation-absorbent products

Front 78

explain clean catch

Back 78

The urinary tract naturally contains bacteria, which can contaminate a urine sample. The clean-catch method is used to prevent these bacteria from getting into the urine sample. The clean catch can be used for a routine urinalysis, a urine culture, or other urine tests that require pure urine for accurate results. Urinate in toilet in beginning of stream and then into cup remove container from cup without stopping flow after getting 1-2 oz.

Front 79

what are the early signs of UTI

Back 79

fever,chills,malise, nausea and vomiting

Front 80

does a cystoscope require sedation

Back 80

yes to anxiety and trauma to the patient

Front 81

Most important thing that can occur with diversions is

Back 81

skin breakdown

Front 82

protein in urine would indicate

Back 82

a UTI

Front 83

specific gravity measures

Back 83

concentration of particles in urine

Front 84

what is a condom catheter and what are the factors to be aware of

Back 84

non invasive and make sure to leave a 2.5-5 cm (1-2in) space btw tip of penis and end of cath, never use adhesive tape, make sure blood flow is not impaired

Front 85

What is a Nephrostomy

Back 85

urinary drainage directly from one or both kidneys and a tube is placed directly into renal pelvis

Front 86

what to be aware of in a patient that has diarrhea

Back 86

edit dehydration/loss of Potassium/skin breakdown

Front 87

How do you prepare for a colonostmy

Back 87

clear liquids day b4,bowel cleaner,light sedation also

Front 88

After Joe has had a colostomy what should his diet consist of

Back 88

low fiber diets like bread,noodles,rice,cream cheese,eggs,lean meats,poultry...avoid fruits and veggies

Front 89

Explain different color of stools and what it indicates

Back 89

clay=no bile black=upper gi bleeding or iron red=hemmroids or lower gi bleed

Front 90

what should you as the nurse do for the patient after abdominal surgery

Back 90

listen to bowel sounds if no peristalsis do not feed

Front 91

Joe has too much potassium in his body(KA) what should you as the nurse give him

Back 91

Give IV insulin with glucose which will move it to ECF to ICF/ monitor blood sugar/ IV calcium gluconate can be given if cardiac arrithymias (edit)

Front 92

How would you check to see if joes Ng tube is in the right place

Back 92

edit xray or look at ph of gastric juices in stomach and should be btw 1-4

Front 93

What is Hypertonic solution do

Back 93

osmolarity greater than body fluid/shifts fluid into blood plasma by moving fluid from tissue cells ICF-ECF

Front 94

You are the nurse and amy is constipated how will you treat this

Back 94

slowed peristalisis, fiber, mobility, fluids

Front 95

Agglutination is what

Back 95

clumping effect occurring when an antibody acts as a cross link between 2 antigens

Front 96

phagocytosis is a WBC

Back 96

cells that engulf destroy ingest foreign bodies or toxins

Front 97

WBCs or leukocytes participate in

Back 97

the natural and acquired immune responses

Front 98

a phagocytic cell is also referred to as

Back 98

nongranular leukocytes/monocyte

Front 99

The inflammatory response is elicited in response to

Back 99

tissue injury or invading organisms

Front 100

what happens when something becomes inflammed

Back 100

blood loss is lessened/ walling off invading organism / phagocytes are activated and scar tissue is formed/ regeneration of injured tissue

Front 101

physical and chemical barriers are facilitated by

Back 101

inflammatory response

Front 102

T cells are important for what

Back 102

producing a cellular immune response

Front 103

descendants of stem cells become what

Back 103

B and T lymphocytes

Front 104

Tcells move from the bone marrow to thymus where

Back 104

they mature into several kinds of cells with different functions

Front 105

In the proliferation stage t cells turn into ? and B cells do what

Back 105

T cells into cytotoxic killer and b cells produce and release antibodies

Front 106

first cells to be on site of infection

Back 106

neutrophils

Front 107

cellular response t cell includes

Back 107

transplant rejection-viral /fungal/parsite infections

Front 108

humoral response includes b cells

Back 108

bacterial and some viral/anaphylaxis/asthma/hay fever

Front 109

Tcells can become killer and do what

Back 109

attack antigen directly and get outside help

Front 110

Natural Immunity is what

Back 110

rapid immunity and is present at birth

Front 111

True

Back 111

natural immunity has a broad spectrum of defense against and resistance to infection

Front 112

natural immunity provides a nonspecific response

Back 112

to ANY foreign invader

Front 113

This is able to tell self from non self

Back 113

natural immunity

Front 114

Acquired Immunity is

Back 114

acquired in life but not at birth and usually develops as a result of prior exposure to antigen

Front 115

A Vaccine is what

Back 115

Acquired immuinty

Front 116

There are two kinds of lymphocytes

Back 116

the B lymphocytes and the T lymphocytes. Lymphocytes start out in the bone marrow and either stay there and mature into B cells or they leave for the thymus gland where they mature into T cells. B lymphocytes and T lymphocytes have separate jobs to do: B lymphocytes are like the body's military intelligence system seeking out their targets and sending defenses to lock onto them. T cells are like the soldiers destroying the invaders that the intelligence system has identified. Here's how it works.

Front 117

Once the B lymphocytes have produced antibodies

Back 117

these antibodies continue to exist in a person's body so that if the same antigen is presented to the immune system again the antibodies are already there to do their job. That's why if someone gets sick with a certain disease like chickenpox that person typically doesn't get sick from it again. This is also why we use immunizations to prevent getting certain diseases. The immunization introduces the body to the antigen in a way that doesn't make a person sick but it does allow the body to produce antibodies that will then protect that person from future attack by the germ or substance that produces that particular disease.

Front 118

Although antibodies can recognize an antigen and lock onto it

Back 118

they are not capable of destroying it without help. That is the job of the T cells. The T cells are part of the system that destroys antigens that have been tagged by antibodies or cells that have been infected or somehow changed. (There are actually T cells that are called "killer cells.") T cells are also involved in helping signal other cells (like phagocytes) to do their jobs.

Front 119

Antibodies can also neutralize toxins (poisonous or damaging substances) produced by different organisms. Lastly

Back 119

antibodies can activate a group of proteins called complement that are also part of the immune system. Complement assists in killing bacteria viruses or infected cells.

Front 120

Innate Immunity

Back 120

Everyone is born with innate (or natural) immunity a type of general protection that humans have. Many of the germs that affect other species don't harm us. For example the viruses that cause leukemia in cats or distemper in dogs don't affect humans. Innate immunity works both ways because some viruses that make humans ill — such as the virus that causes HIV/AIDS — don't make cats or dogs sick either.

Front 121

Innate immunity

Back 121

also includes the external barriers of the body like the skin and mucous membranes (like those that line the nose

Front 122

Passive Immunity

Back 122

Passive immunity is "borrowed" from another source and it lasts for a short time. For example antibodies in a mother's breast milk provide an infant with temporary immunity to diseases that the mother has been exposed to. This can help protect the infant against infection during the early years of childhood.Everyone's immune system is different. Some people never seem to get infections whereas others seem to be sick all the time. As people get older they usually become immune to more germs as the immune system comes into contact with more and more of them. That's why adults and teens tend to get fewer colds than kids — their bodies have learned to recognize and immediately attack many of the viruses that cause colds.

Front 123

Gamma globulin injections

Back 123

are usually given in an attempt to temporarily boost a patient's immunity against disease. Injections are most commonly used on patients who have been exposed to hepatitis A or measles

Front 124

antibodies are

Back 124

large proteins called immuloglobbins bc they are found in the globulin fraction of plasma proteins

Front 125

steroids cause

Back 125

immunsuppressive in Latent TB

Front 126

How do you identify a stoma

Back 126

edit color/moisture/bleeding

Front 127

Active immunity

Back 127

the immune defenses are developed by persons own body

Front 128

passive immunity

Back 128

is temporary from source outside of body that has gained immunity thru previous disease or immunization

Front 129

If your Potassium is high you can bring it down with Kayxelate via the oral or rectal route or you can give an IV of D5W with some insulin. For too little Potassium you augment their diet with Bananas, give them oral potassium or an IV with Potassium. JPM

Back 129

potassium

Front 130

active vs passive immunity

Back 130

Naturally acquired active immunity occurs when the person is exposed to a live pathogen, develops the disease, and becomes immune as a result of the primary immune response. Artificially acquired active immunity can be induced by a vaccine, a substance that contains the antigen. A vaccine stimulates a primary response against the antigen without causing symptoms of the disease (see vaccination).

Artificially acquired passive immunity is a short-term immunization by the injection of antibodies, such as gamma globulin, that are not produced by the recipient's cells. Naturally acquired passive immunity occurs during pregnancy, in which certain antibodies are passed from the maternal into the fetal bloodstream. Immunologic tolerance for foreign antigens can be induced experimentally by creating conditions of high-zone tolerance, i.e., by injecting large amounts of a foreign antigen into the host organism, or low-zone tolerance, i.e., injecting small amounts of foreign antigen over long periods of time.

Front 131

Passive immunity response is immediate, but not long lasting. Because no time is taken for the production of sufficient level of antibodies,(as antibodies are being injected) and after the level of antibodies is reduced or they are used up-No more antibodies production is there.

Back 131

Most of the vaccines consist of non virulent, mutant strains of the poliovirus. The use of vaccines, which stimulate the production of antibodies in the body, and making a person immune against the disease or infection, is called active immunity. Active immunity response is not immediately available but it is long lasting.