Excelsior College Health Differences / Formally Exam 2 - Elimination

Front 1

What is Peristalsis?

Back 1

A wavelike movement that occurs in the large intestines and propels the intestinal contents forward

Front 2

What is Haustral churning or shuffling?

Back 2

Movement of the chyme back and forth within the haustra. Mixes contents, and aids in the absorption of water, moves contents forward

Front 3

What is Mass peristalsis?

Back 3

A wave of powerful muscular contraction that moves over large areas of the colon

Front 4

List the four steps in order to assessing the abdomen

Back 4

1 - Inspect the abdomen
skin integrity, rash or other lesions; contour & symmetry – look for distention, obesity, ascites, tumors; abdominal movement –limited mvmt D/T pain or disease process, Visible peristalsis, Marked aortic pulsations; vascular pattern – visible venous pattern(dilated veins) associated with liver disease, ascites & venocaval obstruction
2 - Auscultate for bowel & vascular sounds
Absent, hypoactive, hyperactive bowel sounds; Loud bruit over aortic area; Bruit over renal, iliac or femoral arteries
3 - Percuss several areas in each of the 4 quadrants
Tympany – gas in stomach and intestines
Dullness – decrease, absence or flatness of resonance heard over solid masses or fluid
Percuss the liver to determine its size
4 - Palpate the Abdomen
Light palpation: tenderness, hypersensitivity, superficial masses, localized areas of increased tension or tenderness
Deep palpation: Generalized or localized areas of tenderness, mobile or fixed masses, muscle tightness, guarding & pain
Palpate the bladder above the pubic symphysis for distention & tense mass

Front 5

What is the recommended daily fluid intake for an adult?

Back 5

2000-3000 ml of fluid daily

Front 6

Three common drugs that cause constipation are?

Back 6

Pain Medications such as morphine and codeine as well as Iron

Front 7

What medication can turn the stool RED?

Back 7

Aspirin

Front 8

What medications can turn the stool whitish?

Back 8

Antacids

Front 9

What medications can turn the stool BLACK?

Back 9

Iron
Aspirin

Front 10

What medications can turn the stool gray-green?

Back 10

Antibiotics

Front 11

General Anesthesia can block what stimulation and cause constipation? How long can this last?

Back 11

Parasympathetic stimulation to the muscles of the colon. Paralytic ileus lasts 24-48 hours post surgery. Normal bowel function will resume with food intake

Front 12

Constipation is described as fewer than ____ weekly bowel movements?

Back 12

Three

Front 13

True / False
Opiates and Iron Salts can cause diarrhea

Back 13

False. The use of opiates and iron salts as well as frequent enema use can cause chronic constipation

Front 14

Use Valsalva maneuver with caution in these patients

Back 14

heart disease
brain injuries
respiratory diseases

Front 15

Take care not to cause _________ when performing a digital exam of the rectum

Back 15

A drop in patient's heart rate.
Perform a digital exam gently to avoid over stimulation of the vagus nerve in the rectal wall

Front 16

This is a loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter

Back 16

Bowel Incontinence

Front 17

Inability to control flatus or minor soiling is called _________

Back 17

Partial Bowel Incontinence

Front 18

Inability to control feces of normal consistency is called ____________

Back 18

Major Bowel Incontinence. This is associated with impaired functioning of the anal sphincter or nerve supply caused by neuromuscular disease, spinal cord trauma or tumors of the external anal sphincter muscle

Front 19

This is an opening through the abdominal wall for the elimination of feces or urine

Back 19

Ostomy

Front 20

This is an opening through the abdominal wall into the stomach

Back 20

Gastrostomy

Front 21

This opening is made through the abdominal wall into the jejunum

Back 21

Jejunostomy

Front 22

This opening is made into the ileum or small bowel

Back 22

Ilestomy

Front 23

This opening is made into the colon or large bowel

Back 23

Colostomy

Front 24

This opening is made into the ureter

Back 24

Ureterostomy

Front 25

This procedure is performed for traumatic injuries or due to inflammatory conditions of the bowel

Back 25

Temporary colostomies

Front 26

This procedure is performed when the rectum or anus is nonfunctional as a result of a birth defect or disease such as cancer of the bowel

Back 26

Permanent colostomies

Front 27

This procedure produces a constant liquid fecal drainage. It contains digestive enzymes which are damaging to the skin. Odor is minimal because few bacteria are present

Back 27

Ileostomy

Front 28

This Colostomy causes the drainage of liquid with digestive enzymes present. There is an increased odor that requires a deodorant to be utilized inside the appliance due to the presence of bacteria

Back 28

Ascending Colostomy

Front 29

This procedure causes the removal of malodorous mushy drainage with no control

Back 29

Transverse Colostomy

Front 30

This colostomy produces an increasingly solid fecal drainage

Back 30

Descending Colostomy

Front 31

After this procedure, stool will be normal and have a formed consistency. Frequency can be regulated. Patient may not have to wear appliance at all times and odors can usually be controlled

Back 31

Sigmoidostomy

Front 32

During the assessment of a patient with an ostomy, the RN should _____________

Back 32

nursing history, performing a physical examination of the abdomen, rectum and anus and inspecting the feces for color, consistency, shape, amount, odor and the presence of abnormal constituents

Front 33

True / False
During the physical exam of a patient with an ostomy, Auscultation should take precedence over palpation?

Back 33

True.
Auscultation precedes palpation because palpation can alter peristalsis

Front 34

The primary regulators of fluid and acid-base balance in the body

Back 34

Kidneys

Front 35

This hormone is released from the adrenal cortex and causes sodium and water to be reabsorbed in greater quantities which in turn increases blood volume and decreases urine output

Back 35

Aldosterone

Front 36

This is the reservoir for urine and is the organ of excretion

Back 36

Bladder

Front 37

The wall of the bladder is made up of how many layers?

Back 37

Four
1 - Inner mucous layer
2 - Connective tissue layer
3 - Three layers of smooth muscle fibers
4 - Outer serous layer

Front 38

Where is the voiding reflex center located at in the body?

Back 38

Second to Fourth sacral vertebra

Front 39

This substance will cause a retention of urinary fluids

Back 39

Sodium

Front 40

These substances will cause an excessive amount of urinary fluids to be excreted from the body

Back 40

Alcohol and Caffeine

Front 41

The abnormal production of large amounts of urine is called __________

Back 41

Polyuria

Front 42

Excessive fluid intake

Back 42

Polydypsia

Front 43

Low urine output is called ___________

Back 43

Oliguria. Usually indicated impaired blood flow to the kidneys or impending renal failure

Front 44

Oliguria is defined as eliminating < or > __ ml daily or __ ml/hr of urine

Back 44

< 500 ml a day or 30 ml/hr

Front 45

Voiding of urine more than usual is also known as

Back 45

Frequency

Front 46

Enuresis

Back 46

The involuntary urination in children beyond the age of normal bladder control (usually age 4-5)

Front 47

Dysuria

Back 47

Painful or difficult voiding possibly caused by a UTI or injury to the bladder and urethra

Front 48

Urgency to urinate can be caused by _____________

Back 48

Psychological stress, irritation of the trigone and urethra, poor external sphincter control

Front 49

Voiding of urine more than twice nightly is also known as _________

Back 49

Nocturia

Front 50

This is a symptom, not a disease. It can be caused from stress, sneezing, coughing, laughing and lifting as well as other more serious conditions

Back 50

Urinary Incontinence

Front 51

Urinary incontinence that follows a strong sense of urgency is called ______

Back 51

Urge urinary incontinence

Front 52

This urinary incontinence occurs at predictable intervals when a specific bladder volume is reached

Back 52

Reflex urinary incontinence

Front 53

This urinary incontinence occurs from sneezing, coughing and lifting

Back 53

Stress urinary incontinence

Front 54

This type of urinary incontinence occurs involuntary. It is the unpredictable passage of urine

Back 54

Functional urinary incontinence

Front 55

This type of urinary incontinence is continuous and occurs at unpredictable times

Back 55

Total urinary incontinence

Front 56

Over distension of the bladder can cause poor contraction of the detrusor muscle, also known as ______ ______ and can be caused by surgery, enlarged prostrate or by use of certain medications.

Back 56

Urinary retention

Front 57

Caused when a person has no perception of bladder fullness and lacks the ability to control their urinary sphincters

Back 57

Neurogenic bladder

Front 58

Normal urine consists of ___% water?

Back 58

96%

Front 59

Normal urine consists of ___% solutes?

Back 59

4%
Urea, ammonia, creatine, uric acid, sodium, chloride, potassium, sulfate, magnesium and phosphorus

Front 60

The urine retained after voiding is called ________

Back 60

Residual urine

Front 61

Measurement of the concentration of solutes present in urine

Back 61

Specific gravity - normal range 1.010 - 1.025

Front 62

What findings would you expect with a person experiencing dehydration or fluid deficit? Specifically related to the concentration of their urine (specific gravity)

Back 62

Concentrated urine would have an increased specific gravity

Front 63

Normal pH for Urine

Back 63

6, slightly acidic

Front 64

When fatty acids are broken down in the body, the byproducts excreted in urine are also known as ________?

Back 64

Ketones

Front 65

Certain populations may have an increased risk of producing ketones in their urine. List some

Back 65

Poorly controlled diabetes
Alcoholics
Fasting or starving persons
Consumption of very high protein diet

Front 66

Normally these are too large to escape from glomerular capillaries into the filtrate

Back 66

Proteins

Front 67

This test is conducted to determine the presence of blood in the urine/stool

Back 67

Occult blood - urine / Occult blood - stool
Both are a good indication of infection

Front 68

This is the end product of protein metabolism. It is produced in relatively constant quantities by the muscles

Back 68

BUN

Front 69

As an important part of the muscle, this byproduct is excreted exclusively through the urine. This test is a sensitive indicator of renal function

Back 69

Creatinine, a breakdown product of creatine
Normal creatinine values can range from 500 to 2000 mg/day
Results depend greatly on age and amount of lean body mass
14 to 26 mg per kg of body mass per day for men
11 to 20 mg per kg of body mass per day for women

Front 70

This type of urinary catheter remain in the bladder to drain urine

Back 70

Retention catheter

Front 71

What is the most important excretory organ?

Back 71

The kidneys

Front 72

List some functions of the kidneys

Back 72

1 - Eliminate nitrogenous waste, water, electrolytes, toxins and drugs, regulates blood volume, balances pH and blood pressure and helps with red blood cell production

Front 73

List the three regions of the kidneys

Back 73

Renal Cortex
Renal Medulla
Renal Pelvis

Front 74

This is the functional unit of the kidney and is responsible for making urine

Back 74

Nephron unit - composed of tubular and vascular structures

Front 75

Hormone that stimulates the distal tubule to reabsorb Na+ and H2O and excrete K+

Back 75

Aldosterone - secretion is regulated by the renin-angiotension-aldosterone system

Front 76

This hormone stimulates the collection duct to reabsorb water as it is released from the posterior pituitary gland in response to low blood volume and increased concentration of solute in the plasma

Back 76

Antidiuretic Hormone (ADH)

Front 77

Inhibits the reabsorption of Na+ and H2O causing natriuresis

Back 77

Atrial natriuretic factor

Front 78

Stimulates the renal absorption of calcium and the excretion of phosphate

Back 78

Parathyroid hormone

Front 79

These vegetables are considered laxatives stimulating the intestinal mucosa and increasing motility and secretion

Back 79

Figs, prunes, pears, raisins, and rhubarb. The active ingredient of rhubarb, oxalic acid, is concentrated in the plant’s leaves, a serious threat of poisoning if eaten. Rhubarb also contains tannin, an astringent that produces constipation as a side-effect

Front 80

Glycerine, Sorbitol, Lactulose and saline (magnesium cations and phosphate anions) are all forms of what type of laxative?

Back 80

Hyperosmotic laxative

Front 81

These are the most physiologic of laxatives mimicking the action of dietary fiber in the digestive tract. They are not absorbed, rather carried out of the body as feces.

Back 81

Bulk-forming Laxatives
Contraindicated in patients with dysphasia

Front 82

Various oils that retard the re-absorption of water from fecal mass in the colon. Can interfere with absorption of fat-soluble nutrients (A,D,E,K)

Back 82

Lubricant laxatives

Front 83

Moistening agents. Best used 2-3 days in advance of anticipation of constipation

Back 83

Stool softerners

Front 84

Sodium phosphate has a major activity as a ______ ______

Back 84

Saline cathartic

Front 85

Most common side effect of Sucralfate

Back 85

Constipation

Front 86

Adverse effects of Metoclopramide

Back 86

Dystonic or extrapyramidal effects

Front 87

List some appropriate uses of laxatives

Back 87

Prevent straining in patients with cardiovascular disease
Bulk forming agents for diverticulitis
Treatment for certain drug overdoses