Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/44

Click to flip

44 Cards in this Set

  • Front
  • Back
Ureterostomy
Diversion of urine away from a diseased or defective bladder through an artificial opening in the skin.
Single Ureterostomy
Bring the end of one ureter to the abdominal surface.
Double Ureterostomy
Bringing the end of both ureters to the abdominal surface.
Transureterostomy
Connect the ureters and brings one out through the abdominal wall.
Illeal loop
Separating a loop of intestinal ileum with its blood supply.
UTIs
are responsible for more than 7 million physician visits a year and are the most common hospital acquired (nosocomial) infections in the US, accounting for 40% of the total.
Escherichia coli remains the most common cause pathogen.
The adult normally voids-
1500-1600ml of urine daily.
Normal urination-
An hourly ouput of less than 30ml for more than 2 hours is cause for concern. Similarly, consistenly high volumes of urine (polyuria), over 2000-2500ml daily, should be reported to a physician.
Random (routine urinalysis)-
can be collected during normal voiding, from an indwelling catheter or urinary diversion collection bag.
Clean-voided or midstream (culture and sensitivity)-
Collected in a sterile specimen cup. collect 30-60ml.
Sterile specimen (culture and sensitivity)-
If the pt. has a catheter, a sterile specimen can be collected using aseptic technique through the special port.
Timed urine speciments (for measuring levels of adrenocortical steroids or hormones, creatine clearance, or protein quantity-
Test 2,12, or 24 hours starts at first void and end at specified time, dumped into a clean container provided by the Dr.
Factors affecting bowel elimination-
*AGE- Systemic changes in the function of digestion and absorption of nutrients result from changes in older clients' cardiovascular and neurological systems, rather than their gastrointestinal system. Arteriosclerosis may cause decreased splanchnic and mesenteric blood flow, thus decreasing absorption from the small intestine.
*DIET- Fiber, the undigestivle residue in the diet, provides the bulk of fecal material. Bulk-forming foods, such as grains, fruits, and vegetables, absorb fluids and increase stool mass.
*Fluid intake- An inadequate fluid intake or disturbances resulting in fld. loss (vomiting) affect the character of feces. Fld liquifies intestinal contents, easing its passage through the colon. Reduced fld intake slows passage of food through the testine and can result in hardening of stool contents.
*Physical activity- Physical activity promotes peristalsis, whereas immobilization depresses peristalsis.
*Psychological factors- If an individual becomes anxious, afraid, or angry, the stress reponse is initiated, which allows the body to restore defenses. The digestive process is accelerated, and peristalsis is increased. Side effects of increased peristalsis are diarrhea and gaseous distention. If a person becomes depressed, the autonomic nervous system slows impulses and peristalsis can decrease, resulting in constipation.
A number of diseases of the GI tract are believed to be associated w/ stress, these include...
ulcerative colitis, certain gastric and duodenal ulcers, and Crohn's disease.
Diagnostic tests-
Diagnostic examinations involving visualization of GI structures often require that portion of the bowel be empty of contents. The client usually receives a prescribed bowel preparation before the test.
Surgical openings
may be created in the ileum (ileostomy) or colon (colostomy) w/ the ends of the intestine brought through the abdominal wall to create the stoma.
Ileostomy byppasses-
the entire large intestine. As a result, stools are frequent and liquid. The same is true for a colonoscopy of the ascending colon.
Colostomy of the transverse colon-
generally results in a more solid, formed stool.
The sigmoid colostomy-
emits near-normal stools.
Loop colostomy-
is usually performed in a medical emergency when closure of the colostomy is anticipated. Usually temperary large stomas constructed in the transverse colon. the surgeon pulls a loop of bowel onto the abdomen. An external supporting device such as a plastic rod, bridge, or rubber catheter is temporarily placed under the bowel loop to keep it from slipping back. The surgeon then opens the bowel and sutures it to the skin of the abdomen. It has 2 openings through the one stoma. The proximal end drains stool, where the distal portion drains mucus. W/in 7-10 days the external supporting device is removed.
End colostomy
consists of one stoma formed from the proximal end of the bowel w/ the distal portion of the GI tract either removed or sewn closed (Hartmann's pouch) and left in the abdominal cavity. For many clients, end colostomies are a result of surgical tx of colorectal cancer. In such cases the rectum might also be removed. Clients w/ diverticulitis who are treated surgically often have a temporary end colostomy w/ a Hartmann's pouch.
Double-Barrel colostomy-
Unlike the loop colostomy, the bowel is surgically severed in a double-barrel colostomy, and the two ends are brought out onto the abdomen. The double-barrel colostomy consists of two distinct stomas; the proximal functioning stoma and the distal nonfunctioning stoma.
Kock continent ileostomy-
is created using the client's small intestine to create a pouch. This procedure is occasionally used in the tx of ulcerative colitis. The pouch has a continent stoma, a nipple type of valve that is drained w/ an external catheter, which is placed intermittently in the stoma. The client empties the pouch several times a day. The stoma is covered w/ a protective dressing of stoma cap.
Lab tests-
*(Fecal specimens)-
Medical aseptic technique should be used during collection of stool specimen. B/C about 25% of the solid portion of a stool is bacteria from the colon, the nurse should wear disposable gloves when handling specimens.
Occult (microscopic) blood in the stool and stool cultures require only a small sample.
The nurse collects about an inch of formed stool or 15 to 30ml of liquid diarrhea stool. Tests for measuring the ouput of fecal fat require a 3 to 5 day collection of stool. All fecal material must be saved throughout the test period.
Ova and parasite tests require-
the stool to be warm.
Fecal occult blood testing (FOBT), or guaiac test
which measures microscopic amounts of blood infeces. It isuseful as a dx screening test for colon cancer, the test should be repeated 3 times.
Diagnostic Examinations-
A variety of radiological and dx tests are used w/ the client experiencing altered bowel elimination. Visualization of GI structures may be direct or indirect.
Enemas-
is the instillation of a solution into the rectum and sigmoid colon. The primary reason for an enema is to promote defecation by stimulating peristalsis. The volume of fld. instilled breaks up the fecal mass, stretches the rectal wall, and initiates the defecation reflex. Enemas are also given as a vehicle for medications that exert a local effect on rectal mucosa.
Cleansing enemas-
promote the complete evacuation of feces from the colon. They act by stimulating peristalsis through the infusion of a large volume of solution or through local irritation of the colon's mucosa. Tap water, normal saline, soapsuds solution, and low-volume hypertonic salin. Children should receive only normal saline bc they are at risk for fld imbalance.
Tap water-
The infused volume stimulates defecation before large amounts of water leave the bowel. Tap water enemas should not be repeated b/c water toxicity or circulatory overload can develop if large amounts of water absorbed.
Normal saline-
Physiologically normal saline is the safest solution to use bc it exerts the same osmotic pressure as flds in interstiial spaces surrounding the bowel. Giving saline enemas does not create the danger of excess fld absorption.
Hypertonic solution-
The colon fills w/ fld, and the resultant distention promotes defecation. Clients unable to tolerate large volumes of fld benefit most from this type of enema, which is, by design, low volume.
Soapsuds-
may be added to tap water or saline to create the effect of intestinal irritation to stimulate peristalsis. Only pure castile soap is safe, and it comes in a liquid form included in most soapsuds enema kits.
Oil retention-
lubricate the rectum and colon. The feces absorb the oil and become softer and easier to pass. Hold for several hours if possible.
Carminative enemas-
Provides relief from gaseous distention. Improve flatus.
medication enema-
contain drugs.
Digital removal of stool-
Excess rectal manipulation may cause irritation to the mucosa, bleeding, and stimulatio of the vagus nerve, which results in a reflex slowing of the heart rate. Because of the procedure's potential complication, a physician's orders is necessary for the nurse to remove a fecal impaction.
Intermittent catheters-
only introduced long enough to drain the bladder (5 to 10 minutes), then w/draw. Single lumen from the tip.
Indwelling foley catheter-
has a small inflatable balloon that encircles the catheter just above the tip, which rests against the bladder outlet to anchor the catheter in place, may have 2 to 3 lumens.
Indwelling Coude' catheter-`
(curved tip)- used on males who may have enlarged prostates that partly obstruct the urethra, less traumatic during insertion b/c its stiffer and easier to control than the straight tip catheter.
French-
the larger the gauge number, the larger the catheter size.
Children- 8-10
Women- 14-16
Men-16-18
Suprapubic catheterization-
Surgical placement of a catheter through out the abdominal wall above the symphysis pubis and into the urinary bladder. Local or general anesth. anchored w/ sutures, a commercially prepared body seal, or both.
Condom cath.-
Suitable for incontient or comatose mwn who still have complete and spontaneous bladder emptying.