Final Exam Unit 9

Front 1

Ureterostomy

Back 1

Diversion of urine away from a diseased or defective bladder through an artificial opening in the skin.

Front 2

Single Ureterostomy

Back 2

Bring the end of one ureter to the abdominal surface.

Front 3

Double Ureterostomy

Back 3

Bringing the end of both ureters to the abdominal surface.

Front 4

Transureterostomy

Back 4

Connect the ureters and brings one out through the abdominal wall.

Front 5

Illeal loop

Back 5

Separating a loop of intestinal ileum with its blood supply.

Front 6

UTIs

Back 6

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.

Front 7

The adult normally voids-

Back 7

1500-1600ml of urine daily.

Front 8

Normal urination-

Back 8

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.

Front 9

Random (routine urinalysis)-

Back 9

can be collected during normal voiding, from an indwelling catheter or urinary diversion collection bag.

Front 10

Clean-voided or midstream (culture and sensitivity)-

Back 10

Collected in a sterile specimen cup. collect 30-60ml.

Front 11

Sterile specimen (culture and sensitivity)-

Back 11

If the pt. has a catheter, a sterile specimen can be collected using aseptic technique through the special port.

Front 12

Timed urine speciments (for measuring levels of adrenocortical steroids or hormones, creatine clearance, or protein quantity-

Back 12

Test 2,12, or 24 hours starts at first void and end at specified time, dumped into a clean container provided by the Dr.

Front 13

Factors affecting bowel elimination-

Back 13

*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.

Front 14

A number of diseases of the GI tract are believed to be associated w/ stress, these include...

Back 14

ulcerative colitis, certain gastric and duodenal ulcers, and Crohn's disease.

Front 15

Diagnostic tests-

Back 15

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.

Front 16

Surgical openings

Back 16

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.

Front 17

Ileostomy byppasses-

Back 17

the entire large intestine. As a result, stools are frequent and liquid. The same is true for a colonoscopy of the ascending colon.

Front 18

Colostomy of the transverse colon-

Back 18

generally results in a more solid, formed stool.

Front 19

The sigmoid colostomy-

Back 19

emits near-normal stools.

Front 20

Loop colostomy-

Back 20

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.

Front 21

End colostomy

Back 21

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.

Front 22

Double-Barrel colostomy-

Back 22

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.

Front 23

Kock continent ileostomy-

Back 23

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.

Front 24

Lab tests-
*(Fecal specimens)-

Back 24

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.

Front 25

Occult (microscopic) blood in the stool and stool cultures require only a small sample.

Back 25

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.

Front 26

Ova and parasite tests require-

Back 26

the stool to be warm.

Front 27

Fecal occult blood testing (FOBT), or guaiac test

Back 27

which measures microscopic amounts of blood infeces. It isuseful as a dx screening test for colon cancer, the test should be repeated 3 times.

Front 28

Diagnostic Examinations-

Back 28

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.

Front 29

Enemas-

Back 29

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.

Front 30

Cleansing enemas-

Back 30

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.

Front 31

Tap water-

Back 31

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.

Front 32

Normal saline-

Back 32

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.

Front 33

Hypertonic solution-

Back 33

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.

Front 34

Soapsuds-

Back 34

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.

Front 35

Oil retention-

Back 35

lubricate the rectum and colon. The feces absorb the oil and become softer and easier to pass. Hold for several hours if possible.

Front 36

Carminative enemas-

Back 36

Provides relief from gaseous distention. Improve flatus.

Front 37

medication enema-

Back 37

contain drugs.

Front 38

Digital removal of stool-

Back 38

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.

Front 39

Intermittent catheters-

Back 39

only introduced long enough to drain the bladder (5 to 10 minutes), then w/draw. Single lumen from the tip.

Front 40

Indwelling foley catheter-

Back 40

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.

Front 41

Indwelling Coude' catheter-`

Back 41

(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.

Front 42

French-

Back 42

the larger the gauge number, the larger the catheter size.
Children- 8-10
Women- 14-16
Men-16-18

Front 43

Suprapubic catheterization-

Back 43

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.

Front 44

Condom cath.-

Back 44

Suitable for incontient or comatose mwn who still have complete and spontaneous bladder emptying.