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236 Cards in this Set
- Front
- Back
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naso, rhino
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nose
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tonsillo
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tonsil
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laryngo
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larynx
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tracheo
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trachea
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bronchus, broncho
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bronchus (pl. bronchi)
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pulmo, pneuma, pneum
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lung
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neuro
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nerve
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cerebrum
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brain
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ochulo, ophtalmo
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eye
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oto
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ear
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psych, psycho
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mind
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urethro
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urethra
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cysto
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bladder
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uretero
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ureter
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reni, reno, nephro
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kidney
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pyelo
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pelvis of kidney
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uro
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urine
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vulvo
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vulva
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perineo
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perineum
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labio
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labium (pl. labia)
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vagino, colpo
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vagina
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cervico
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cervix
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utero
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womb, uterus
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tubo, salpingo
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fallopian tube
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ovario, oophoro
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ovary
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orchido
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testes
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crani
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head
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cervico, tracheo
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neck
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thoraco
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chest
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abdomino
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abdomen
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dorsum
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back
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cutis, dermato
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skin
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lipo
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fat
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musculo, myo
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muscle
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osteo
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bone
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myelo
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marrow
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chondro
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cartilage
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cyto
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cell
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genetic
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formation, origin
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gram
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tracing or mark
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What does the upper GI tract include?
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mouth, esophagus, stomach, & small intestine
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what does the lower GI tract include?
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large intestine
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what is the chief function of the large intestine?
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absorption of water & elimination of waste
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what are hemorrhoids?
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enlarged veins in the anal canal
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describe the internal anal sphincter
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made of smooth muscle; involuntary control in response to distension in the rectum
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describe the external anal sphincter
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under voluntary control; skeletal muscle
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what is peristalsis?
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passage of food through the GI tract through wavelike/propulsion. stimulated by intake of food & fluid in the GI tract
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how often does peristalsis occur in the large intestine?
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1-4 times in 24 hours
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what muscles are normally used in defecation?
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pressure is exerted to expel feces by contracting the abdominal muscles & the diaphragm. contraction of the muscles in the pelvic floor & simultaneous relaxation of the sphincter help push fecal mass through anal canal
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what does feces consist of?
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solid waste material consisting chiefly of dead bacteria, undigested food particles & water
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what does bright or dark red blood in the feces indicate?
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a lower GI bleed
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what does blood on the surface of stool or toilet tissue usually indicate?
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lower rectal bleeding or hemorrhoids
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what causes black tarry stools?
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1. meds can make feces black ex. iron
2. blood entered in stomach or small intestine called melena |
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what does guaiac test for?
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determines occult blood
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what are 2 changes the elderly experience in defecation?
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1. atony: lack of normal muscle tone-slower peristalsis-hard, dry feces.
2. decreased tone of abdominal muscles decreases pressure exerted during bowel evacuation |
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how can psychological stressors affect defecation?
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1. excessive stress may lead to increased peristaltic activity & diarrhea; or decreased peristaltic activity & constipation
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what are nursing measures to promote regular defecation?
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1. balanced diet that contains adequate bulk/high residue (prunes, bran, fiber, fresh fruit & veggies, whole grain)
2. adequate fluid intake 3. regular time & adequate time to defecate 4. regular exercise 5. privacy 6. rectal suppositories, enemas, laxatives only when necessary |
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what should the nurse observe the pt's stool for?
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color, consistency, shape, & amount
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constipation
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passage of unduly hard dry stools due to delay in evacuation of feces
-frequency may be a hint, but the most important factor is consistency! |
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predisposing factors that can lead to constipation
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1. weak abdominal muscles
2. diet poor in bulk or fluid 3. no food 4. prolonged bedrest or immobilization 5. ignoring call to defecate 6. chronic abuse of harsh laxatives 7. painful lesions 8. obstruction 9. systemic diseases 10.medications 11. emotional person w/ poor diet or neurotic persons 12. pregnancy 13. lack of exercise |
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symptoms of constipation
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1. loss of appetite
2. headache 3. distension of abdomen 4. flatus 5. tenesmus (frequent painful straining in attempts @ defecation-unproductive of stool) |
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nursing measures to prevent or relieve constipation
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1. teach client importance of exercise, healthy diet, adequate fluids, & regular time for defecation
2. help pt get on regular routine 3. privacy 4. provide hot/warm fluids to facilitate peristalsis |
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fecal impaction
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mass or collection of hard feces in rectum resulting from prolonged retention
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signs of fecal impaction
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no normal stool, passage of liquid material
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causes of fecal impaction
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poor defecation habits & constipation; certain medications-barium enema
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treatment of fecal impaction
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digital removal or enema
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sources of air in flatulence
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swallowed air;
gas from bacterial decomposition of food residue; gas diffused from blood stream |
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treatment for flatulence
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exercise or rectal tube
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fecal incontinence
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loss of voluntary ability to control fecal & gaseous discharges
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diarrhea
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passage of excessively liquid unformed stool due to rapid passage through lower GI tract;
consistency is most important factor |
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common causes of diarrhea
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hyper motility of intestines/increased peristalsis;;;
emotional stress intestinal infection food intolerance food allergies meds colon diseases surgical alterations |
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symptoms of diarrhea
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frequent watery stools;
intestinal cramps; spasmodic abdominal pain';; symptoms due to loss of fluid & electrolytes: poor tissue turgor, thirst, weightloss, weakness, fatigue, general malaise |
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treatment of diarrhea
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replace fluid & electrolytes if there is a major loss;
diet gradually increased; have bedpan convenient; ventilate room if possible; treat skin excoriation around anus; emotional support; antidiarrheal agents may be ordered |
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stomach functions
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stores food while eating;
secretes digestive fluids; churns food to aid in digestion; pushes chyme into small intestine through pyloric sphincter |
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small intestine functions
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secretes enzymes that digest proteins & carbs
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enema
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introduction of a solution into the large intestine, usually to remove feces. the solution irritates the intestinal mucosa, thus increasing peristalsis
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oral intestinal lavage
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used to cleanse intestine of feces
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what are the vital signs?
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temp
pulse respiration bp pain |
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temperature
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balance b/w heat production & loss in degrees
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heat production
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source of body heat is cellular activity especially in muscles & secreting glands produced by metabolic processes of the body
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factors causing rise in amount of heat produced
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1. shivering
2. specific dynamic action of foods 3. increased metabolic rate 4. exercise/ambulation 5. vital physiological processes 6. basal heat production 7. carbs, fats, proteins 8. strong emotions 9. increased environment temp 10. drugs like caffeine & smoking |
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factors causing decrease in heat produced:
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1. illness decreases muscular activity
2. fasting 3. lowered vitality & activity 4. sleep 5. depression of nervous system 6. drugs (antipyretics) |
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heat loss
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heat is lost from body by radiation, conduction, convection, evaporation, & small amount through body wastes
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define radiation
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transfer of heat from one object to another w/o touching, contact, or transfer medium
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define conduction
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transfer of heat b/w 2 objects which are in contact
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define convection
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transfer of heat through air or liquid
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define evaporation
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occurs when water is changed to vapor using heat in process
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heat regulation center of body
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hypothalamus
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average oral body temp
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98.6f, 37c
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average rectal body temp
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1 degree higher than oral
99.6f, 37.4c |
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average axillary body temp
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1 degree lower than oral
97.6f, 36.4c |
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factors that affect body temp & may cause variations
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1. age: newborns increased, elderly decreased
2. time of day; lowest in am, highest in pm 3. sex or gender-female rise in ovulation 4. emotions 5. exercise increases temp 6. temp of environment 7. foods, fluids, & smoking |
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how do you convert C to F?
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multiply by 9/5 & add 32
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how do you convert F to C?
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subtract 32 & multiply by 5/9
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define pyrexia
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elevation of body temp above normal-disturbance in heat regulation-either increase heat production or decrease heat loss
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constant fever
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increase in body temp with no more than 1 degree variation in 24 hours
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remittent fever
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implies variation during 24 hours but minimum-remains above normal
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intermittent fever
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when body temp rises and returns to normal daily
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what are the stages of fever?
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1. onset
2. course 3. termination |
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symptoms of onset of fever
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chills c/o feeling cold
shivering pallid skin goose bumps pulse rate rising rectal temp |
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symptoms of course of fever
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headache
flushing skin warm to touch rise in temp-disorientation, confusion, convulsions weakness and achiness weight loss anorexia, nausea dehydration |
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termination of fever
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diaphoresis (very sweaty)
reddening of skin possible dehydration |
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crisis
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temp returns to normal suddenly
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lysis
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temp returns to normal gradually
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care of febrile patient
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1. remove underlying pathology (cultures, antibiotics, prevent reinfection)
2. fluid & electrolyte balance (I&O, increase oral intake, IVs) 3. promote nutrition (small frequent feedings) 4. reduce fever (antipyretics, tepid water sponge bath, hypothermia pad) 5. provide comfort (keep skin, clothing, & linen clean & dry; mouth care) |
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circulation of blood in the heart
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vena cava--r atrium--tricuspid valve--r ventricle--pulmonary artery---lungs--pulmonary veins---l atrium---mitral valve---l ventricle--aorta--arteries--arterioles--capillaries---venules---veins
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define pulse
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the expansion of the arterial wall occurring as the wave of blood is forced through it by the contraction of the l ventricle. rate determined by counting each expansion in a given period of time.
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what can cause a change in pulse?
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a. change in volume of blood pumped through heart
b. any interference c functioning of heart c. any variation in the rate of the heart beat d. any change in the elasticity of the arterial wall |
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what are the pulse sites?
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temporal
carotid apical brachial radial femoral popliteal posterior tibial dorsalis pedis/pedal |
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how to take a pulse
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use 2nd, 3rd, 4th fingers. place lightly on skin at a place where artery passes over underlying bone
dont use thumb count for 1/2 minute, multiply by 2 |
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when should you take a pulse for a full minute?
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when initially counting a pulse;
if irregular; on meds that affect heart; any cardiac problems |
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pulse rate
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# of bmp
adults range 60 to 100 bpm |
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factors causing variations in pulse rate
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1. age-decreases w/ age
2. physique 3. sex, female slightly higher 4. posture-increases as you assume upright position 5. exercise 6. food-metabolic rate increases after eating 7. increased body temp-10 beats per degree elevation 8. drugs 9. blood pressure: bp decreases, pulse increases; bp increases, pulse decreases 10. disease conditions 11. hemorrhage causes bp decrease, pulse increase |
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tachycardia
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fast heart rate (higher than 100 bpm)
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bradycardia
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slow heart rate (less than 60 bpm)
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pulse rhythm
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pattern of beats
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normal pulse rhythm
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equal force & equal time interval b/w beats
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arrhythmia
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irregular rhythm
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volume
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normal pulse can be felt w/ moderate pressure of fingers & can be obliterated w/ greater pressure
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normal volume
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volume of each beat is equal
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bounding pulse
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forceful or full blood volume that is obliterated only w/ difficulty
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weak/thready/feeble pulse
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is readily obliterated c pressure
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apical pulse
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point of maximum impulse of heart against chest wall on L side of chest; space b/w 5-6 ribs, 2-3" left of sternum just below L nipple
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indications of apical pulse
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radial pulse is difficult to count;
some cardiac conditions; pts on meds where accurate pulse rate is important |
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apical/radial pulse
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2 people-1 counts radial & 1 counts apical
healthy=equal pulse deficit is difference b/w apical & radial pulses |
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define respiration
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means by which a person exchanges gases w/ atmosphere;
inspiration-breathe in expiration-breathe out |
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external respiration
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exchange of O2 & CO2 b/w alveoli of lungs & blood
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internal respiration
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exchange of O2 & CO2 b/w blood & body, takes place in cells that make up tissues
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respiratory center
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medulla oblongata; controls rate & depth of respiration
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thoracic breathing
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accomplished chiefly by costal muscles of the chest (women)
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abdominal breathing
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accomplished by abdominal muscles (men)
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average rate of respiration for a normal adult
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12-20/minute
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factors influencing rate of respiration
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1. age: decreases w/ age
2. body temp increases, respiration increases 3. exercise 4. emotions |
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tachypnea
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abnormal increase in respiratory rate-20 per min
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bradypnea
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abnormal decrease in respiratory rate 12 per min
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eupnea
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normal breathing regular, effortless
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depth of respiration
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determined by observing chest movement. normal adult inhales & exhales 500 ml air c each breath
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title volume
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volume of air normally exchanged c each breath
characterized by shallow, deep, normal |
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hyperpnea
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increased depth in respiration
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hypopnea
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decreased depth in respiration
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quality or character of respirations
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digressions from normal effortless breathing, also presence of sounds accompanying breathing
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dyspnea
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difficulty breathing
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orthopnea
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difficulty breathing lying down c relief when sitting
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apnea
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lack of breathing
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cheyne-stokes respirations
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irregularity in depth & periods of apnea
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Kussmauls respirations
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"air hunger"
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stertorous breathing sounds
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noising breathing, snoring sound
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strider breathing sounds
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acute constriction of trachea
harsh crowing sound |
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rales of rhonchi
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bubbling or crackling sounds
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respiratory rhythm
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refers to regularity of inspiration & expiration
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respiratory symmetry
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synchronous movements of each side of chest
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respiratory color
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anoxia is present when a pt is not receiving adequate O2
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define blood pressure
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the force exerted by the blood against the walls of the blood vessels
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systolic pressure
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max pressure/force exerted on walls of arteries when L ventricle contracts & pushes blood into the aorta
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diastolic pressure
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constant minimum pressure on the arterial walls
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pulse pressure
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difference b/w systolic & diastolic
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factors affecting normal arterial pressure
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1. cardiac output
2. peripheral resistance 3. volume of blood in circulatory system 4. viscosity of blood 5. elasticity of vessel walls |
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factors affecting bp
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1. age: bp may be increased in older, decreased in children
2. sex: slightly higher in men 3. body build: obesity increases bp 4. exercise: muscular exertion temporarily increases bp 5. pain: severe pain increases bp 6. emotions 7. disease: diseases affecting circulatory & renal systems may increase bp; diseases that weaken the heart may decrease bp 8. drugs: vasoconstrictors increase bp; vasodilators decrease bp 9. hemorrhage: decreases blood volume, decreases bp |
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average adult bp
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120/80
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average range of systolic
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100-140
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average range of diastolic
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60-90
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hypertension pressure
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140 systolic or 90 diastolic
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hypotension pressure
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100 systolic
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systolic sound
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1st sound heart
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diastolic sound
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last sound heard; point of complete cessation
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BP is contraindicated:
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1. diseased or injured extremity
2. paralyzed extremity 3. dialysis shunt or fistula (pt c red bracelet) 4. same side as breast or axillary surgery (pt c red bracelet) 5. avoid IV arm if possible 6. avoid picc line (peripherally inserted catheter) |
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pediatric pain scales
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wong baker faces pain rating scale: 3 yrs & older
Flacc scale: for newborn to 7 years |
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Painad scale
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for cognitively impaired pts
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primary hypertension
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has no known cause
characterized by an increase above normal in both systolic & diastolic pressures |
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secondary hypertension
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cause by another disease condition like kidney disease, disorders of the adrenal cortex & aorta`
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what are some high fiber foods?
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whole grains
bran dried peas & beans fresh fruit & veggies |
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what are some constipating foods?
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processed cheese
lean meats eggs pasta |
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what are some foods with a laxative effect?
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certain fruits & veggies
bran chocolate spicy foods alcohol coffee |
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what are some gas producing foods?
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onions
cabbage beans cauliflower |
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Cathartic or laxative drugs
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induce defecation, may have laxative or purgitive effect
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suppository
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solid cone shaped, medicated or glycerine substance inserted into the rectum
melts at body temp needs to be inserted beyond the internal anal sphincter must be lubricated |
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digital removal
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manual extraction of feces
done for clients c an impaction where the fecal mass may be too large to be passed involves breaking fecal mass c finger & removing it in sections usually followed by an enema or cathartic |
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what can excessive manipulation during digital removal cause?
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irritation to the mucosa
bleeding stimulation of the vagus nerve which may cause the heart rate to slow |
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rectal tube
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should be used as a last resort, exercise used first
used for excessive flatus insert tube 3-5" leave in place for 20 mins |
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GUAIAC
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fecal occult blood specimen test
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enema
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instillation of solution into rectum & sigmoid colon
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primary reason for enemas
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to promote defecation by stimulation of peristalsis
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uses for enemas
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temporary relief of constipation
removal of impacted feces emptying bowel before diagnostic tests, surgery, or child birth beginning a bowel program vehicle for drugs that exert effect on rectal mucosa |
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types of enemas
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cleansing
carminative oil retention return flow medicated |
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cleansing enemas
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promote evacuation of feces
act by stimulating peristalsis through infusion of large volume of solution or local irritation of colon's mucosa |
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types of cleansing enemas
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TWE
SSE Saline Hypertonic |
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TWE
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tap water enema
hypotonic solution water toxicity/circulatory overload can occur in repeated TWEs |
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SSE
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soap suds enema
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Saline enema
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same osmotic pressure as fluids in interstitial spaces
volume stimulates peristalsis |
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hypertonic solution enema
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draws water into intestine, use small amount
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Carminative enema
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provides relief from flatus & distension
improves ability to pass flatus MGW 30-60-90 (30 magnesium 60 glycerin 90 water) |
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oil retention enemas
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lubricates rectum & colon
feces absorb oil; become softer & easier to pass retained for several hours often followed by a cleansing enema |
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return flow enemas
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aka Harrish Flush, Slush enema
mild colonic irrigation that helps to expel flatus administer small amount into rectum and lower container to allow solution to flow back through rectal tube and into container process is repeated several times reduces flatus & promotes peristalsis |
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medicated enemas
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enemas that contain drugs
1. Kayexalate-used to treat PTs c dangerously high potassium levels 2. enema c Neomycin solution-antibiotic to reduce bacteria in bowel before surgery |
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guidelines for administering enemas
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use clean technique, wear gloves
tube is lubricated warm temp solution 105-110 F (too hot solution can burn intestinal mucosa, too cold can cause cramping & is difficult to retain) adult enema usually 750-1000 cc position: L lateral or L simms position so sigmoid colon is below the rectum facilitating instillation of fluid insert tube 3-4" solution is held 12-18" above rectum |
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stoma
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part of the ostomy (intestinal mucosa) brought to the abdominal wall
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ileostomy
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allows liquid fecal content from the ileum to be eliminated through the stoma
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colostomy
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permits formed feces in the colon to exit through the stoma
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nitrogenous wastes of cellular metabolism excreted in the urine
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play an important role in fluid & electrolyte balance
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kidneys
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2, in retroperitoneal space
chief function-filter waste products from blood produce urine normal output: 50cc/hr less than 30 cc/hr may indicate hypovolemia or kidney failure |
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bladder
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reservoir for urine average adult bladder holds 60cc
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urine amounts
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1000 to 2000 cc/24 hrs
anything less than 750cc or more than 3000cc is unusual minimum output of urine is 30cc/hr 720 cc/day |
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how does sodium affect urine output?
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fluid retention, decrease output
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urine color characteristics
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color: yellow ranging from straw to amber
darker: more concentrated lighter: more dilute bleeding from kidneys or ureters: dark red blood bleeding from bladder or urethra: bright red blood |
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urine clarity characteristics
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clarity: normally clear & transparent
may turn cloudy on standing due to precipitation of mucous |
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urine odor characteristics
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faintly aromatic
as it stands becomes more concentrated; ammonia like odor fishy odor-may be bacteria fruity odor may indicate ketonuria |
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urine specific gravity
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measures concentration of particles in urine
1.010-1.030 |
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pH of urine
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4.6-8.0 slightly acidic
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what is I &O recorded in?
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cc; not oz. 1oz=30cc
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anuria
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technically no urine voided; 24hr output less than 100 cc
renal failure |
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dysuria
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painful or difficult urination
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polyuria
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voiding large amounts
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oliguria
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small amount in relation to fluid intake
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nocturia
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frequency of urination at night
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hematuria
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blood in the urine
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pyuria
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pus in the urine
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glycosuria
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sugar or glucose in the urine
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proteinuria
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albumin or protien in the urine
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urgency
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feeling need to void immediately
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frequency
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voiding at frequent intervals
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hesitancy
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difficulty intiating urination
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dribbling
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leakage of urine despite voluntary control
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retention
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accumulation of urine in blader with inability to empty
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incontinence
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inability to voluntary control urination
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enuresis
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bedwetting at night
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burning
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warm local irritation when voiding
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urinary retention
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bladder is unable to empty or completely empty
usually holds about 600cc but in retention may hold more than 1000cc bladder distends to level of umbilicus |
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UTI
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commonly caused by e coli
common causes: catheterization organisms enter urethral meatus residual urine ideal site for microorganism symptoms: burning, urgency, frequency |
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stress incontinence
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inability to control urine when intra abdominal pressure increases
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urge incontinence
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passage of urine c strong sense of urgency to void
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reasons for urinary catheterization
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1. relieve urinary retention
2. obtain sterile urine specimen 3. measure amount of residual urine 4. long term management of incompetent bladder 5. empty bladder before, during, or after surgery |
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hazards associated c urinary catheterization
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1. infection-U system is sterile
2. trauma especially c male pts |
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who may need to be on I&O?
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pts c pyrexia
pts c edema pts receiving diuretics pts placed on restrictive fluids pts c excessive fluid & electrolyte loss pts c IV post op pts |
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what does intake include?
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all liquids & liquids at room temp
liquids taken: orally tube feedings by vein (IV, blood products) any liquids |
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what does liquid output include?
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urine
diarrhea vomitus gastric suction contents of drainage devices |
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how is I&O measured?
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in cc
1 oz=30 cc average daily intake 2,000-2,500cc average daily output 1,000-2,000cc |
