Unit 13 Elimination

Front 1

Anuria

Back 1

the inability to produce urine

Front 2

Cathartic

Back 2

a substance that causes the evacuation of the bowel (soften stool and promotes peristalsis)

Front 3

Cystitis

Back 3

an inflammation of the urinary bladder or ureters characterized by pain, urgency, and frequent urination

Front 4

Defecation

Back 4

- the elimination of feces from the digestive tract through the rectum (when the fecal mass moves into the rectum)

Front 5

Diuresis

Back 5

an increase in urine formation (can be bought on by coffee, tea, caffeine)

Front 6

Dysuria

Back 6

pain or burning during urination (painful urination)

Front 7

Enuresis

Back 7

incontinence of urine

Front 8

GI tract

Back 8

purpose is to absorb food and nutrients, prepare food for absorption, provide temporary storage of feces, fluid balance, and receives secretions from organs (GB and pancreas)

Front 9

Glycosuria

Back 9

presence of sugar, specifically glucose, in the urine

Front 10

Impaction

Back 10

a collection of hardened feces wedged in the rectum, which cannot be expelled. Results from unrelieved constipation.

Front 11

Ketonuria

Back 11

presence of excessive ketone bodies in urine; occurs as a result of uncontrolled diabetes, starvation, or other metabolic condition in which fats are rapidly catabolized.

Front 12

Kidneys

Back 12

purpose; waste product elimination, fluid & electrolyte balance, hormone secretion ( Erythropoietin and rennin) and calcium & phosphate regulation.

Front 13

Melena

Back 13

a black tarry stool containing digested blood

Front 14

Micturition

Back 14

the act of passing urine

Front 15

Occult blood

Back 15

blood that is not grossly apparent and appears from a nonspecific source with obscure signs or symptoms

Front 16

Oliguria

Back 16

diminished capacity to form urine less than 400 mL a day

Front 17

Polyuria

Back 17

excessive urination

Front 18

Proteinuria

Back 18

the presence of large proteins in urine (a sign of glomerula injury)

Front 19

Pyuria

Back 19

the presence of WBC’s in urine, a sign of infection of the urinary tract

Front 20

Residual urine

Back 20

when urine is retained in the bladder after voiding (occurs in older people because the bladder doesn’t contract as effectively)

Front 21

Retention

Back 21

the ability of the digestive system to hold food or fluid (the inability to urinate or defecate)

Front 22

Retention with overflow

Back 22

the pressure of retained urine after voiding results in dribbling

Front 23

Steatorrhea

Back 23

greater than normal amount of fat in feces (frothy foul smelling feces that floats)

Front 24

Urosepsis

Back 24

the spread of bacteria into the bloodstream and kidneys

Front 25

Influences of urinary elimination:

Back 25

- Anxiety- cause a sense of urgency and increased frequency, and unable to relax. If the external urethral sphincter is not completely relaxed, voiding may be incomplete, and urine is retained in the bladder.
- Long term use of in-dwelling catheter
- Increased fluid intake-causes an increase in urine production
- Diabetes mellitus- creates neuropathic conditions that alter bladder function (lack of sensation) Any condition that affects the nerves leading to the bladder causes loss bladder tone, reduces sensation of bladder fullness, and difficulty in controlling urination.
- Narcotic analgesics- slows the glomerular filtration rate, reducing urine output. They also impair sensory and motor impulses traveling between the bladder, spinal cord, and brain.

Front 26

Kidneys

Back 26

- Waste products of metabolism that collect in the blood are filtered in the kidneys, in the glomerula capillaries
- Only 1% of glomerula filtration is excreted as urine, the rest is reabsorbed into plasma.
- The normal adult 24hr urine output is 1500-1600ml.
- The kidney produces Erethropoietin and renin.

Front 27

Ureters

Back 27

- Urine enters the renal pelvis from collecting ducts where ureters join them to the bladder.
- Ureters are lumens approximately 10-12” long and ½” in diameter in the adult.
- Urine drainage from the ureters to the bladder is usually sterile.
- Peristaltic waves cause the urine to enter the bladder in spurts rather than steadily.

Front 28

Bladder

Back 28

- The bladder is a hollow, muscular organ that is both a reservoir for urine and the organ of excretion.
- When empty, the bladder lies behind the pubic symphysis.
- In men, it lies on the anterior wall of the rectum, in women, in the anterior wall of the uterus and vagina.
- The bladder capacity is approximately 600ml of urine.
- Normal voiding is 300ml. and average of 1000 to 1500 mLs a day.
- With a catheter approximately 30mLs an hour

Front 29

Urethra

Back 29

- Urine travels from the bladder through the urethra and passes outside the body through the urethral meatus.
- Normally the turbulent flow of urine through the urethra washes it free of bacteria.
- In women, the urethra is 1½” – 2½” in length (this short length predisposes women to UTI’s).
- In men, the urethra is approximately 8” long.

Front 30

Small intestine

Back 30

- during normal digestion, chyme leaves the stomach and enters the small intestine.
- a tube approximately 1” in diameter and 20’ long which contains three divisions: duodenum, jejunum, and ileum.
- Chyme mixes with digestive enzymes while traveling through the small intestine, & travels slowly to allow the absorption of nutrients and electrolytes.
- The enzymes (bile and amylase) in the SI break down fats, protein, and carbohydrates into simple elements.
- NUTRIENTS ARE ALMOST ENTIRELY ABSORBED BY THE DUODENUM AND JEJUNUM.
- The ilium absorbs certain vitamins, iron, and bile salts

Front 31

Large intestine

Back 31

- larger in diameter than the SI and 5’-6’ long
- divided into the cecum, colon, and rectum.
- responsible for the absorption of water and is the primary organ for bowel elimination.
- Unabsorbed chyme enters the cecum at the ileocecal valve where it travels to the colon & the water volume lessens as it moves along.

Front 32

Colon

Back 32

- divided into the ascending, transverse, descending, and sigmoid colon.
- 4 interrelated functions: absorption, protection, secretion, and elimination.
- A large volume of water (2.5 L) & significant amounts of sodium (55mEq) & chloride (23mEq) are absorbed daily.
- The amount of water absorbed from chyme depends upon the speed at which colonic contents move. (fast=’s watery stools, slow=’s hard mass of stool)
- Serious alterations in colon function, such as diarrhea, can cause electrolyte imbalance due to loss of potassium and chloride.
- eliminates waste products and gas.

Front 33

Rectum

Back 33

- Waste products that reach the sigmoid colon are called feces.
- The final division of the GI tract.
- is normally empty of feces until defecation.
- When a fecal mass moves into the rectum, the walls distend and defecation begins

Front 34

Normal urine color

Back 34

- normal urine ranges from a pale, straw color to amber, depending on its concentration.
- more concentrated in the morning
- Bleeding can cause it to look dark red if from the kidneys or ureters or bright red if from the bladder or urethra.

Front 35

normal urine clarity

Back 35

- normal urine appears transparent at voiding.
- Urine that stands in a container for several minutes appears cloudy.
- Urine appears thick and cloudy as a result of bacteria

Front 36

normal urine odor

Back 36

- urine has a characteristic odor, the more concentrated the urine, the stronger the odor.
- Stagnant urine has an ammonia odor (common for incontinent people).
- A sweet or fruity odor can indicate acetone as seen in diabetes mellitus or starvation

Front 37

Normal Feces:

Back 37

- Color- Normal adults brown, infants yellow (abnormal: white/clay, black/tarry, red, pale w/fat)
- Odor- pungent, affected by food type
- Consistency- soft or formed
- Frequency- adults, daily of 2-3 times a week
- Amount- normal adult is approximately 150g per day
- Shape- resembles the diameter of the rectum
- Constituents- Undigested food, dead bacteria, fat, bile pigment, cells lining, intestinal mucosa, water (abnormal Blood, pus, foreign bodies, mucus, worms)

Front 38

Diseases that cause irreversible damage to the glomerulus or tubules

Back 38

Chronic or ESRD (End-Stage Renal Disease:

Front 39

kidneys: flank tenderness = inflamed kidneys

Back 39

Bladder: dull percussion = full bladder. Palpatation smooth & rounded = partially full

Front 40

Common Urine Tests

Back 40

- Urinalysis

Front 41

Common Urine Tests

Front 42

Laboratory Tests for stool:

Front 43

Diagnostic Examination for stool:

Front 44

Urinalysis:

Back 44

- A specimen of urine for laboratory testing.
- All specimens are labeled with the client’s name, date, and time of collection.
- The specimen should be examined within 2 hours and it should be the first voided specimen in the morning to ensure uniform concentration of constituents

Front 45

Sterile specimen

Back 45

- A method of collecting urine for a culture by obtaining the specimen from an indwelling catheter or from a sterile collection bag.
(It is not recommended to catheterize a patient just for a lab test due to the risk of infection)
- Clean the port with an antimicrobial swab and withdraw 3-5ml of urine via a syringe.

Front 46

Specific gravity

Back 46

- The weight or degree of concentration of a substance compared with an equal volume of water.
- The concentration of dissolved substances in urine aids in the determination of a client’s fluid balance.
- A specific gravity below 1.010 reflects an inability of the kidneys to concentrate urine or an insufficient secretion of ADH.

Front 47

Midstream specimen

Back 47

- Use to obtain a specimen relatively free of microorganisms growing in the lower urethra.
- Used for Culture and Sensitivity (C+S) tests.
- The patient cleanses the external genitalia, begins to urinate allowing the initial portion to escape, then during the middle of voiding, collects a specimen.
- The initial urine stream cleanses resident bacteria.

Front 48

Stool specimen

Back 48

- The nurse is responsible to ensure proper technique is used, and the sample is put in the appropriate properly labeled container which is transported to the lab in a timely manner.
- Medical aseptic technique should be uses during the collection of a stool sample (wear gloves).
- The nurse collects about 1” of formed stool or 15-30ml of liquid diarrheal stool.

Front 49

Guaiac test

Back 49

- Fecal occult blood test (FOBT) which measures microscopic amounts of blood in stool.
- Helps reveal visually undetectable blood.

Front 50

Urinary retention

Back 50

- the marked accumulation of urine in the bladder as a result of the inability of the bladder to empty.
- Urine continues to collect in the bladder, stretching its walls and causing feelings of pressure, discomfort, & tenderness over the pubic symphysis, restlessness & diaphoresis
- the bladder becomes unable to respond to the micturition reflex and is thus unable to empty.
- As bladder retention progresses, overflow may develop.
- Pressure in the bladder builds to a point where the external urethral sphincter is unable to hold back urine & temporarily opens to allow a small volume of urine (25-60ml) to escape.
- As urine exits, the bladder pressure falls enough to allow the sphincter to regain control and close.

Front 51

Types of urinary incontinence:

Back 51

1) Functional- Involuntary, unpredictable passage of urine in a client with intact urinary and nervous system. Can be caused by changes in the environment such as sensory, cognitive, or mobility deficits. (urge to urinate and pee before reaching a toilet, or forget what to do)
2) Overflow- described above. Can be caused by reaction to drugs, diabetes, fecal impaction, prostate enlargement

Front 52

Types of urinary incontinence:

Back 52

3) Reflex- Involuntary loss of urine occurring at somewhat predictable intervals (large or small volume). Can be caused by spinal cord dysfunction. The person is unaware of the bladder filling and need to void.
4) Stress- leakage of small volumes of urine cause by sudden increase in intraabdominal pressure. Can be caused by coughing, laughing, sneezing, or lifting with a full bladder.
5) Urge- Involuntary passage of urine after a strong sense of urgency to void. Can be caused by decreased bladder capacity, irritation to stretch receptors, infection, and alcohol/caffeine ingestion

Front 53

measures appropriate for promoting a patient’s normal urinary elimination:

Back 53

1) Stimulating micturition reflex- the client’s ability to void depends on feeling the urge to urinate, being able to control the urethral sphincter, and being able to relax during voiding. Women void better when sitting, and men while standing.
2) Maintain elimination habits- many client’s follow normal routines, the nurse should integrate the client’s habits into the care plan to foster normal voiding.
3) Maintain adequate fluid intake- a person with normal renal function who does not have heart disease or alterations requiring fluid restrictions should drink 2000-2500ml of fluid daily. An average daily intake of 1200-1500ml is usually adequate.

Front 54

Kegel exercises (pelvic floor exercises)-

Back 54

- repetitive contractions of muscle groups to improve the strength of pelvic floor muscles.
- The client begins the exercises while urinating, and continues to practice during non-voiding times.
- The person tightens the urinary sphincter during urination to feel the sensations associated with urinary sphincter contraction (stop the flow of urine).
- Hold the sphincter closed for 3-4 seconds 25-30 times 3 times a day for 6 months.

Front 55

Valsalva maneuver

Back 55

- the voluntary contraction of abdominal muscle during forced expiration with a closed glottis (holding your breath while straining).
- Because the valsalva maneuver can cause changes in heart rate and rhythm, it is contraindicated in clients such as those with heart problems or perineal surgery.
- One can avoid this maneuver by exhaling through the mouth during straining.

Front 56

causes of constipation:

Back 56

- Irregular bowel habits and ignoring the urge to defecate
- Low fiber diet high in animal fats (meat, dairy products, eggs, and refined sugars)
- Low fluid intake slows peristalsis
- Lengthy bed rest or lack of physical exercise
- Heavy laxative use causes loss of normal defecation reflex
- Medications such as opiates, anticholinergics, iron & diuretics
- Bowel obstruction, paralytic ileus, diverticulitis
- Neurological conditions that block nerve impulses to the colon

Front 57

Patients at risk for developing constipation:

Back 57

- Recent rectal, abdominal, or gynecological surgery
- Those with history of cardiovascular disease
- Those who have diseases causing elevated intraocular pressure (glaucoma), increased intracranial pressure

Front 58

Deviations associated with fecal impaction:

Back 58

- An inability to pass stool for several days despite the urge to defecate
- When a continuous oozing of diarrheal stool develops (liquid seeps around the impacted mass)
- Loss of appetite
- Abdominal distention, cramping, and rectal pain

Front 59

How high fiber diets promote bowel elimination:

Back 59

- Fiber provides bulk in fecal material.
- Bulk-forming foods absorb fluids, thereby increasing stool mass.
- The bowel walls are stretched, creating peristalsis, thus initiating the defecation reflex.
- By stimulating peristalsis, bulk foods pass quickly through the intestines, keeping the stool soft.
- Ingestion of a high fiber diet improves the likelihood of a normal elimination pattern if other factors are normal.

Front 60

Possible cause of each fecal characteristic:

Back 60

- White or clay colored- absence of bile
- Black or tarry (melena)- iron ingestion or upper GI bleeding
- Red- lower GI bleeding or hemorrhoids
- Melena-
- Liquid consistency- moving quickly through GI tract, diarrhea, reduced absorption
- Narrow or pencil shapes- obstruction or rapid peristalsis

Front 61

goals appropriate for a patient with bowel elimination problems:

Back 61

- Understanding normal elimination
- Attaining regular defecation habits
- Understanding and maintaining proper fluid and food intake
- Achieving a regular exercise program
- Achieving comfort
- Maintaining skin integrity
- Maintaining self-concept

Front 62

Noninvasive Procedures

Back 62

- Abdominal X-Ray
- IV Pyelogram
- Renal Scan
- CT Scan
- Renal Ultrasound

Front 63

Invasive Procedures

Back 63

- Endoscopy
- Angiography (Arteriogram)
- Urodynamic Testing

Front 64

The first 1 to 2 days following surgery the nurse expects the client’s urine output to ________ (increase/decrease) as a result of the adaptation response to surgery.
A. Increase
B. Decrease

Back 64

b. The stress response releases an increased amount of antidiuretic hormone, which increases water reabsorption. Stress also elevates aldosterone, causing sodium and water retention. Both of these physiological responses reduce urine output.

Front 65

A client has had a total knee replacement and was placed on patient-controlled analgesia (PCA), which has been used an average of 4 times per hour. The nurse has assisted the client on and off the bedpan 2 to 3 times an hour for the past 2 hours. Urine output was about 50 ml with each void. The nurse now begins to suspect:
A. Retention overflow
B. Urge incontinence
C. Fluid overload
D. Urinary tract infection (UTI)

Back 65

a. Urinary retention may cause increased pressure in the bladder to the point where the external urethral sphincter is unable to hold back urine. The sphincter temporarily opens to allow a small volume of urine to escape. Bladder pressure then falls, and the sphincter closes again. The nurse should also assess the lower abdomen for bladder distention.
b, c, and d. The symptom presented does not justify the selection of these other conditions. There is no sense of urgency. Fluid overload would more likely present as lung congestion. A UTI would have additional symptoms.

Front 66

3. The nurse recognizes that the organism that most frequently causes urinary tract infections in women is:
A. Escherichia coli
B. Staphylococcus aureus
C. Aspergillus
D. Streptococcus

Back 66

a. Because the female urethra is positioned close to the anus, most UTIs are a result of contamination of the urethra with organisms from the gastrointestinal (GI) tract.
b, c, and d. These are not organisms normally found in the GI tract and thus are not commonly associated with UTIs.

Front 67

The nurse is about to insert a urinary catheter into an uncircumcised client. After retracting the foreskin and inserting and securing the catheter, it is essential that the nurse:
A. Clean the urinary meatus with betadine
B. Secure the catheter to the client’s leg
C. Return the foreskin over the glans penis
D. Culture the first urine to drain into the collection bag

Back 67

c. If the nurse does not pull the foreskin back over the glans penis, it could act as a tourniquet. The glans penis could become extremely swollen and require an emergency circumcision.
a. The insertion of the urinary catheter already required cleansing of the meatus.
b. Securing the catheter to the leg or to the abdomen is important, but it is not essential.
d. Cultures are not obtained on urine that has drained into the collection bag.

Front 68

A client is scheduled for an intravenous pyelogram (IVP). Before the test the most important assessment the nurse performs is asking about:
A. Previous experience with an IVP
B. Ability to remain still during the procedure
C. Family history of a reaction to an IVP
D. Allergies to shellfish

Back 68

d. The contrast media often used for IVP contains iodine. If a client is allergic to shellfish, this suggests an allergy to iodine. Thus, the client may need to receive a contrast medium that does not contain iodine in order to avoid an allergic reaction.

Front 69

A client has the following fluid documentation for the past 4 hours: intravenous (IV) fluids of 125 ml/hour; urine output of 150 ml; 50 ml of irrigation fluid via nasogastric (NG) tube; 120 ml of NG drainage; and 52 ml of bile from biliary drain. Calculate the client’s fluid status (does not consider insensible loss). _________

Back 69

In: 125 ml × 4 = 500 In: 50 ml of irrigation fluids Total: 550 ml in
Out: 150 ml urine Out: 120 ml N/G drainage Out: 52 ml biliary drainage Total: 322 ml out
550-322 = 228 ml

Front 70

A female client is having difficulty voiding following childbirth. The nurse implements the following interventions to promote voiding. (Select all that apply.)
A. Offer the client a large glass of cranberry juice.
B. Position the client on a fracture bedpan flat in bed.
C. Ambulate client to bathroom.
D. Turn the water tap on.
E. Trickle warm water over the mons pubis.

Back 70

c, d, and e. A woman urinates best in a sitting position on the toilet. Hearing water run may help the client relax to promote urination. Trickling warm water over the mons pubis may also signal the woman to relax the pelvic muscles and allow for sphincter release of urine.

Front 71

A client reports to the nurse that he wakes up early because of a need to urinate. The nurse recommends that the client avoid the following liquids after 8 PM. (Select all that apply.)
A. Coffee
B. Tea
C. Cola
D. Wine

Back 71

a, b, c, and d. All of the above are diuretics. In addition, alcohol inhibits the release of antidiuretic hormone, thus increasing water loss in urine.

Front 72

The nurse is teaching a group of young (20- to 25-year-old) women how to prevent UTIs. Which of the following foods does the nurse recommend to reduce the incidence of UTIs? (Select all that apply.)
A. Cranberry juice
B. Grapefruit juice
C. Prunes
D. Whole-grain breads

Back 72

a, c, and d. These foods acidify the urine, which makes for an inhospitable environment for pathogens. In addition, cranberry juice has been shown to decrease adherence of bacteria to the bladder wall.
b. Grapefruit juice has not demonstrated prevention of UTIs.

Front 73

A client with multiple sclerosis is being taught how to perform self-catheterization. The nurse includes in the teaching that the client (select all that apply):
A. May use clean technique
B. Must use sterile technique
C. Should increase fluids
D. Use Vaseline to lubricate catheter tip

Back 73

a and c. Sterile technique is required for urinary catheter insertion in the hospital, but when being performed at home by the client only clean technique is required. The hospital contains a wide variety of microorganisms that could become pathogenic to the client. The client's own organisms are generally not pathological. Fluids are important to minimize the occurrence of urinary tract infections.
b. This is sterile technique; see above.
d. An oil-based lubricant is not recommended and may increase urinary tract infections. Use water-based lubricants, which can be expelled from the urethra during voiding.

Front 74

Wanting to prevent the Valsalva maneuver, the nurse requests a stool softener for which of the following clients? (Select all that apply.) Clients with:
A. Risk for increased intracranial pressure
B. Glaucoma
C. Hypotension
D. Cardiovascular disease

Back 74

a, b, d
a. Valsalva can increase intracranial pressure, which is undesirable.
b. Valsalva can increase intraocular pressure and increase risk for optic nerve damage.
c. Hypotension is not aggravated by Valsalva.
d. Valsalva can increase blood pressure, which could place strain on the heart

Front 75

The nurse teaches clients with a new colostomy to eat whatever foods they like but that some foods (such as the following) typically produce gas and should be evaluated. (Select all that apply.)
A. Onions
B. Garlic
C. Cauliflower
D. Beans
E. Pasta

Back 75

a, c, and d. Foods affect clients differently. However, some foods appear to produce more gas than others. Warning the client about these traditional gas producers will alert them to be aware of the possible problem and allow them to make informed choices.
b and e. These are not known to produce excessive gas.

Front 76

Soon after the client's abdominal surgery the nurse includes in the plan of care the following intervention, which is essential for promoting peristalsis:
A. Large doses of opioids
B. High-fiber diet
C. Restricted fluid intake
D. Early ambulation

Back 76

d. Early ambulation is essential for maintaining peristalsis through improved abdominal muscle tone and stimulation.
a. Large doses of opioids may suppress peristalsis. Dose of opioid should be that which adequately controls pain with the fewest side effects.
b. High-fiber diet is inappropriate immediately following surgery. The bowel is inflamed from surgery.
c. Restricted fluids could contribute to constipation. Fluids should be started as soon after surgery as possible, when bowel sounds have returned.

Front 77

The nurse begins to suspect a fecal impaction in a client who has not had a stool in 10 days when the client (select all that apply):
A. Has a rounded abdomen
B. Oozes liquid stool
C. Feels nauseated
D. Has continuous bowel sounds

Back 77

b, c, and d. These are all symptoms of an impaction. Liquid stool can seep around the impaction. If stool cannot exit, there is a backup of gastrointestinal (GI) contents, which often results in nausea. Bowel sounds may be increased as the body attempts to push the impaction forward.
a. A rounded abdomen by itself may mean obesity or even ascites. To be a symptom of an impaction, there needs to be distention.

Front 78

The nurse is instructing the client about opioids for pain. Included in the teaching is the fact that opioids may cause:
A. Headaches
B. Hypertension
C. Constipation
D. Muscle weakness

Back 78

c. Constipation is a known side effect of opioids that the client often does not become tolerant to.
a, b, and d. These are not known side effects of opioids.

Front 79

The nurse instructs the client to avoid which of the following foods that could give a false reading of the fecal occult blood test? (Select all that apply.)
A. Fish
B. Lasagna
C. Raw vegetables
D. Cranberry juice

Back 79

a and c. Fish and some raw vegetables can produce false positives if consumed during the collection of stool for occult blood.
b and d. Although these foods are red, they do not irritate the GI tract such that bleeding occurs. The fecal occult blood test measures blood in the stool and is unaffected by foods that are red.

Front 80

A client with a Salem sump tube begins to drain stomach contents from the blue "pigtail." Which nursing actions would be appropriate for the nurse to implement at this time? (Select all that apply.)
A. Clamp the blue "pigtail."
B. Irrigate the large lumen with saline.
C. Position the blue "pigtail" at the level of the client's ear.
D. Attach suction to the blue "pigtail."

Back 80

b and c. Irrigating determines patency of the main sump drain. If it is obstructed, stomach contents can and will exit via the blue "pigtail." Positioning the blue "pigtail" above the level of the stomach minimizes its becoming a drain.
a and d. One never clamps or applies suction to the blue "pigtail" because that would eliminate its function as an air vent, which prevents the gastric mucosa from being sucked into the sump's eyelets.

Front 81

When irrigating a colostomy, the nurse is sure to use the following equipment.
A. An enema set
B. A cone-tipped irrigator
C. A 50-ml irrigation syringe
D. A 16 Fr Foley catheter with a 30-ml balloon

Back 81

b. Using a cone-tipped irrigator is important to prevent irritation or injury to the stoma. It prevents bowel perforation and prevents backflow of irrigating solution.
a, c, and d. These are all inappropriate for colostomy irrigation because they could cause injury to the bowel mucosa and/or allow backflow of the irrigating solution.

Front 82

A client with a recent bout of diarrhea is requesting something to drink. There is an order to force clear liquids to prevent fluid and electrolyte imbalance. The nurse decides to give the client:
A. A cup of hot coffee
B. Room-temperature bouillon
C. A cold Popsicle
D. Ice cream

Back 82

b. Hot and cold liquids (a, c, and d) stimulate peristalsis, causing abdominal cramping and further diarrhea. Thus room-temperature liquids are better tolerated. Bouillon also contains some electrolytes that may prevent electrolyte imbalance. In addition, ice cream is not a clear liquid.