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83 Cards in this Set
- Front
- Back
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Normal flora in the colon aid digestion & produce which nutrients?
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vitamins B & K
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What type of urinary diversion reroutes the ureter directly to the surface of the abdomen, creating a stoma?
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cutaneous ureterostomy
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What type of urinary diversion (most common) uses a small piece of ileum to create a pouch into which the ureters are connected?
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Bricker's loop
(ileal conduit) |
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What type of urinary diversion helps patients retain continence (has to be manually drained)?
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Kock pouch
(continent urostomy) |
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What are the two variations of an ileostomy?
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1) Kock pouch (drained manually)
2) Total colectomy w/ ileoanal reservoir (pt uses commode as usual; liquid feces) |
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Name 5 behavioral interventions for managing urinary incontinence.
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lifestyle modifications
bladder training scheduled voiding pelvic floor muscle rehab (Kegel exercises) vaginal weight training biofeedback supportive interventions |
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Urinary catheterization is used for what 4 things?
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1) to obtain a sterile urine specimen
2)to empty the bladder for a surgical or diagnostic procedure 3) to prevent overdistention after surgery or diagnostic procedure 4) to measure residual urine |
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Feces is a mixture of what things?
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fiber & undigested food
shed epithelial cells inorganic material bacteria water |
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Increasing the pressure by contracting the abdominal muscles while maintaining a closed airway.
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Valsalva maneuver
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Green-black, tarry, sticky substance that a newborn (<2days) secretes through the anus.
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meconium
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The ability to control defacation typically develops at about ____ years of age?
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2 to 3
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Name 3 things that affect normal bowel patterns as a result of aging?
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decreased peristalsis
decreased intestinal smooth muscle tone decreased perineal muscle tone decreased sphincter control |
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Name 6 high fiber foods.
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apples w/ skin
bran cereal broccoli, cauliflower cabbage carrots cherries corn dried beans / legumes dried fruits flaxseed greens (kale, collards) oatmeal oranges pears w/ skin plums w/ skin popcorn potato w/ skin prunes, raisins strawberries whole-grain cereal |
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Name 3 personal / sociocultural factors that affect bowel elimination.
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privacy
time stress fear of leaving children alone |
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How does yogurt affect the bowel?
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active bacteria in yogurt stimulate peristalsis.
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How does calcium affect bowel function?
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causes constipation
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How does magnesium affect bowel function?
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loosens stools
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How does Vitamin C affect bowel function?
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softens stols, may cause diarrhea
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How do antacids affect the function of the GI tract?
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slow peristalsis, dec. stomach acids
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How does aspirin affect the function of the GI tract?
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irritates the stomach, may lead to ulcers
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How do antibiotics affect the function of the GI tract?
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decreases the normal flora, resulting in diarrhea
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How does iron affect the function of the GI tract?
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causes constipation
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How do pain medications affect the function of the GI tract?
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slow peristalsis, resulting in constipation
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How do antimotility drugs affect the function of the GI tract?
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used to treat diarrhea, decrease peristalsis
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How do laxatives affect the function of the GI tract?
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used to treat constipation, increase peristalsis
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Describe why anesthesia and surgery cause patients to experience sluggish bowel eliminiation.
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Anesthesia slows motility
Stress slows peristalsis Manipulation of the bowel during surgery may result in paralytic ileus. Decreased mobility leads to constipation. with Perineal surgery patients may resis the urge due to fear. |
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A surgically created opening for elimination of digestive waste products.
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bowel diversion
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A procedure which brings a portion of the ileum through a surgical opening in the abdomen, bypassing the large intestine entirely.
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ileostomy
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A procedure which brings a portion of the colon through a surgical opening in the abdomen.
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colostomy
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What bed position promotes normal defacation?
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semi-Fowler's
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What are the 2 primary concerns with diarrhea?
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water & potassium loss
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Describe the BRAT diet for managing diarrhea.
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Bananas
Rice Applesauce Toast |
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What are the 2 primary anti-diarrhea drugs prescribed?
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Paregoric
Immodium |
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What are the 2 diagnostic lab tests for the urinary system? What are the normal ranges?
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BUN (Blood Urea Nitrogen): range 8-20 mg/dl
Creatinine clearance: range 0.5-1.1 mg/dl |
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What is the normal rate of urine production by the kidneys?
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60 ml/hr
1500 ml/day (5-6x/day) |
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How does the specific gravity of urine compare to distilled water?
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Distilled water: 1.000
Urine: 1.002-1.028 |
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When the specific gravity of urine is higher than normal, what might be the cause?
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dehydration
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On average, how can you assess whether an infants urine output is adequate?
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8-10 wet diapers per day
(250-500 ml/day) |
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Occassional wetting in school age children
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enuresis
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What are the 3 classifications of diuretics?
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Thiazide (HCTZ)
Potassium sparing (Aldactone) Loop-acting (Demadex, Lasix) |
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Name 4 medications associated with urinary retention.
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antihistamines
tricyclic antidepressants MAO inhibitors antispasmotics antiparkinsonism meds B-adrenergic blockers |
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What type of meds relieve bladder spasms?
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anticholinergic
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Abnormally large amounts of urine.
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polyuria
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Less than 500ml per day or 30 ml per hour of urine production.
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oliguria
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lack of urine production
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anuria
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What are the 2 types of dialysis?
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hemodialysis
peritoneal dialysis |
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What are the two types of symptoms associated with dysuria?
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- voiding that is painful or difficult
- urinary hesitancy |
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Involuntary urination beyond the age when voluntary control is normally acquired (occurs after age 6, especially in boys).
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enuresis
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Name 5 states of altered urine elimination.
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urinary frequency
urgency dysuria enuresis urinary incontinence urinary retention neurogenic bladder |
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Give 4 reasons that urinary frequency may increase.
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UTI
stress pregnancy nocturia (>/= 2x/night) |
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Surgically created opening for elimination of urine which bypasses the bladder.
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Urostomy (urinary diversion)
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Overactive bladder
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urge incontinence
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loss of urine with pressure
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stress incontinence
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distention of bladder with urine loss
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overflow incontinence
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cannot reach toilet in time before incontinent
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functional incontinence
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short-term incontinence
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transient incontinence
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bladder is full with no urge to urinate when incontinence occurs
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unconcscious (reflex) incontinence
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Give two medications that can be used for urinary incontinence.
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- topical estrogen
- Oxybutynin (Ditropan) - Tolterodine (Detrol) |
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Give 3 causes of urinary retention.
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obstruction
inflammation / swelling neurological problems medications anxiety |
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Give two nontraditional ways to help assist with urinary elimination.
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run water nearby
pour water over perineum |
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List 4 ways to promote normal elimination.
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- make bathroom easily accessible
- accessible call bell - provide urinary equipment close to bedside - assist with positioning (Fowler's) - promote adequate fluids & nutrition - assist with hygiene |
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Urine on skin is converted to __________.
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ammonia
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How does caffiene affect urine production?
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increases
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How does salt affect urine production?
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decreases
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How does alcohol affect urine production?
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increases
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How does dehydration affect urine production?
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decreases
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What are some pathological conditions affecting voiding?
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renal failure
hypertension shock vomiting urinary stone |
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What is the number 1 nosocomial infection obtained by patients?
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urinary catheter infections
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What tool/procedure is used frequently in the acute care setting to measure bladder fullness & retention?
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bladder scan
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Is placing a condom catheter a clean or sterile procedure?
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clean
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When would you clean the perineal area with an antiseptic cleanser like Dial soap instead of using Providine when placing a urinary catheter?
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when the patient is allergic to iodine or shellfish
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If you feel resistance when inserting a urinary catheter, what should you do?
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rotate the catheter and try to advance
have pt take a few deep breaths and bear down check to see if you are in the vagina in women |
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What is the most important aspect of inserting a urinary catheter?
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maintaining a sterile field
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What position is used for inserting a urinary catheter for mobile patients? For immobile patients?
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mobile: dorsal recumbent
immobile: Sims' |
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In what instances in women would you not insert an indwelling catheter?
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menstruation
yeast infection / discharge herpes w/ open lesions |
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When would you insert a mini-catheter?
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for sterile specimens in women
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Most adults will use what sized urinary catheter?
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16 - 18F
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What kind of lubricant is used for inserting a urinary catheter on men? on women?
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men - none, 2% lidocaine is used prior to insertion
Women - water-soluble |
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How far do you insert a urinary catheter on men? on women?
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men - about 1" from the Y piece
women - 2 in. past the point where urine flow is obtained |
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In what patients would a hypertonic enema solution be contraindicated?
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renal failure
CHF |
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What type of enema is used to soften the feces and lubricate the rectum (usually given 1-3 hrs before a cleansing enema)?
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oil enema
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What type of enema is used to clear as much of the large intestine as possible and may involve the patient moving from one side to another?
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high enema
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Why is a return-flow (Harris flush) enema used?
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to help a patient expel gas
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