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83 Cards in this Set

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

Women - water-soluble
How far do you insert a urinary catheter on men? on women?
men - about 1" from the Y piece

women - 2 in. past the point where urine flow is obtained
In what patients would a hypertonic enema solution be contraindicated?
renal failure
CHF
What type of enema is used to soften the feces and lubricate the rectum (usually given 1-3 hrs before a cleansing enema)?
oil enema
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?
high enema
Why is a return-flow (Harris flush) enema used?
to help a patient expel gas