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132 Cards in this Set
- Front
- Back
Name the reflex that controls fullness in the rectum
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Sacral Cord Reflex
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What type of muscles line the internal sphincter?
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Longitudinal muscles.
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How is the external sphincter controlled?
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Consciously by the person in the cerebral cortex
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What will happen to the defecation reflex if there is an injury below T12?
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The reflex will not occur
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What will happen to the defecation reflex if there is an injury above T12?
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The defecation reflex will occur
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People with an injury below T12 will have to have this to control solid elimination...
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Bowel management program
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What other function do sacral nerves control?
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Urination
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What gives the color to stool?
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bilirubin pigment
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What color is stool of a person with gall bladder disease who produces no bile?
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Grayish
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What color is the stool of a person with a liver problem (cirrhosis)?
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Grayish-whitish
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What can be true of a person with bloody stools?
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GI Bleeding, colon bleeding
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What color is the stool of a person with stomach bleeding?
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Tarry black because the blood in the stomach is digested.
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What type of stool is characteristic of a person with a superinfection?
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Green, liquid.
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An stool with excessive mucous indicates...
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Inflammation or CDiff infection.
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What does it indicate when there are lots of WBC's in the stool?
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Sign of infection
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What color is stool of a person on antibiotics?
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Green/gray color
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What color stool will a patient have after a barium test?
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Whitish
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What does it indicate when a patient has blood streaks on the outside of stool?
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Hemmorhoids
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What is the normal stool pattern?
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Every 1-3 days
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What is the first stool of an infant called?
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Muconium - and it's black and tarry looking.
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A tube-like connection in the bowel that can be between the bowel and bladder, bowel and skin, or bowel and vagina.
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Fistula
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When does a fistula occur?
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In malnutrition or inflammation
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What is one of the causes of constipation?
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High fat diet
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A twisting of the intestines that causes the feces to not move along.
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Volvulus
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Name 4 bowel obstructions
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Volvulus (twisting)
Tumor Intussusception (telescoping) Strangulation (through hernia) |
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What type of medication induces bowel movement?
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Laxative
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What type of medication induces a bowel movement and is very potent and fast-acting?
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Carthartic
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When is a laxative contraindicated?
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When the patient has undiagnosed abdominal pain.
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What problems do carthartics cause?
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Fluid and electrolyte disturbances
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Some problems of laxatives in pregnant women.
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May initiate labor
Laxatives go into fetus and fetus has diarrhea (fluid & electrolyte imbalance) |
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Don't give laxatives to a patient with severe anemia because it can cause
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further loss of nutrients
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Surgery patients can use what type of laxative.
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mild laxatives
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Never give a fiber laxative in an NG tube because it can
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clog the tube
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How does a fiber laxative work?
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It increases bulk and water in the stool and increases peristalsis
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What happens when a laxative is given without enough water?
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The stool gets hard and solid.
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What do you always assess before giving a laxative?
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Bowel sounds.
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A laxative coats the inside of the colon and has a demulcent effect - therefore it is good for people with
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irritable bowel syndrome (IBS)
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A condition whereby a patient has alternating diarrhea and constipation with pain.
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Irritable bowel syndrome
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What type of laxative is good for a patient with diverticular disease?
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Bulk-forming Laxative
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Do laxatives cause physical dependence?
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No
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What is another name for stool softener?
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Emolliant
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These specific drugs have an osmotic effect and are used as prep for colonoscopy
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saline cathertics
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What is the safest type of laxative?
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Bulk forming laxative
Metamucil, Naturacil, Cologel, Hydrolose, Mitrolan |
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What type of laxative works the quickest?
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Stimulant cathartics
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What type of laxative works in 1-3 hours
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Cathartic
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Which laxative works in 1-3 days?
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Stool softeners
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Which type of laxative is used after a myocardial infarction, cataract surgery, pregnancy, stroke patients?
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Stool softener
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Which type of laxative would you never use in an NG tube?
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Bulk-forming laxative
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Which type of laxative contains a salt preparation and causes fluid and electrolyte imbalances?
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Cathartic
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Which laxative would you not use in clients with kidney dysfunction?
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Cathartic
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How do cathartics work?
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Irritate the mucosa to stimulate motility.
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Which laxative is used in severe constipation?
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Cathartic
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Which laxative has side effects of flatulence, cramps, gas, belching?
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Lubricant Laxative
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Which laxative decreases absorption of fat-soluble vitamins (A,D,E,K)?
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Lubricant laxatives
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What type of laxative is Metamucil?
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Bulk forming laxative
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What type of laxative is GoLytely?
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Lubricant laxative
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What laxative is used before a colonoscopy?
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GoLytely, lubricant laxative.
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What type of laxative is Colase?
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Stool softener
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Which type of laxative works in 6-8 hours?
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Lubricant laxative
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Which laxative is the most potent?
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Cathartic
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Which laxative can cause pneumonia if aspirated?
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Lubricant laxative
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Which laxative may cause pruritis?
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Lubricant laxative
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What is a PEG solution used for?
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Bowel cleansing before a colonoscopy.
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What type of laxative is Milk of Magnesia?
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Saline cathartic
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What type of laxative is Fleet?
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Saline cathartic
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What type of laxatives are Ex-Lax and Correctol?
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Stimulant cathartics.
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What laxative used to be used commonly and is a stimulant cathartic?
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Castor oil
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What type of laxative is used to decrease blood ammonia in chronic liver disease?
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Lactulose (Lubricant laxative)
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When is a laxative contraindicated?
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In undiagnosed abdominal pain, possible inflammatory disorders such as appendicitis, ulcertaive colitis. Use caution in pregnancy and breastfeeding.
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What is another name for stool softeners?
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emollient or fecal moistening agent
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What type of laxative should you avoid taking with milk or antiacids?
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Stimulant Cathartic - Dulcolax, Biscodyl
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How fast do stimulant cathartic suppositories work?
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15-60 minutes
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What type of laxative discolors the urine pink, red, violet or brown and comes in a liquid form with an anise flavoring?
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Cascara (stimulant cathartic)
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How should castor oil be given?
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On an empty stomach because it retards emptying of the stomach.
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How should a lubricant laxative be given?
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The client should be upright. Test swallowing before administering.
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How can you make castor oil more tasty?
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Mix with baking soda and orange juice.
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Which laxative can produce cardiac distress, respiratory distress, and nausea with repeated large doses?
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Stimulant cathartics.
Phenolphthalein (Doxidan, Correctol, Ex-Lax) |
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How much water should be given with Polyethylene glycol solution (PEG)?
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240cc q 10 min - total 4 liters
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What are some causes of constipation?
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irregular bowel habits, low fiber diet, high fat diet, fluid intake less than 1500cc.
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What are some types of enemas?
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Fleet - hypertonic
Saline - safest Soap suds Tap water - never give to children Oil retention - for impaction |
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What is a serious complication of diarrhea?
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Dicubitis ulcer - can occur in 1 day of diarrhea.
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Causes of diarrhea
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emotional stress, intestinal infection
food allergies, intolerance to greasy, spicy foods, tube feedings w/ inadequate water, antibiotics, colitis, chron's disease |
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What antidiarrheal agent causes blue gums?
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Pepto bismol (bismuth)
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When using synthetic opioids you should monitor for what?
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toxic response
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What antidiarrheal has an anticoagulent effect?
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Pepto bismol - bismuth
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What nerve controls micturition?
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Sacral nerve
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What type of action is the micturition reflex?
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involuntary
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What type of action involves relaxation of the external urethral sphincter?
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Voluntary
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What is the name of the muscles in the bladder that contracts during micturition?
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The detrusor muscle
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Decreased blood flow to the kidney from intravascular fluid volume deficit results in ...
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oliguria or anuria
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A dilation of the kidney pelvis & calyces due to obstruction of the pelvic outlet.
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Hydronephrosis
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Urinary stasis can lead to ...
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UT infection
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When there is damage to the spinal cord above the sacral region a person can get...
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reflex bladder
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An injury below T12 in the sacral area can damage the reflex arc and result in ...
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Autonomic Bladder
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Management of autonomic bladder is managed by ...
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intermittent catheterization
Alphaadrenergic blocker urinary diversion surgery implantable sphincter stimulator |
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Alphaadrenergic blockers such as prazosin relax the bladder sphincter by ...
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stopping the sympathetic and maximizing the parasympathetic nervous system.
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Bladder distention can cause this by compressing the vessels in the bladder...
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hypertension
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The normal amount of urine that an adult voids in a day.
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1500 ml
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A protrusion of the bladder into the vaginal canal resulting in inability to empty bladder completely is called ...
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Cystocele
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A test that shows the outline of the kidneys, bladder, ureters, urethra. It cannot be given to people who are allergic to iodine and fish.
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Intravenous pyelogram (IVP)
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Symptoms of urinary retention include...
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bladder distentin and small frequent voiding w/o emptying the bladder.
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Two drugs that are given as a bladder antispasmodic
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Probanthene
Bella Donna & Opium suppository (B&O) |
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What type of drug is prazosin?
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Alphaadernergic (blocks the sympathetic nervous system and maximizes the parasympathetic nervous system.)
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Females should wipe from front to back
drink 2000-3000 mL per day void at least q4h avoid bubble baths & tub baths avoid nylon underwear and thongs void immediately after sex |
Things to do to prevent a UTI
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A type of drug for the treatment of UTI
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Fluoroquinolones
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Two very common drugs used to treat UTI's
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Levofloxacin (Levaquin)
Ciprofloxacin(Cipro) |
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When giving sulfa drugs the top nursing priority to prevent crystals in the urine and to clear the urinary tract of pus is...
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2500 - 3000 mL Fluid intake
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When taking sulfa drugs, one may get an adverse effect of
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serum sickness in 7-10 days with joint pain, uritcaria, leukopenia
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A urinary tract analgesic
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Pyridium (phenazopyridine) discolors the urine reddish orange.
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An infection of the upper urinary system is called
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Pyelonephritis
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A defining characteristic of pyelonephritis is...
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very high fever (along with low back pain, N,V, h/a, weakness, cloudy urine, high WBC's.)
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The most important treatment of pyelonephritis is
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IV fluids for nausea, vomiting & to flush kidneys of pus
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When a patient has urge incontinence this may be prescribed to increase the bladder capacitiy & sphincter tone.
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Anticholinergic
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In a teaching plan, the five components to include for each domain.
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Client learning outcome (goal)
Teaching strategy (how) Criteria for evaluation (test) Documentation (report) Teaching content (explanation) |
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What are the 3 domains in a teaching plan?
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Cognitive, Affective, Psychomotor
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What is the most important teaching strategy?
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Praise the client for accomplishments.
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Which type of laxative irritates the mucosa of the colon?
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stimulant cathartic
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Which laxative creates an osmotic effect?
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Saline Cathartic
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Which laxative lowers the surface tension of the stool
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stool softener
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Which laxative is an osmotic bowel cleansing?
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Saline cathartic
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Which laxative relieves straining on defecation?
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stool softener
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Which laxative decreases the blood ammonia level?
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Lactulose (a lubricant laxative)
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Which laxative penetrates and coats the stool prevents excessive absorption?
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Lubricant laxatives
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Which laxative is contraindicated in kidney disease?
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Saline cathartics
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Which laxative could cause aspiration in a dysphagic client?
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Mineral Oil
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Which specific laxative results in a bowel obstruction if not mixed with 240cc of water?
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Metamucil
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Which laxative should be avoided during pregnancy and lactation?
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Dulcolax (stimulant cathartic)
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Which laxative is preferable to use at bedtime?
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Colace because it works in 6-8 hours.
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Types of loss
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Actual
Perceived Maturational Situational Anticipatory |
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Engel's Model of Grief
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Shock and Disbelief
Protest Disorganization Reorganization |
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Kubler Ross's Stages of dying
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Denial, Anger, Bargaining, Depression
Acceptance |
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Preparation of body
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Bathe dirty areas
close eyes and mouth, towel under mouth raise head take tubes out if allowed tag corpse |