NU Exam 5 Nutrition, Sensation, Perception and Response, Urinary Elimination

bradykinetic

slow movement

Estimated Average Requirement (EAR)

the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage or gender group

mixed incontinence

the combination of stress incontinence and urge incontinence

stress incontinence

the inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing

functional incontinence

the person has bladder control but cannot use the toilet in time

Ageusia

the rare ability to detect any flavor at all

Hyposmia

the reduced ability to smell and detect odor

hypoguesia

the reduced ability to taste flavor (sour, salty, bitter, rancid, metallic)

sensoristasis

the state in which a person is in optimal arousal

Factors that affect urinary elimination: infants and children

timing and toilet training enuresis nocturnal enuresis

Types of UTIs

urethritis, cystitis, pyelonephritis, CAUTI

micturition

urination

The nurse is educating unlicensed nursing assistive personnel (NAP) about recording output for a client. What fluids should the nurse include in the output for accuracy?

urine emesis diarrhea nasogastric drainage

An individual who suffers from anorexia nervosa is at risk for what type of disruptions in the body?

weakened immune system and hormonal imbalance

common side effects of diuretics

weakness, muscle cramps, skin rash, increased sensitivity to sunlight, dizziness, lightheadedness, joint pain

A new mother comments on the expense of formula and asks the nurse why she cannot feed the baby the same milk that the rest of the family drinks. Which is the best response that the nurse can provide to the mother?

"cow's milk can cause GI bleeding and stress on the kidneys, and it can lead to iron-deficiency anemia"

aldosterone

"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention promotes water retention, which promotes a higher blood volume and pressure

diuretics

"water pills" treat BP, fluid retention, and edema by increasing elimination of urine.

Hyperglycemia

(blood glucose greater than 109 mg/dL fasting or greater than 127 mg/dL at random) may be a sign of diabetes mellitus, an endocrine problem, which may develop as a result of either insufficient insulin production or resistance to the existing supply of insulin

Hypoglycemia

(blood glucose of less than 50 mg/dL) limits the fuel supply to the body, resulting in symptoms ranging from weakness to coma

Enteral nutrition (EN)

(tube feeding) refers to the delivery of liquid nutrition into the upper intestinal tract via a tube

Preventing UTIs

-Drink 8 ounce glasses of water per day -Practice frequent voiding (every 2 to 4 hours) -Avoid use of harsh soaps, bubble bath, powder, or sprays in the perineal area. -Avoid tight-fitting pants or other clothing that creates irritation to the urethra and prevents ventilation of the perineal area. -Wear cotton rather than nylon underclothes. -Girls and women should always wipe the perineal area from front to back -If recurrent urinary infections are a problem, take showers rather than baths.

The parents of a 2-year-old child voice concern to the nurse that they are not able to toilet train the child yet. Which factors should the nurse explain to the parents that affect toilet training?

-The child must be able to sense the urge to void -the child must be able to voice the need to urinate -The child must be able to remove his or her clothes

What factors regarding nutrition should the nurse consider when working with an older adult?

-Tooth loss and gum disease limit chewing ability -it is not unusual for older adults to lose interest in eating and for the thirst sensation to decrease -the ability to taste and smell diminishes with age, and many clients find some diets unappealing -arthritic hands may create difficulty preparing and eating foods

The nurse is providing discharge teaching for a client who will be taking a loop diuretic. What should the nurse include in the teaching?

-change positions slowly -report any muscle weakness -notify the health-care provider of any rash

How does urinary elimination occur?

1. distention 2. stretch receptors 3. motor impulses 4. when the person is ready to urinate 5. after the detrusor muscle relaxes

normal BMI for adults

18.5-24.9

erythropoietin

A hormone produced and released by the kidney that stimulates the production of red blood cells by the bone marrow.

Basal Metabolic Rate (BMR)

A measure of the energy used while at rest in a neutral temperature environment—the energy required for vital organs such as the heart, liver, and brain to function

Asian Diet

A plant-based diet with a low amount of animal products. It consists of rice, fresh fruits, and vegetables, such as melons, bananas, tangerines, bok choy, cabbage, and other green leafy vegetables. Protein intake primarily consists of beans, nuts, and seeds, and occasional poultry, shellfish, and eggs.

Pureed Diet

A pureed diet is a blended diet. It may have some or no foods excluded.

Nutritional Standards

A reference for nutrient intake thought to meet the nutritional needs of most healthy population groups.

triple lumen

A triple-lumen indwelling catheter is used when the patient requires intermittent or continuous bladder irrigation

A client who has an indwelling catheter reports a need to urinate. Which of the following actions should the nurse take? A. Check to see whether the catheter is patent B. Reassure the client that it is not possible for them to urinate C. Recatheterize the bladder with a large-gauge catheter D. Collect a urine specimen for analysis

A. Check to see whether the catheter is patent

A nurse is caring for a client who has a prescription for a 24-hr urine collection. Which of the following actions should the nurse take? A. Discard the first voiding B. Keep the urine in a single container at room temp C. Dispose of the last voiding D. Ask the client to urinate into the toilet, stop midstream, and finish urinating into the specimen container.

A. Discard the first voiding

A nurse is reviewing factors that increase the risk of urinary tract infections (UTIs) with a client who has recurrent UTIs. Which of the following factors should the nurse include? Select all that apply. A. Frequent sexual intercourse B. Lowering of testosterone levels C. Wiping from front to back D. Location of the urethra closer to the anus E. Frequent catheterization

A. Frequent sexual intercourse D. Location of the urethra closer to the anus E. Frequent catheterization

A nurse is caring for a client who has several risk factors for hearing loss. Which of the following medications the client currently takes should alert the nurse to a further risk for ototoxicity? Select all that apply. A. Furosemide B. Ibuprofen C. Cimetidine D. Simvastatin E. Amiodarone

A. Furosemide B. Ibuprofen

A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply.) A. Older adults are more prone to dehydration than younger adults are. B. Older adults need the same amount of most vitamins and minerals as younger adults do. C. Many older men and women need calcium supplementation. D. Older adults need more calories than they did when they were younger. E. Older adults should consume a diet low in carbohydrates.

A. Older adults are more prone to dehydration than younger adults are. B. Older adults need the same amount of most vitamins and minerals as younger adults do. C. Many older men and women need calcium supplementation.

A nurse is caring for a client who reports difficulty hearing. Which of the following assessment finding indicate a sensorineural hearing loss in the left ear? Select all that apply. A. Weber test showing lateralization to the left ear B. Light reflex at 10 o'clock in the left ear C. Indications of obstruction in the left ear canal D. Rinne test showing less time for air and bone conduction E. Rinne test showing air conduction less than bone conduction in the left ear

A. Weber test showing lateralization to the left ear D. Rinne test showing less time for air and bone conduction

Factors that affect urinary elimination: older adults

Age related changes in the kidneys: loss of fluids and electrolytes, chronic diseases physiological changes: loss of elasticity of muscle in bladder wall

acute renal failure (ARF)

An acute rise in the serum creatinine level of 25% or more. May be caused by inadequate blood flow to the kidney, injury to the kidney glomeruli or tubules, or obstruction of kidney outflow.

Dietary Approaches to Stop Hypertension (DASH)

An eating plan designed to reduce blood pressure; also serves as an overall healthy way of eating that can be adopted by nearly anyone; may also lower risk of coronary heart disease.

Hair cells

Are receptors for hearing. Located in the cochlea of the ear, they detect sound waves. In the vestibular apparatus of the ear, receptors for equilibrium and balance also detect acceleration of the body and position of the head.

A nurse is teaching a client who reports stress urinary incontinence. Which of the following instructions should the nurse include? Select all that apply. A. Limit total daily fluid intake B. Decrease or avoid caffeine C. Take calcium supplements D. Avoid drinking alcohol E. Use the Crede maneuver

B. Decrease or avoid caffeine D. Avoid drinking alcohol

A nurse is preparing to initiate a bladder-retraining program for a client who has incontinence. Which of the following actions should the nurse take? Select all that apply. A. Restrict the client's intake of fluids during the daytime B. Have the client record urination times C. Gradually increase the urination intervals D. Remind the client to hold urine until the next scheduled urination time E. Provide a sterile container for urine

B. Have the client record urination times C. Gradually increase the urination intervals D. Remind the client to hold urine until the next scheduled urination time

A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take? A. Give the client thin liquids B. Instruct the client to tuck their chin while swallowing C. Have the client us a straw D. Encourage the client to lie down and rest after meals

B. Instruct the client to tuck their chin while swallowing

A nurse is caring for a client who had a stroke and has aphasia. Which of the following interventions should the nurse use to promote communication with this client. Select all that apply. A. Speak at a higher volume to the client B. Make sure only one person speaks at a time C. Avoid discouraging the client by indicating that they cannot be understood D. Allow plenty of time for the client to respond E. Use brief sentences with simple words

B. Make sure only one person speaks at a time D. Allow plenty of time for the client to respond E. Use brief sentences with simple words

What is the equation for determining BMI?

BMI = weight (kg) / height (m^2)

symptoms of UTI

Back pain (flank) Bladder spasms Chills Dysuria Edema Fever Foul-smelling urine Hematuria Nausea and vomiting Pyuria Urgency Frequency

A nurse is caring for a client who had an amphetamine toxicity and has sensory overload. Which one of the following interventions should the nurse implement? A. Immediately complete a thorough assessment B. Encourage visitors to distract the client C. Provide a private room, and limit stimulation D. Speak at a higher volume to the client

C. Provide a private room, and limit stimulation

A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following foods on the client's tray? A. Cooked barley B. Pureed broccoli C. Vanilla custard D. Lentil soup

C. Vanilla custard

What is the primary source of energy for the body?

Carbohydrates

Cataracts

Clouding of the lens, resulting in blurred vision, sensitivity to glare, and image distortion. Can occur in one eye or both.

Full Liquid Diet

Contains all the liquids included in the clear liquid diet plus any food items that are liquid at room temperature. Foods Included: Add to clear liquid diet: soups, milk, milk shakes, puddings, custards, juices, some hot cereals, and yogurt.

Indian Diet

Contains fresh, home-cooked foods containing a wide array of spices. The selection of meat is based on religious preference (e.g., traditionally, Muslims don't eat pork, Hindus aren't permitted to eat beef, and Buddhists are vegetarian). People who eat a traditional Indian diet that is high in fruits, vegetables, legumes, and nuts, and low in processed foods reap the benefit of low incidence of diabetes, heart disease, and other chronic diseases.

A nurse is reviewing instructions with a client who has a hearing loss and has just started wearing hearing aids. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I use damp cloth to clean the outside part of my hearing aids" B. "I clean the ear molds of the my hearing aids with rubbing alcohol" C. "I keep the volume of my hearing aids turned up so I can hear better" D. "I take the batteries out of my hearing aids when I take them off at night"

D. "I take the batteries out of my hearing aids when I take them off at night"

A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with the most energy? A. Fat B. Protein C. Glycogen D. Carbohydrates

D. Carbohydrates

oliguria

Decreased urine output

otosclerosis

Hardening of the bones of the middle ear, especially the stapes. The stapes becomes fixed, leading to poor sound transmission to the inner ear.

double-lumen

Has two lumens, one drains urine, other is used to inflate balloon

Which type of lipid removes cholesterol from the bloodstream?

High-density lipids (HDLs)

proprioreceptors

In the skin, muscles, tendons, ligaments, and joint capsules coordinate input to enable us to sense the position of our body in space (proprioception)

Glaucoma

Increased pressure in the anterior cavity of the eyeball distorts the shape of the cornea and shifts the position of the lens. Results in loss of peripheral vision or blindness. The most common type is open angle glaucoma.

Minerals

Inorganic elements found in nature. They occur in foods either naturally or as additives, as well as in supplements.

Catabolism

Involves the breakdown of larger molecules into smaller components. This process releases energy.

Anabolism

Involves the formation of larger molecules from smaller ones. For example, if protein is needed for tissue repair, amino acids are recombined to form proteins. This process requires energy.

Normal urination patterns

Kidneys produce urine at a rate of about *50 to 60 mL per hour* or 1500 mL per day. - output may fluctuate by 1000 mL to 2000 mL depending on various factors. - most people void about five or six times per day, even eight times is normal.

Which source of energy is butter?

Lipid

Stimulus

May be a sight, sound, taste, touch, pain, or anything that stimulates a nerve receptor. The brain must receive and process it to make it meaningful.

Nutritional Food Guides

More practical tools that you can use to educate patients and families. They specify the number of daily servings of foods needed so nonprofessionals can use them in making healthful meal choices.

Seizures

Occur because of sudden, abnormal electrical activity in the brain. They may be either generalized or focal. The difference between these types is in how and where they begin. Recurrent seizures are often due to a brain disorder, called epilepsy.

Strabismus

One eye deviates from a fixed image. Can lead to permanent vision loss.

PICOT Components

Population/Patient Intervention/Indicator Comparator/Control Outcome Time

Clear Liquid Diet

Provides fluids to prevent dehydration and supplies some simple carbohydrates to help meet energy needs. Foods Included: Water, tea, coffee, broth, clear juice (usually apple, grape, or cranberry juice), popsicles, carbonated beverages, and gelatin.

Hispanic Diet

Relies heavy on grains, especially rice, and legumes (e.g., beans), and corn-based products. Beans as a staple provide a diet rich in fiber, B vitamins, calcium, phosphorus, and iron; however, when prepared with lard, the health benefits diminish. The traditional Hispanic fare includes few fresh vegetables, except for tomatoes, which are rich in vitamins A and C, as well as potassium and iron.

Mediterranean diet

Rich in olive oil, fish, fruits, vegetables, and nuts and low in dairy foods, processed foods and saturated fats, red meat, and includes a glass of red wine.

Hypokinetic

Small movements (Parkinsonian movement)

The nurse is performing discharge teaching for a client newly diagnosed with hypertension. What area on a nutrition label should the patient limit?

Sodium

Macronutrients

Supply the body with energy (kilocalories)

Adequate Intake (AI)

The amount of a nutrient consumed by a group of healthy people

Glomular Filtration Rate (GFR)

The amount of filtrate formed by the kidneys per minute

Recommended Daily Allowance (RDA)

The average daily dietary intake of a nutrient that is sufficient to meet the nutritional requirements of approximately 98% of healthy people

A client blames recent weight gain on his or her metabolism. Which is the best information that the nurse can provide to the client about how metabolism works?

The body converts food into complex forms of chemical energy and then into usable energy; therefore, extra food intake must have equal energy exertion in order to not gain weight.

parenternal nutrition (PN)

The delivery of nutrition intravenously into a large, central vein. This is the preferred method of feeding for clients who cannot be nourished through the GI tract.

Mechanical Soft Diet

The diet of choice for people with chewing difficulties resulting from missing teeth, jaw problems, or extensive fatigue. Foods Included: Add to the full liquid diet: soft vegetables and fruits; chopped, ground, or shredded meat; and breads, pastries, eggs, and cheese.

Tolerable Upper Intake Level (UL)

The maximum daily intake of a nutrient that is likely to be without adverse health effects for almost all individuals

Acceptable Macronutrient Distribution Range (AMDR)

The percentage of protein, fat, and carbohydrate associated with reduced risk of chronic disease, provided there is an intake of other essential nutrients

Reception

The process of receiving stimuli from nerve endings in the skin and inside the body. A receptor converts a stimulus to a nerve impulse and transmits the impulse along sensory neurons to the central nervous system (CNS).

Bladder irrigation

To wash out bladder remove blood clots in bladder after surgery

What could potentially occur if a client takes Vitamin A, D, E, and K supplements daily?

Toxicity

complications of urinary retention

UTI, bladder damage, kidney damage

phantom taste perception

Unpleasant taste even though there is nothing in the mouth

anuria

absence of urine

personal, sociocultural, and environmental factors

anxiety, lack of time, lack of privacy, loss of dignity, cultural influences

end-stage renal disease (ESRD)

any type of kidney disease in which there is little or no remaining kidney function, requiring the patient to undergo dialysis or kidney transplant for survival

transiet incontinence

appears suddenly and lasts 6 months or less

pessary

appliance inserted into the vagina to support the uterus

semi-vegetarian

are the most inclusive, allowing fish, eggs, and dairy products as well as plant-based foods

hematuria

blood in the urine

nephrotoxic

capable of causing kidney damage

Presbyopia

change in vision associated with aging

The nurse has an order to obtain a urine specimen for a culture and sensitivity test from a client with an indwelling urinary catheter. Which procedure is accurate for obtaining the specimen?

clamping the tubing and withdrawing a fresh specimen from the tubing aseptically

lacto-vegetarian

consume only dairy and plant-based foods

overflow incontinence

continuous leaking from the bladder either because it is full or because it does not empty completely

Central deafness

damage to the auditory areas in the temporal lobes

retinopathy

damage to the retina that causes vision impairment

Fruitarian

diet includes only fruits, nuts, honey, and vegetable oils

Tactile Hyposensitivitie

diminished perception of touch sensations

tactile defensiveness

diminished tolerance for touch sensations; hypersensitivity

nephropathy

disease of the kidney

tactile apraxia

disturbance of hand movements when handling objects

ovo-lacto vegetarian

eat eggs and dairy products, but not fish

vegan

eat only foods of plant origin

Metabolism

encompasses all the ways in which the body changes and uses nutrients for vital processes and bodily functions

polyuria

excessive urination

Positive Nitrogen Balance

exists when nitrogen intake exceeds output, making a supply of amino acids available for growth, pregnancy, and tissue maintenance and repair

Negative Nitrogen Balance

exists when nitrogen intake is less than nitrogen loss. This occurs in illness, injury (e.g., burns), and malnutrition

Chemoreceptors

for taste are located in our taste buds (chemoreceptors for smell) are located in the epithelium of the nasal cavity

nephron

functional unit of the kidney

Micronutrients

help manufacture, repair, and maintain cells

renin

hormone secreted by the kidney; it raises blood pressure by influencing vasoconstriction (narrowing of blood vessels)

Phantom sensation

hypersensitive nerve conduction involving agitated nerve endings that conduct sensation for a limb that is not there

Mechanoreceptors

in the skin and hair follicles detect touch, pressure, and vibration

Thermoreceptors

in the skin detect variations in temperature

Urinary incontinence (UI)

inability to control urination

urinary retention

inability to empty the bladder

Anosmia

inability to smell

urinary tract infection (UTI)

infection of one or more organs of the urinary tract

antidiuretic hormone (ADH)

influences the absorption of water by kidney tubules

urge incontinence

involuntary leakage of urine with a sudden, strong desire to urinate

enuresis

involuntary urination

astigmatism

irregular curvature of the cornea or lens that scatters light rays and blurs or distorts the image on the retina

detached retina

is separation of the retina from the layer underneath

Perception

is the ability to interpret the impulses transmitted from the receptors and give meaning to the stimuli

What are the organs of the urinary system?

kidneys, ureters, urinary bladder, urethra

akinetic

lack of movement

Reticular Activating System (RAS)

located in the brainstem, controls consciousness and alertness

Photoreceptors

located in the retina of the eyes detect visible light

macular degeneration (MD)

loss of central vision due to damage to the macula lutea, the central portion of the retina

unconscious incontinence

loss of urine when the person does not realize the bladder is full and has no urge to void

Crede's maneuver

manual exertion of pressure on the bladder to force urine out

conduction deafness

may be a temporary or permanent condition caused by infection of the middle ear, a punctured tympanic membrane, arthritis of the auditory bones, cerumen impaction, or a foreign object lodged in the ear canal can cause it

sensory deficits

may stem from impaired reception, perception, or both

Otitis media

middle ear infection

sersorineural hearing loss

nerve deafness that occurs when there is damage to cranial nerve VIII (vestibulocochlear nerve) or the receptors in the cochlea

sensory deprivation

occurs as a result of altered sensory reception in which the person does not receive and process meaningful sensory input

sensory overload

occurs when stimuli such as pain, unfamiliar sights, sounds, odors, and routines overwhelm the patient's senses

Hyperkinetic

often with repetitive, involuntary motor activity (dystonia, tremors, myoclonus, opisthotonos, chorea, tardive dyskinesia, restless leg movement, tics, rigidity, cramps, spasm)

indwelling catheter

one that remains inside the body for a prolonged time

Vitamins

organic substances that are necessary for metabolism or preventing a particular deficiency disease

dysuria

painful urination

presbycusis

progressive sensorineural loss associated with aging

proteinuria

protein in the urine

pyuria

pus in the urine

tactile aphasia or agnosia

reduced or lack of ability to recognize objects by touch

Functions of the kidneys

removes metabolic waste from the blood; forms urine

Which functions of the kidney are considered secondary functions?

renin production vitamin D activation Erythropoietin secretion

Where are the kidneys located?

retroperitoneal "flank area"

Tinnitus

ringing in the ears

Myopia (nearsightedness)

sees close objects well but not distant objects

Hyperopia (farsightedness)

sees distant objects well