Elimination HCC

small volume enema

Administered after oral laxative fails to produce sufficient stool return. Laxative solution is hypertonic Mineral oil softens hardened stool. (Given when an impaction is suspected) Patient feels urge to deficate 5-10 min after administrateion

normal red blood cell count

3.99-5.65M/ul

normal pH of urine

5-6 with a range of 4.5-8

normal color of stool in children and adults

Brown

inorganic constituents of urine

ammonia, sodium, chloride, traces of iron, phosphorus, sulfur, potassium, and calcium

The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.

Glomerular filtration rate (GFR)

nursing history regarding urinary elimination

a pattern of urination signs and symptoms of alterations factors affecting urination and a physical assessment

continent urinary diversion

a surgical alternative that uses a section of the intestine to create an internal reservoir that holds urine, with the creation of a catheterizable stoma

cutaneous ureterostomy

a type of incontinent cutaneous urinary diversion in which the ureters are directed through the abdominal wall and attached to an opening in the skin

return flow or flush enema

administered to expel intestinal gas, large volume instilled in small increments (100-200 ml) lower container to allow solution to flow back into the container back and forth motion helps to increase peristalsis and relieve flatus

factors affecting bowel elimination

age, diet, physical activity, psychological factors, position, pain, personal habits, pregnancy, surgery and anesthesia, and medications

the internal and external sphincters at the base of the bladder

becomes under voluntary control after child development progresses to walking

waste residues of digestion

bio, intestinal secretions, shed epithelial cells, bacteria, and inorganic material

autonomic bladder

bladder no longer controlled by the brain because of injury or disease; void by reflex only

occult blood

blood present in such minute quantities that it cannot be detected with the unassisted eye

abnormal constituents of poop

blood, pus, excessive fat, parasites, over, and mucus foreign bodies may also be found

nursing diagnosis regarding the colon

bowel incontinence, constipation, risk for constipation, diarrhea, fluid imbalance, nutritional imbalance, pain

inorganic material of the colon

chiefly calcium and phosphates but also seeds, meet fibers, and fat may be present in small amounts

common bowel elimination problems

constipation, fecal impaction, diarrhea, and consonants, flatulence, and hemorrhoids

total incontinence

continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation

isotonic solution enema

does not pull electrolytes from the body or shift fluid and now the colon reduces the risk of electrolyte imbalance and fluid volume excess / deficit only type that be should used for children and infants

flatulence

excessive formation of gases in the gastrointestinal tract

polyuria

excessive urination

nocturia

excessive urination during the night

patient teaching before an enema

explain the purpose and procedure positioning requirements like sideline with right knee flexed or left-sided Sims position how long they need to retain the solution which is normally 5 to 10 minutes for the cleansing and 30 minutes minimum for retention possible abdominal discomfort during the procedure

nephron

filtration system

meconium

first stool of the newborn

normal consistency of feces

formed, soft, semisolid, moist

kidneys

function to filter waste products from the blood produce essential regulatory substances like renin and erythro poetin 25% of cardiac output circulates to the kidneys each minute

how surgery in anesthesia affect the colon

general anesthetics causes a temporary cessation of peristalsis which is also why a clients are NPO just before or after surgery also it is the body's natural instinct to shut down digestion and waste removal once it's been cut into

bladder training

goal is to gain control of urination done as directed by nurse and care plan person uses toilet/pan at frequent regular intervals and is slowly increased. Person has catheter which is clamped to prevent urine flow for periods of time (1-2hrs at first then up to 3-4hrs) to train bladder

green poop

green leafy vegetables food may be moving through LI too fast green/blue food coloring

continent

having self-control over urination

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease?

incontinence

nursing diagnosis regarding urinary elimination

incontinence, risk for infection, toileting self-care deficit, impaired urinary elimination, and urinary retention

black poop

iron bleeding meconium

how age affects the bowel

neuromuscular control bowel elimination not develop until the age of two or three older adults lose muscle tone in the perineal floor and anal sphincter aging causes the slowing of nerve impulse to signal ahead for the need of defecation

things to do in bladder training

normal body positions/posture to void sound of running water warm water over perineum adequate fluid intake - no caffeine regular attempts to void privacy and screening pelvic muscle exercises

transient incontinence

occurrence that appears suddenly and lasts for 6 months or less and usually is caused by treatable factors, such as confusion secondary to acute illness, infection, and as a result of medical treatment, such as the use of diuretics or intravenous fluid administration

stoma

opening and the abdominal wall

loop colostomy

performed when closer and reversal of the colostomy is anticipated loop of bowel brought to surface of abdomen plastic or metal rod holds loop at surface opening in bowel drains feces

paralytic ileus

peristalsis stops as a direct manipulation of bowel or exposure of the intestines to air during abdominal surgery and or general anesthesia May resolve in 24 to 48 hours or may progress to intestinal infarction in necrosis which can be life-threatening ​

how the position affects the colon

sitting or squatting during defecation AIDS because it increases the abdominal pressure and contraction of the pelvic floor muscles hospitalization and imposed use of bedpans or bedside commode man hit it a client's bowel elimination since they are predominantly laying down for that and laying down causes a difficult time in voiding

The nurse is working with a client who has been diagnosed with urge incontinence related to detrusor muscle contractions. Part of the educational material suggesting lifestyle changes should include information that which situation increases muscular contractions?

smoking ****Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 246

lab test for the bowel

stool specimens, fecal occult blood, emily, alkaline phosphatase, and a CEA

if bleeding occurs during an enema

stop installation immediately, measure their vital signs, and notify the provider

intermittent urethral catheter

straight catheter used to drain the bladder for short periods (5-10 minutes)

constipation

the passage of a hard, dry stool

diuresis

increased output of urine (promoted)

flatus

intestinal gas

A postpartum woman has been unable to urinate since giving birth. When the nurse is assessing the woman, which finding would indicate that this client is experiencing bladder distention?

Uterus is boggy.

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

White blood cell (WBC) count of 20,000/mm3

specific gravity

a characteristic of urine that can be determined with manufactured plastic strips or an instrument called a urinometer or hydrometer

how pregnancy affects the colon

a growing uterus exerts pressure on the rectum, peristalsis slows and third trimester, constipation is common and may lead to the development of hemorrhoids

fissure

a linear break on the margin of the anus

The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:

a loss of over half the client's normal kidney function.

hemorrhoids

abnormally distended rectal veins

anuria

absence of urine

functions of the colon

absorption of water, sodium, and chloride (NaCl) secretion of bicarbonate elimination of waste

contraindications for enemas

active rectal bleeding arrhythmia recent colon, rectal, prostate surgery recent MI undiagnosed abdominal pain increased intracranial pressure glaucoma

nursing interventions regarding your bowel

associative for changes in assessment activity and exercise stool softeners or laxatives as prescription encourage toileting at the same time of day or 30 minutes after meals provide privacy for toileting 0 monitor bowel movements for frequency and characteristics provide fiber intake position sitting upright if possible food intake of fruit juice, water, hot beverages manual exam for impaction manual removal of impaction suppositories stool softeners laxatives

metabolic factors relating to urinary elimination

basal metabolic body functions such as breathing and digestion account for a insensible loss (500-1000 mL/day) conditions increasing the metabolic rate increase fluid consumption (fever)

melena

black, tarry stools; feces containing digested blood

hematuria

blood in the urine

hematuria

blood in the urine; if present in large enough quantities, urine may be bright red or reddish brown

fecal impaction

collection in the rectum of hardened feces that cannot be passed

bacteriuria

condition that occurs when bacteria enter the bladder during catheterization, or when organisms migrate up the catheter lumen or the urethra into the bladder; bacteria in the urine

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom?

constipation

social culture factors involved in urinary elimination

cultural experiences influence when and where it is appropriate to urinate and how much privacy is / is not required

reflex bladder

damage to the spinal cord above the sacral region causes loss of voluntary control of urination if the reflex pack the way is intact, urination occurs reflexively rather than voluntarily

A client with a history of advanced liver disease comes to the emergency department (ED) with dehydration. White blood cell count shows elevation in bands and neutrophils. When preparing to catheterize the client, what color urine does the nurse anticipate will drain?

dark brown, cloudy

high specific gravity indicates

dehydration

cognitive impairments that affect to urinary elimination needs

dementia or Alzheimer's - affect a client's ability to correctly perceive the need to avoid and how to meet that need

A 57-year-old man is suffering from polyuria. What can cause polyuria?

diabetes insipidus or UTI

constipation

difficulty in passing stools

endoscopy

direct visualization of hollow organs of the body using an endoscope (a flexible, lighted tube)

medications affecting urination

diuretics by preventing the reabsorption of water and some electrolytes which increase the urine output antihistamines and anticholinergics can contribute to urinary retention some meds change your in color like pyridium, amitriptyline, and Levodopa

laxative

drug used to induce emptying of the intestinal tract

incontinent

experiencing involuntary or uncontrolled loss of urine or feces

bladder

functions as a hollow surge receptacle for urine

A transgender female client taking synthetic estrogen therapy is experiencing sudden and rapidly intensifying pain in the upper right abdominal quadrant. Which complication, associated synthetic estrogen therapy, aligns with these symptoms?

gallstones

urinary incontinence

inability to control urination

urinary retention

inability to void although urine is produced by the kidneys and enters the bladder; excessive storage of urine in the bladder

nocturia

increased urine production at night - occurs in clients whose renal blood flow or venous return is affected by rest and lying down at night

possible causes of abnormal constituents in the feces

internal bleeding, infection, inflammation, and other pathologic conditions

feces

intestinal waste products

enema

introduction of solution into the lower bowel

urinary incontinence

involuntary loss of urine as a continuous or intermittent basis mobility problems, energy limitations, Boston manual dexterity contribute to the incidence frequent episodes of incontinence contribute siskin breakdown has several classifications

overflow incontinence

involuntary loss of urine associated with overdistention and overflow of the bladder

the GI system

mouth to esophagus to stomach to small intestine to iliocecal valve to colon to rectum

anus

opening at the end of anal canal

ileostomy

opening into the small intestine allows fecal content from the ileum to be eliminated through the stoma

suppository

oval- or cone-shaped substance that is inserted into a body cavity and that melts at body temperature

low specific gravity indicates

over hydration

diarrhea

passage of liquid and unformed stools

micturition

process of emptying the bladder; urination; voiding

urination

process of expelling urine; also called micturition

normal odor of poop

pungent maybe affected by foods ingested

pyuria

pus in the urine

fluid intake

reduce fluid intake May contribute to constipation milk and milk products slows peristalsis adequate water and fruit juice promote normal bowel function

oliguria

reduced urine output

physical assessment regarding urinary elimination

skin and mucous membranes, kidneys and bladder, urinary meatus, and characteristics of urine

stress incontinent

stay in which the person experiences a loss of urine of less than 50 ml that occurs with increased abdominal pressure

soap suds enema

stimulate peristalsis through the intestinal irritation pure Castle soap is the only safe option use cautiously and pregnant patients and older adults because it can lead to an electrolyte imbalance or damaged intestinal mucosa

classifications of urinary incontinence

stress, functional, overflow, reflex, and urge

planning nursing care for the bowel

support regular bowel habits correct fluid and electrolyte loss through diarrhea correct discomfort from constipation promote bowel control reduce / relief pain correct nutritional deficiencies educate client about bowel health

urinary diversion

surgical creation of an alternate route for excretion of urine

urinary retention

the accumulation of urine and the bladder from obstruction, urethral demo, trauma, childbirth may result in 2000 to 3,000 mL of urine causes bladder spasms and can result in nerve damage to bladder and the sphincter the bladder is assessed by palpitation and catheterization for residual urine

the nephron is composed of

the glomerulus, proximal convoluted tubule, loop of henley, Bowman's capsule, distal tubule, and collecting duct

white poop

too much milk or no bile (possible liver failure)

urethra

tubular passage for urine from the bladder to the meatus women: 1.5-2.5 inches long (more susceptible to bladder infections bc of this) men: 7-8 inches long

organic constituents of urine

urea, uric acid, creatinine, hippuric acid, indican, urine pigments, and undetermined nitrogen

Which clinical finding should a nurse look for in a client with chronic renal failure?

uremia

ileal conduit

urinary diversion in which the ureters are connected to the ileum with a stoma created on the abdominal wall

urine

waste product excreted by the kidneys

0 muscle tone factors

weak abdominal or pelvic floor muscles affect ability to control urination leading to incontinence prolonged immobility stretching a muscles from childbirth muscle atrophy from menopause trauma to muscles

normal color of stool in infants

yellow to Brown

Types of enemas

cleansing, oil retention, commercial preparation

A client who is 14 weeks' pregnant mentions that she has been having difficulty moving her bowels since she became pregnant. Which hormone is responsible for this common discomfort during pregnancy?

progesterone

benign prostate hypertrophy or BPH

prostate enlargement (not cancer related)

functional incontinence

state in which a person experiences an involuntary, unpredictable passage of urine

urge incontinence

state in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void

postvoid residual

urine that remains in the bladder after the act of micturition; a synonym for residual urine

nursing history regarding bowel elimination

usual elimination pattern ( some patients normal is going 2 to 3 days or week without pooping) typical stool characteristics routines included in normal elimination diet history history of surgery or illness use of enemas, laxatives, fiber supplements at home changes in bowel habits changes in appetite presence and status of bowel diversions daily fluid intake medication history

nephrotoxic

capable of causing kidney damage

A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information?

"I only eat a low-fiber diet."

After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching?

"I'll switch to chewing gum instead of using mints."

nursing interventions regarding urinary elimination

0 to promote prevention of infection to promote normal voiding pattern and bladder control to promote and encourage positive self-concept to educate the patient to promote comfort and well-being

normal bilirubin levels

0.1-1.2 mg/dL

normal specific gravity of urine

1.015-1.025

oliguria

24-hour urine output is less than 400 ml

When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voidings per day is a good indicator of adequate fluids?

6 to 8

Which client is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old client with an indwelling catheter

A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client?

Anemia

The nurse is preparing the client for an assessment of the abdomen. What should the nurse complete prior to this assessment?

Ask the client to empty the bladder.

diagnostic exams for urinary function

BUN, creatinine urinalysis urine culture iv pyelogram cystoscopy

A client is admitted to the health care facility with a diagnosis of a bleeding gastric ulcer. The nurse expects the client's stools to have which description?

Black and tarry

indwelling urethral catheter

catheter that remains in place for continuous urine drainage; synonym for Foley catheter

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:

Circumcision

Which diagnostic study would be effective in determining direct visualization of the bladder and ureters?

Cystoscope

Which occurrence is most likely to cause increased urination?

Decrease in antidiuretic hormone

surgical influence on urinary elimination

G.A.S. causes the release of ADH which in turn it stimulates water reabsorption an increase in aldosterone will innervate the water and sodium retention NPO status reduces food intake anesthetics and meds glomerular filtration rate reducing urinary output effects of anesthetics and surgery affect mobility and the ability to void

Which factor contributes to the development of polycystic kidney disease?

Hereditary mutations in polycystin I and II

Which diagnosis is most likely to require surgical correction?

Hypospadias

Which factor contributes to UTI in older adults?

Immunocompromise

Which statement most accurately captures the function of the ascending loop of Henle?

Impermeability to water and absorption of solutes yields highly dilute filtrate.

The nurse is working with a client who requires continence training. Which client teaching about pelvic floor muscle exercises (Kegel exercises) will the nurse include?

Keep muscles contracted for at least 10 seconds.

A 71-year-old client reports to the nurse that he often notices a pink tinge to his urine. Upon further questioning, he states that he experiences no pain when voiding and has not noticed any change in the frequency of his voiding. Which response by the nurse is best?

Promptly report this finding to the client's health care provider.

The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:

Steatorrhea

voiding

process of emptying the bladder; also called micturition or urination

Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?

The stretch receptors in the bladder wall become hypersensitive.

The nurse is planning care for a 4-day-old breastfed infant receiving phototherapy. What interventions and outcomes support a decrease in the serum bilirubin levels

Urine output is 3 mL/kg/hr. Infant has 3 to 4 seedy, yellow stools per day. Infant breastfeeds every 2 to 3 hours.

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?

Urine output of 20 ml/hour

urinary incontinence

any involuntary loss of urine

how medications affect the colon

laxatives and cathartics promote peristalsis and flu retention in the bowel promoting defecation opioid analgesic suppressed peristalsis medications to treat diarrhea primary styluses

normal urine color

light yellow to amber

oil retention enemas

lubricates the rectum and colon while oil is absorbed by feces need to be retained as long as possible usually a minimum of 30 minutes

red poop

medications, lower GI bleed, food dye

ostomy

general term referring to an artificial opening; usually used to refer to an opening created for the excretion of body wastes

The client who has been admitted with a problem with his bladder has a postvoid residual (PVR) of 250 mL. The nurse understands that this indicates:

inadequate bladder emptying.

A 70-year-old client confides to the nurse that she is "terribly embarrassed" that she has developed urinary incontinence over the past year. Which nursing response supports the client's self-esteem?

"Let's explore structuring activities and toileting breaks."

A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor?

"Make an appointment with your health care provider immediately."

The parents of an infant with a colostomy are concerned that their child's colostomy bag is filling up frequently with gas. What is the most appropriate response by the nurse?

"Open the bag slightly whenever this happens."

A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response?

"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital."

A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?

Check the patient's urine for hematuria.

documentation of the enema

1. date, time, and type of enema 2. volume and type of solution administered 3. the output - amount, consistency, color, bowel sounds, abdominal distension 4. a patient tolerance of the procedure 5. any adverse reactions are unexpected outcomes of the enema

A new client on hemodialysis is watching his blood being filtered through a dialyzer. He asks the nurse how much blood typically passes through the kidney every minute? The nurse responds:

1000-1300 mL/minute.

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate])

When caring for the client in a shock state, the nurse recognizes that which compensatory substance may produce vasoconstriction of renal vessels?

Angiotensin II Antidiuretic hormone Endothelins

The nurse is caring for a client with an ileal conduit is created after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?

Application of an ostomy pouch

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

The nurse is helping a client who experiences frequent constipation select meal choices for the day. Which food should the nurse encourage the client to order?

Bran cereal

A client arrives in the emergency department with hypovolemia related to excretion of "at least 3 gallon jugs of dilute, water-like urine in the past 24 hours." In collaboration with the physician, the nurse prepares to administer which medication?

Desmopressin acetate

common diagnostic test for the colon

EGD barium swallow colonoscopy barium enema x-rays stool culture hemoccult

The nurse is reviewing the laboratory data for a young client in acute kidney failure and notes an elevated serum potassium level. What is the priority assessment action for the nurse based on the laboratory data?

Institute telemetry monitoring

The nurse is educating the parents of a child requiring renal replacement therapy The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?

Peritoneal dialysis

A client has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which type of renal failure should the nurse closely monitor for?

Postrenal failure ****Chapter 34: Acute Kidney Injury and Chronic Kidney Disease - Page 893

When teaching a pharmacology class the nurse relates that 65% of all reabsorptive and secretory processes that occur in the tubular system take place in which area?

Proximal tubules

Which term refers to inflammation of the renal pelvis?

Pyelonephritis

A client with Paget's disease comes to the hospital and reports difficulty urinating. The emergency department health care provider consults urology. What should the nurse suspect is the most likely cause of the client's urination problem?

Renal calculi

A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?

The child does not have intravenous access.

A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?

The foreskin is needed for repair.

The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse?

The intestines are displaced by the growing fetus.

A health care provider is caring for an older adult client with a recent diagnosis of renal failure and an acid-base imbalance. The family asks, "What is the underlying cause of the renal failure?" Which phenomenon would most accurately answer the question?

The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body.

Hypertrophy may occur as the result of normal physiologic or abnormal pathologic conditions. The increase in muscle mass associated with exercise is an example of physiologic hypertrophy. Pathologic hypertrophy occurs as the result of disease conditions and may be adaptive or compensatory. Examples of adaptive hypertrophy are the thickening of the urinary bladder from long-continued obstruction of urinary outflow and the myocardial hypertrophy that results from valvular heart disease or hypertension. What is compensatory hypertrophy?

When one kidney is removed, the remaining kidney enlarges to compensate for the loss.

clostridium difficile or C diff

a spore that has a high prevalence amongst the elderly but can affect all ages but the manifestations of symptoms varies depending on age and immunity was boosted by the practice of hand washing or hand sanitizing and antibiotics. antibiotics because they killed the good bacteria as well as the bad bacteria in the gut

nutritional factors relating to urinary elimination

food and drinks that contain caffeine stimulate urine formation alcohol inhibits the release of ADH resulting in increased water loss high sodium foods may cause water retention

Valsalva maneuver

forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

The most frequent reason for admission to skilled care facilities includes which of the following?

Urinary incontinence

A client with a new ileal conduit asks what the disadvantages are to this type of stoma. The nurse explains that the client may experience which disadvantage?

Urine drains from it continuously.

The nurse is assessing a client for constipation. Which factor should the nurse review first to identify the cause of constipation?

Usual pattern of elimination

The nurse walks into a room and finds the client forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term:

Vomiting

complications of an enema

a rigid distended abdomen, abdominal pain, cramping, and bleeding

Kegel exercises

a series of pelvic muscle exercises used to strengthen the muscles of the pelvic floor to control urinary stress incontinence in women

end colostomy

a single proximal section of colon brought to abdominal wall to form a stoma the distal portion of colon and rectum is either removed or sewn closed

ileostomy

alien portion of the intestine exists beyond the abdominal wall

hypotonic solutions enema

also tap water will exert osmotic pressure causing water to move from the colon to the interstitial space should not be repeated because water toxicity or circulatory overload may occur

assessments before the enema

and elimination status like knowing their normal elimination pattern and last bowel movement an abdominal assessment and also an assessment of the anus before inserting the enema

colostomy

and opening into the colon that permits feces to exit through the stoma

psychologic factors relating to urinary elimination

anxiety and stress contribute to urinary frequency or urgency some individuals unable to avoid in situations provoking stress or without sufficient privacy

normal urine smell

aromatic

empire client's ability to get to the toilet

arthritis, degenerative joint disease, surgery to lower extremities, back pain

stoma

artificial opening for waste excretion located on the body surface

the physical assessment for the nurse during vowel elimination

assess the mouth for factors affecting diet intake assess the abdomen for contour, shape, symmetry, skin color, masses, scars, peristaltic waves, distention, pain and bowel sounds assess the rectum for lesions hemoroids or bleeding a digital exam for impaction like an x-ray

free renal congestions affecting urinary elimination

decrease blood flow to the kidneys - such as from chf, blood loss, dehydration - resulting in oliguria or anuria damages to the glomeruli or renal tubule also results and changes in renal efficiency - diabetes mellitus, transfusion reactions obstruction of urine flow from the renal pelvis, ureters, bladder or urethra can occur - coculi, blood clots, scarring, tumors... you're in backs up in the kidneys and causes hydronephrosis which causes lasting damage to the nephrons

reflex incontinence

emptying of the bladder without the sensation of the need to void

defecation

emptying of the intestinal tract; synonym for bowel movement

the blood path through the kidneys

enters the kidney via the renal artery the glomerulus filters water, glucose, Amino acids, urea, koreatinine, and electrolytes 99% of filtrate is reabsorbed into the bloodstream 1% excreted into collecting duck as urine here and leave the nephron via the collecting ducks goes into the renal pelvis goes into the ureters as peristalsis and ends in the bladder

polyuria

excessive output of urine (diuresis)

stool

excreted feces

enuresis

involuntary urine; most often used to refer to a child who involuntary urinates during the night

urine leaving the kidneys

is sterile unless a kidney infection or generalized sepsis is present

jejunostomy

jejunum brought to the abdominal wall

fluid balance factors

kidneys try to maintain balance between fluids and electrolytes increased fluid intake causes increased urine production

colon

large intestine is five to six feet in length consists of the cecum, the colon (ascending, transverse, descending and sigmoid) and elimination of waste

medicated enema

maybe given for the local effect the exert on the rectal mucosa antibiotic neomycin to reduce colon bacteria before surgery, sodium polystyrene siphonate to treat patients with dangerous high high serum potassium levels, caminative enemas used to treat flautas and abdominal distension it usually has magnesium and glycerin additives medication enema should only be administered by an RN

the urine collection for testing

midstream specimen, straight catheterized specimen, sterile collection from indwelling catheter

impact client ability to meet urinary elimination needs

mobility

incontinence-associated dermatitis

moisture-associated skin breakdown caused by prolonged contact of the skin with urine or feces

urinary tract infections

most common nosocomial infection in the US hospitals catherization or surgical instrumentation ranges from bladder infections to Euro sepsis and can become life-threatening immobility contributes to the development of UTIs

bicarbonate

neutralizes stomach acid

how to perform an enema

position client and left Sims position wearing exam gloves, lubricate the enema administration tip. insert two to three inches into the rectum initiate flow solution with bag 18 in above client's hips monitor clients tolerance

glucosuria

presence of glucose in the urine

bowel training program

program that manipulates factors within a person's control (timing of defecation, exercise, diet) to produce a regular pattern of comfortable defecation without medication or enemas

The nurse is reviewing a client's urine culture and sensitivity test results. Which findings would the nurse expect to see in small amounts in normal urine?

protein white blood cells

proteinuria

protein in the urine

hypertonic or sodium phosphate enemas

pull fluid from the interstitial space into the colon should not be used on infants and dehydrated patients also known as a fleet enema

how diet affects the colon

regular eating patterns support regular bowel habits fiber provides bulk to fecal material and stimulates peristalsis some foods produce gas causing intestinal distension

infection control of UTIs

related to poor hand hygiene comment inadequate or incorrect toileting hygiene, incorrect catheterization technique, inadequate catheter care

The client with herpes simplex virus (HSV) encephalitis is receiving acyclovir. The nurse monitors blood chemistry test results and urinary output for

renal complications related to acyclovir therapy.

related nursing diagnosis regarding urine elimination

rest grandparent skin integrity, risk for falls, alteration and self-concept, knowledge deficit, and pain

signs and symptoms of renal failure or end-stage renal disease

results from irreversible damage to the glomerulus or tubules increase in bun, fluid and electrolyte imbalances, high bp, headache, in and v, seizures,

Which procedure is performed to examine and visualize the lumen of the small bowel?

small bowel enteroscopy

types of cleansing enemas

soapsuds saline (fleet) tap-water Harris flush

urinary sheath (external condom catheter)

soft, pliable sheath made of silicone material that is applied externally to the penis and directs urine away from the body; also known as external condom catheter

A nurse is caring for a client who has an infant age 4 months. The client informs the nurse that she has been experiencing a sudden loss of urine whenever she laughs; this is causing embarrassment to her. Which type of urinary incontinence is this client experiencing?

stress incontinence

physiological factors that affect the colon

stress response may stimulate peristalsis and digestion which in turn may cause diarrhea or gas depression slows peristalsis and may promote constipation strong length of psychological influences on ulcerative colitis and Crohn's disease

how pain affects the colon

surgery, hemorrhoids, rectal fistulas etc may make a defecation painful causing the client to suppress the urge which leads to constipation really see this in children recommended to lube the anus to rectum and see if that will help

colonostomy

surgical opening of the colon

bowel diversion

surgical openings created to drain intestinal waste performed and response to a disease process such as alternative colitis, colon cancer, etc

mixed incontinence

symptoms of urge and stress incontinence are present, although one type may predominate

bowel incontinence

the inability of the anal sphincter to control the discharge of fecal and gaseous material

how personal habits affect the colon

the need for privacy, the need for convenience, regular habits all affect how someone can eliminate or feel safe and comforted too eliminate gastrocolic reflex = the response to defecate approximately 30 to 60 minutes after meals

urinary diversions

the order of surgically created to drain urine through the abdominal wall a collection device that had here's to the abdomen collects urine draining from the kidney the issues regarding this is skin breakdown at the stomachite, risk for infection, and self-concept alterations

large volume enemas

usually 500 -1000 mL to clean the bowel as much as possible (ex. soapsuds, hypotonic, isotonic)

normal shape of stool

usually about 1 in in diameter and has a tubular shape of the colon but maybe larger or smaller depending on the condition of the colon

toddlers and urinary elimination

2 to 3 years old where they start to begin having a neurological maturity to sense bladder fullness and hold the bladder for 2 hours and hopefully have the ability to communicate the need to urinate

anuria

24-hour urine output is less than 50 ml

normal white blood cell count

3.6-11.6K/ul or 3600-11,600

Which client would the nurse consider having the highest risk for developing a urinary tract infection?

Client with obstructed urinary outflow from a kidney stone

BRAT diet

bananas, rice, applesauce, toast

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

assessing present voiding patterns

abnormal constituents of urine

blood, pus, albumin, glucose, ketone bodies, casts, gross bacteria, and bile

suprapubic catheter

catheter inserted into the bladder through a small abdominal incision above the pubic area

yellow poop

dumping or baby poop

urinary hygiene

frequent hand watching and strict aseptic technique for catheterizations help prevent / control UTIs

diarrhea

frequent passage of loose, watery stools

signs and symptoms of urinary tract infections

pain, frequency, dysuria, hematuria, fever, chills, cloudy / foul smelling urine, flank pain and tenderness, chills, and malaise

dysuria

painful urination

paralytic ileus

paralysis of intestinal peristalsis

how physical activity affects the colon

physical activity promotes peristalsis immobility can lead to the loss of muscle tone, constipation, ileus and bowel obstructions

A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?

Stool specimen for ova and parasites

A young mother asks, "Why can my 3-year-old daughter have a bowel movement on the toilet but she wets her pants?" What is the nurse's best response?

"Bowel control occurs earlier than bladder control."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?

"Tell me about the types of stools your child has been having."

The nurse is educating a client with chronic kidney disease (CKD). What is the recommended daily fluid intake for this client?

A daily fluid intake of 500 to 800 mL/day to maintain hydration

The nurse observes a client's uric acid level of 9.3 mg/dL. When teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest?

A low-purine diet

A nurse is working with a patient to establish a bowel training program. Based on the nurse's understanding of bowel function, the nurse would suggest planning for bowel evacuation at which time?

After breakfast

Which type of pharmacologic therapy does the nurse anticipate administering to a client for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications

One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. To reduce the likelihood of a false-positive result on these tests, what instructions will the nurse provide?

Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 week prior to testing.

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful?

Change diapers promptly, especially after bowel movements. A fever is commonly noted with a UTI. Female urethras are shorter and straighter than males.

The nurse is caring for a child with an ileostomy. What nursing intervention will be included in this child's plan of care?

Check for leakage around the stoma.

If a client with CKD (chronic kidney disease) is developing uremic encephalopathy, the nurse will recognize which manifestations as one of the earliest?

Decreased alertness Diminished awareness

The parent of a 2-year-old toddler tells the nurse she needs to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?

Deficient parental knowledge related to inappropriate method for toilet training

The nurse has completed instilling fluid with a bladder irrigation and does not have a return of the fluid into the catheter bag. What is the next action the nurse should do?

Ensure there are no kinks in the catheter tubing.

The nurse is instructing a 3-year-old's parent regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?

Enuresis

The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which finding does the nurse anticipate?

Excessive urine output

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely?

Fundal height has dropped since the last recording. ****Chapter 11: Maternal Adaptation During Pregnancy - Page 354

A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from:

Gastroesophageal sphincter

A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing?

Metabolic alkalosis

A nurse is caring for a child with celiac disease. How would the nurse evaluate the effectiveness of nutritional therapy?

Monitor the appearance, size, and number of stools.

elimination

excretion of waste products from the kidneys and intestines

A group of students are reviewing the phases of acute renal failure. The students demonstrate understanding of the material when they identify which of the following as occurring during the second phase?

Oliguria (scanty urination

Which can be used for rehydration therapy for diarrheal disorders?

Oral rehydration salts (ORS)

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

Perform meticulous perineal care daily with soap and water

The nurse is analyzing the results of a client's urinalysis. Which finding requires the need for follow-up by the nurse because it is an abnormal result?

Specific gravity 1.034

The nurse is caring for a client with multiple myeloma with Bence Jones proteins. With this "light chain" form of the disease, it is important for the nurse to include assessment for:

Renal disease

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

hypospadias

congenital abnormality in which the male urethral opening is on the undersurface of the penis, instead of at its tip

A client with a neurogenic bladder has a lesion at the level of sacral reflexes/peripheral nerves that innervate the bladder. The nurse anticipates the client will experience which type of bladder dysfunction?

flaccid bladder dysfunction -Flaccid bladder dysfunction: results from lesions at the level of the sacral reflexes or the peripheral nerves that innervate the bladder -Spastic bladder dysfunction: usually results form neurologic lesions located above the level of the sacral micturition reflexes. -Detrusor sphincter dyssynergia: is the presence of lesions that affect the micturation center in the pons or impair communication between he micturition center and spinal cord centers, interrupting the coordinated activity of the detrusor muscle and external sphincter https://quizlet.com/100236317/ch-27-disorders-of-bladder-flash-cards/

The nurse administers bethanechol 25 mg PO to a client as prescribed. What assessment should the nurse prioritize when assessing for therapeutic effects?

urine output and voiding pattern