Unit 4 Review Questions (Key Terms/ Objectives)
______ is the process of regulating the pH, bicarbonate concentration, and partial pressure of carbon dioxide of body fluids.
Acid-base balance
What is defined by: A process in which molecules move against the concertation gradient. External energy is needed for this process.
Active transport
Which are variables that affect elimination? a. pathologic conditions b. fluid and food intake c. medications d. activity/lifestyle
All of the above
There are many terms associated with impaired urinary elimination including the absence of urine which is termed as:
Anuria
A bowel movement of hard, dry, formed stool can be associated with which condition? a. bowel incontinence b. constipation c. diarrhea d. fecal impaction
B
A child is admitted with possible fluid and electrolyte overload. What do you check first? a. skin turgor b. lung sounds c. urine output d. mucus membranes
B
Alkalosis is: a. determined by the base excess in the body b. caused by loss of too much acid or retention of too much base c. caused by loss of too much base d. determined by the pH alone
B
As the nurse is conducting the discharge assessment, the two day old neonate expel a large amount of meconium. Which would the nurse conclude regarding this occurrence? a. It is the precursor of newborn diarrhea. b. It is a common finding in a two day old neonate. c. It is a pathological condition of the digestive system. d. It reflects immaturity of the autonomic nervous system.
B
Continuing and restorative care of a patient with bowel elimination problems includes: a. nasogastric tube replacement b. bowel training c. enema administration d. colorectal cancer screening
B
How many days of excessive loose stool would be classified as persistent diarrhea? a. 7 days b. 14 days c. 21 days d. 28 days
B
The following statement is which step of the nursing process? Patient will have one soft bowel movement per day a. assessment b. planning c. diagnosis d. evaluation
B
The nurse documents that a child lacks physical readiness for toilet draining. Which assessment findings supports the nurses conclusion? a. The child wets two diapers per day. b. The child stays dry for one hour during the day c. The child behaves impatiently with soiled diapers. d. The child sits on the toilet for six minutes without fussing.
B
What is the term used for difficulty controlling urination? a. nocturia b. dysuria c. urinary retention d. impaction
B
Which intervention would the nurse implement when providing care for an older adult male client who is immobile and incontinent of urine? a. Restricted clients fluid intake. b. Regularly offer the client a urinal. c. Apply incontinence pants. d. Insert an indwelling urinary catheter.
B
which sign or symptom would the nurse expect when assessing a client with type one diabetes who is experiencing hypoglycemia? Select all that apply. a. Vomiting b. Headache c. Tachycardia d. Cool, clammy skin e. Increased respirations
B, C, D
A client arrives in the emergency department with epigastric pain and prolonged vomiting. Assessment findings include rapid and shallow, respirations, dry and flushed skin, weakness, and lethargy. Which is a primary nursing concern? a. Acute pain. b. Risk for injury. c. Metabolic alkalosis. d. And effective breathing.
C
Approximately how much urine can the bladder hold? a. 100-300 mL b. 500-700 mL c. 300-500 mL d. 700-900mL
C
The first sign of hypovolemia (decreased volume of circulating blood) is: a. decreasing blood pressure b. nausea and vomiting c. rapid weak pulsed d. thirst
D
The passing of a bowel movement is: a. Incontinence b. Impaction c. Urination d. Defecation
D
What foods should the nurse tell the patient who has lowered potassium to eat? a. milk products and green leafy vegetables b. canned vegetables and pork products c. nuts and whole grains d. OJ and bananas
D
Which food would not promote bowel elimination? a. apple b. wheat bread c. broccoli d. pizza
D
The body is composed of 30-45% of water. TRUE OR FALSE
FALSE
What is defined by: Involves the use of a protein carrier in the cell membrane. The protein carrier combines with a molecule, especially one too large to pass easily through the cell membrane and helps move the molecule across the membrane from an area of high to low concentration.
Facilitated diffusion
Describe the scope of glucose regulation
Hypoglycemia ---->Euglycemia---->Hyperglycemia
Loss of control of urine, feces, or both is what?
Incontinence
______ refers to the loss of control of either urine or bowel elimination.
Incontinence
What are the most important age-related differences to consider in regard to nutrition?
Infants, children, older adults also: pregnant and breast feeding moms (think: before conception, during pregnancy, during lactation)
Define: Intracellular
Inside the cell- 70% of body fluids
What does insulin do?
It makes the liver convert glucose into glycogen. This causes blood glucose levels to decrease. After eating carbohydrates, insulin will lower blood glucose levels and it is the only hormone that does so.
Describe the scope of nutrition
Malnutrition--> Insufficient Nutrition--> Optimal Nutrition Status--> Excess Nutrition--> Malnutrition
The nurse is caring for a client with the following ABG values PO2 : 89 MMHG PCO2: 35MMHG PH: 7.37 These findings indicate that the client is experiencing which condition?
Normal acid base balance Rationale: all data are expected limits PO2 is 80-100 PCO2 is 35-45 PH is 7.35-7.45
What refers to the "science of optimal cellular metabolism and its impact on health and disease"
Nutrition
What is defined by: The process of water movement through a semipermeable membrane from an area of low solute concentration to an area of high solute concentration?
Osmosis
Define: Extracellular
Outside the cell - 30% of body fluids
Which body fluid does intravascular refer to?
Plasma
Education on healthy eating (American dietary guidelines and MyPlate) are _____prevention interventions:
Primary
What kind of glucose problem preventions are the following? Emphasis on healthy lifestyle behaviors, balanced diet, exercise regularly, weight control
Primary
What are electrolytes?
Substances that release ions in water sodium, potassium, chloride
What are secondary preventions for irregular blood glucose? (screenings)
Testing for gestational diabetes (pregnancy) Hemoglobin labs A1c blood pressure screening lipid analysis, cholesterol levels microalbuminuria screening Dental, foot, and eye examinations, thyroid function monitoring. Education about glucose regulation.
Describe the process of absorption
The duodenum (upper intestine): the primary site for absorbing trace minerals The jejunum, (middle): the primary site for absorbing water-soluble vitamins and proteins The ileum (lower): the site of fat and fat-soluble vitamin absorption The colon: where water is primarily absorbed.
What are the principle organs of the urinary system?
The kidneys
What is defecation?
The process of passing a bowel movement
The term ________ refers to the purposeful control of urinary or fecal elimination.
continence
What is defined as: "The process of regulating the extracellular fluid volume, body fluid osmolality, and plasma concentrations of electrolytes"
fluid and electrolytes regulation
Define: Interstitial
fluid between cells
What are the counter-regulatory hormones?
glucagon, epinephrine, norepinephrine, growth hormone, cortisol hormones that counteract the actions of another (aka stress hormones)
What is hyperglycemia?
high blood glucose levels
Describe what factors effects urinary/bowel continence and retention for pregnant women
increased pressure is placed on the bladder, and frequent urination is required the fetus can also interfere with intestinal peristalsis and cause constipation prenatal vitamins with iron can also contribute to constipation.
What is the skin turgor test?
it's a test for dehydration. Pull on the skin and see how long it takes to come back.
What is hypoglycemia?
low blood glucose levels
What are the basic therapeutic diets?
low salt low fat calorie reduction consumption of fiber
What does polyuria mean?
multiple episodes of urination, as with diabetes
What are anions?
negatively charged ions (gain electrons)
Define: Euglycemia
normal blood sugar level 70-140 mg/dL
What does the NSI address? (Nutrition Screening Initiative)
nutritional concerns associated with chronic diseases that are frequently seen in older adults. The NSI requires collection and evaluation of data in four areas: clinical, dietary, body composition, and biochemical.
LPNs cannot do which of the following? a. administer oral, subQ, and IM meds b. start a peripheral IV line c. start a blood transfusion or TPN d. gather data and report findings
C
The movement of molecules from an area of high concentration to low concentration is a. hypovolemia b. osmosis c. diffusion d. hypervolemia
C
What is the baby's 1st bowel movement called? a. colostrum b. nuchal c. meconium d. placenta
C
Which action would the nurse take for an older adult client with Alzheimer's disease who has intermittent episodes of urinary incontinence? a. Points out the behavior to the client. b. Obtain incontinence pads for the client c. Take the client to the bathroom at regular intervals. d. Encourage the client to call for help when there is an urge to urinate.
C
Which action would the nurse take on a client with type one diabetes, reports, hunger, thirst, tiredness, and frequent urination? a. Administer prescribed insulin. b. Notify the healthcare provider immediately. c. Determine the clients blood glucose level. d. Provide a peanut butter and graham cracker snack.
C
Which urinary related task will the nurse assign to the UAP? a. inserting a foley catheter b. interpreting a bladder scan result c. obtaining an midstream urine specimen d. irrigating a catheter after prostate surgery
C
For a client admitted with metabolic acidosis, which two body systems with the nurse assess for compensatory changes? a. Skeletal and nervous. b. Circulatory and urinary. c. Respiratory and urinary. d. Muscular and endocrine.
C Rationale: increased, respirations blow off carbon dioxide, which decreases the hydrogen ion concentration, and the pH increases. Decreased respirations result in CO2 buildup, which increases hydrogen concentration, and the pH falls. The kidneys, either conserve or excrete, bicarbonate and hydrogen ions, which help adjust the bodies pH.
Which blood gas report most likely reflects the acid, based balance of an infant with severe dehydration? a. PH of 7.50 and PCO2 of 34 b. PH 7.23 and PCO2 of 70. c. PH of 7.20 and HCO3 of 20 d. PH of 7.56 and HCO3 of 30
C rationale: low blood, pH, and bicarbonate levels, indicate metabolic acidosis, which occurs with severe dehydration, because the reduced urine output causes retention of hydrogen ions
Describe what factors effects urinary/bowel continence and retention for infants and children
They initially lack control over the sphincters and muscles that control urination and bowel elimination.
What makes up the lower urinary system?
Urinary bladder (stores urine) Urethra (urine leaves the body)
What term is described as the process of expelling urine (the passage of urine through the urinary tract by means of the urinary sphincter and urethra.)
Urinary elimination i.e. micturition or urination
What term means: multiple episodes of urination with little urine produced in a short period of time
Urinary frequency
What term means: the urge to urinate exists, but the person has difficulty starting the urine stream
Urinary hesitancy
Give examples of how ethnicity/race influences nutrition disease and deficiencies:
Vitamin D deficiency is more frequently found among Hispanics and Americans of African heritage than those of European heritage. Type 2 diabetes also seems to affect Hispanic, Native American, and African Americans in higher percentages than Europeans. Diseases more common in European heritage include type 1 diabetes, celiac disease, and neurodegenerative disorders such as Huntington disease and multiple sclerosis
Describe the scope of elimination:
Waste formation-----> waste excretion
What is the MNA? (mini nutritional assessment)
a simple and quick method of identifying individuals with nutritional risk or with malnutrition.
Define buffer
a substance that can maintain the pH of a solution at a relatively constant point
Define: voiding
another term for urination
What is the ultimate end result of glucose metabolism?
cellular use of glucose for energy (adenosine triphosphate [ATP]) synthesis
Which goal would the nurse identify for a toddler with dehydration caused by diarrhea? a. Improvement of fluid balance. b. Continuation of an anti-diarrheal diet. c. Administration of antimicrobial treatments. d. Retention of weight appropriate for height.
A
Assessment of bowel elimination includes which of the following? a. auscultating the 4 quadrants of the abdomen for bowel sounds b. percussing the lower back for flank pain c. palpating the suprapubic region for baldder distention d. inspecting the perineal area for females only
A
What are the primary functions of the kidneys (urinary system)?
-Regulate volume and composition of extracellular fluid (ECF) -Excrete waste products from the body -Control BP -Make erythropoietin -Activate vitamin D -Regulate acid-base balance
Changes in fluid and electrolytes can cause a. changes in the pH of body fluids b. respiratory distress c. fevers d. pain
A
Ongoing assessment of nutritional and elimination needs would include: a. I&O record, food preference chart b. Physical observations, cognitive assessment c. Catheter, IV fluids, enema d. Toileting regime, special diets
A
Which could be the cause of constipation? a. immobility b. vigorous activity c. over the counter pain relievers d. high fiber diet
A
Describe the process of digestion
1. Chew, swallow 2. Mechanical breakdown in the mouth 3. Chemically split into small molecules (saliva/amylase) 4. Breakdown into long-chain organic compounds (gastric enzymes in the stomach) (proteins into amino acids and carbohydrates into simple sugars) 5. Absorption into the blood and lymph system 6. Nutrients are transported to the liver for storage and/or removal 7. Nutrients returned to the blood. Undigested products are eliminated
What makes up the upper urinary system?
2 kidneys (form urine) 2 ureters (drains urine)
An appropriate age to toilet train a child is:
24-36 months
What is the minimum mL/hour an adult must produce of urine for adequate renal function?
30 mL/ hour
The bladder holds approximately ______-______mL before pressure increases to signal the need to void
300-500mL
What are normal blood glucose levels?
70-140 mg/dL
Which is the first action of the nurse when a parent expresses concern about a child's diet? a. Perform a nutritional assessment. b. Provider referral for a nutritionist. c. Encourage the parent to decrease juice intake. d. Speak to the provider about ordering blood tests.
A
Which of the following assessment findings would indicate increased bowel mobility? a. hyperactive bowel sounds b. IBS c. diarrhea d. hypoactive bowel sounds
A
Which of the following is a nursing intervention for a patient with urge incontinence? a. teaching a patient Kegel excersices b. instruct the patient to hold urine for as long as possible c. insertion of a Foley catheter d. admit to urology ICU
A
A client is taught how to recognize science of a hypoglycemic reaction. Which symptoms identified by the client indicate to the nurse that the teaching was effective? Select all that apply. a. Fatigue b. Nausea c. Weakness. d. Nervousness. e. Increased thirst. f. Increased perspiration.
A C D F
Which clinical finding is commonly associated with hyperglycemia? Select all that apply. a. Polyuria. b. Polydipsia. c. Polyphagia. d. Polyphrasia e. Polydysplasia
A, B, C
Which feelings will help promote regular bowel habits? Select all that apply a. privacy b. anxiousness c. comfort d. hunger
A, C
The nurse provides education related to manifestations of hyperglycemia to a client with type one diabetes. Which signs and symptoms, identified by the client indicate that the teaching was effective? Select all that apply. a. Thirst b. Headache. c. Nervous d. Fruity breath odor. e. Excessive urination.
A, D, E
Which information must be clearly described in the MAR before administering a medication? select all that apply a. Dosage and route b. Clients full name. c. Time to be administered. d. Frequency of administration. e. Full name of prescribed medication.
ALL
A parent tells the clinic nurse that their six-year-old child has been wetting the bed for the past three weeks. Previously there had been no problems. How would the nurse respond? a. Try to eliminate fluids after dinner. b. Children sometimes wet the bed when they are angry. c. You did the right thing to bring your child in to be examined. d. Your child every few hours at night to go to the bathroom.
C
What is taking place when villi that line the intestinal tract absorb nutrients into capillaries to be transported by the vascular system?
Absorption
During auscultation, 2 soft, low-pitched gurgles are heard over 5 minutes. This finding would be documented as: a. absent bowel sounds b. normal bowel sounds c. hypoactive bowel sounds d. hyperactive bowel sounds
C
What is BMI?
Body Mass Index; a measure of body weight relative to height BMI calculated by weight in pounds/height in inches/height in inches × 703
What term is described as: the process of expelling stool (also referred to as feces) (passage of stool through the intestinal tract by means of smooth muscle contractions)
Bowel elimination i.e. defecation, defecate, or bowel movement
__________ includes the hormonal and enzymatic processes that occur within cell structures that allow proteins, carbohydrates, or fats to be used for energy or made into new products or tissues"
Cellular metabolism
Which body fluid does transcellular refer to?
Cerebrospinal, GI tract fluids, joint space fluid, pleural, peritoneal, intraocular, and pericardial fluid
What are seconadary prevention methods related to elimination?
Colonoscopy Occult blood screening Prostate cancer screening Urinalysis
A measure that represents the acidity or alkalinity of a solution a. acid b. base c. bicarbonate d. pH
D
Passing of urine or urination: a. enuresis b. incontinence c. nocturia d. micturation
D
Which intervention would the nurse use for a bedridden client with multiple chronic illnesses, who is usually continent, but has started to express anger through urinary incontinence? a. Offer the client a bed pan every two hours. b. Encourage the client to watch more TV. c. Decrease the client fluid intake in the evening. d. Involve a client in setting realistic short-term goals.
D
Which is an appropriate teaching goal for a client who is newly diagnosed as having type two diabetes? a. To perform footcare weekly. b. To administer insulin as prescribed. c. To test urine for both sugar and acetone d. To identify symptoms of hypoglycemia or hyperglycemia.
D
Which of the following individuals may be the least likely to report an accurate bowel movement? a. a healthy teenager b. an alert and oriented older adult c. a middle aged adult male d. a cognitively impaired female
D
Which response would a nurse give to the daughter of an 80-year-old client admitted to the hospital with severe dehydration, who asked how her mother could have become dehydrated? a. The body's fluid needs decrease with age because of tissue changes. b. Access to fluid may be insufficient to meet the daily needs of the older adult. c. Memory declines with age, and the older adult may forget to ingest adequate amounts of fluid d. The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased.
D
What is being defined by" "is the process of mechanical and chemical breakdown of food matter and complex macronutrients"
Digestion
______ is the process of moving fluid and electrolytes between the various body fluid compartments. These fluid compartments include those inside the cells (holding intracellular fluid) and those outside the cells (holding extracellular fluid).
Distribution
What term means painful urination?
Dysuria
Broadly speaking, the term ___________ refers to the removal, clearance, or separation of matter. From a human physiological perspective: excretion of waste products.
Elimination
Excretion of waste from the body is what?
Elimination
The process by which the colon eliminates large food particles and undigested fibers since they are not absorbed defines:
Elimination
Describe the scope of fluid and electrolyte regulation: (hint: 3 scopes)
Extracellular fluid: ECV deficit-->optimal-->ECV Excess Body fluid osmolality: Too dilute (som <280 mosmol/kg)--> optimal (osm 280-300 mosmol/kg)--> too concentrated (osm >300) Electrolyte balance Hypo--->optimal--->hyper
Performing central line maintenance can be delegated to a CNA? true or false
FALSE
What are the ranged for BMI? normal excessive nutrition starvation obestiy
For adults, overweight is described as a BMI between 25.0 and 29.9 The state of being underweight is described as a body mass index (BMI) less than 18.5 Three classes of obesity are class I (BMI of 30 to 34.9), class II (BMI of 35 to 39.9), and class III (BMI >40) children: A child whose BMI is between the 85th and 95th percentile for children of the same age and sex is classified as overweight; obesity is defined as a BMI greater than the 95th percentile.
_______ is the process of maintaining optimal blood glucose levels
Glucose regulation
What are primary prevention methods related to elimination?
Hydration, proper fiber intake, regular elimination (toileting practice), exercise regularly, avoiding environmental contaminations
What glucose levels indicate hyperglycemia (including severe reading range)?
Hyper: > 140mg/dL Severe: > 180 mg/dL
What glucose levels indicate hypoglycemia (including severe reading range)?
Hypo: < 70 mg/dL Severe: < 50 mg/dL
What are some glucose regulation laboratory tests?
o Blood glucose level test o Antibody testing o Lipid analysis o Renal function tests o C-Reactive protein test
Diagnostic tests related to nutrition are:
o serum albumin o pre-albumin o C-reactive protein o blood glucose o hemoglobin A1c o lipid profile o electrolytes o hemoglobin and hematocrit
The primary mechanisms causing retention are usually associated with:
obstructions, inflammation, or ineffective neuromuscular activation within the bladder or the gastrointestinal tract.
The intake of food via the mouth is ____ intake
oral
Define alkalosis
pH above 7.45 accumulation of base or loss of acid
Define acidosis
pH below 7.35 an excessively acid condition of the body fluids or tissues
How many liters do the following make up of body fluid compartments> Plasma Interstitial Intracellular
plasma: 3L interstitial: 10L intracellular: 28L
List symptoms of hyperglycemia
polyuria (abnormally large volumes of urine) polydipsia (abnormally great thirst) dehydration fatigue fruity odor to the breath Kussmaul breathing (rapid, deep) weight loss hunger poor wound healing
What are cations?
positively charged ions
List symptoms of hypoglycemia
reduced cognition tremors diaphoresis weakness hunger headache irritability seizure
What is retention?
refers to the unintentional retention of urine or stool- inability to empty urine: incomplete or complete inability bowel: unable to pass stool successfully from the rectum.
Describe what factors effects urinary/bowel continence and retention for older adults
renal blood flow reduces to an estimated 600 mL/min, and the kidneys lose up to 50% of functioning nephrons urethra muscle weakness, decreased volume of urine to be held atrophy of smooth muscle layers in the colon reduced tone of the external sphincter and neural impulses
What are buffers?
substances that minimize changes in pH ( H+ and OH-) weak acids or bases that can react with strong acids or bases to prevent sharp, sudden changes in pH
What does the counterregulatory hormone glucagon do?
suppresses insulin and stimulates the production of glucose subsequently increasing blood glucose levels.
Define osmolality
the # of solute particles dissolved in 1 kilogram of water; reflects the solution's ability to cause osmosis.
What is glycogenolysis?
the breakdown of glycogen to glucose.
Define pH
the concentration of hydrogen ions in a solution normal 7.34-7.45
What is glycogen?
the major form of stored glucose, primarily in the liver and muscle cells
What is gluconeogenesis?
the process of producing glucose from non-carbohydrate sources (e.g., proteins and fats).
What are secondary prevention methods for acid-base balance?
there are not any!
Which 2 systems are involved in elimination?
urinary system and the gastrointestinal system
What is meant by micturition?
urinating
The Mini Nutritional Assessment (MNA) and Nutrition Screening Initiative (NSI) were developed primarily for ____.
use with elderly clients.
What are physical examination findings in regard to glucose regulation?
vital signs, BMI, waist-to-hip ratio Rationale: assess for hypertension, obesity, and central obesity. (*remember to always assess skin)