Nursing 1; Unit 3 review

how much fluid should a person have per day?

2,000 mL/day (8+ glasses of water)

What is the normal amount voided at 1 time by an adult?

250ml

what are important nursing assessments and interventions for pt.s with urinary incontinence?

Assessments: check to see when the last time they have gone to the bathroom, check their brief to see if wet, and check mental status Interventions:check on them every 2hrs to see if they need to use the bathroom, keep a brief on them to be safe, watch their I&O see if they have something wrong

Stoma with complications

Black around edges, measure correctly for closure no more than 1/8 inch of stoma, change the bag 2-3 days

Anticholinergics

Increase urinary atropine

Diuretics

Increase urine output e.g. Lasix(furosemide), hctz, spironolactone

Polyuria

Large amount of urine formation and excretion of large amounts of urine in the absence of a concurrent increase in fluid intake, more than 200cc in 2hrs e.g. IV or diuretics lassix

how long should it be for a person to void after surgery?

No later than 10hrs to void

What does patency mean?

The state of being freely open

Kegal exercises

can help you prevent or control urinary incontinence and other pelvic floor problems.

void

completely empty.

what complications can occur if barium is not cleared from the GI tract

constipation or fecal impaction

urinary diagnostic test determine UTI

culture & sensitivity

Diuresis

formation and excretion of large amounts of urine

Ureteral stents

helps stones pass along the stint

Bowel Diversions

incontinent ostomy (need to wear appliance pouch), continent ostomy (have control through use of ostomy cap), ileostomy and colostomy are the main procedures, usually creating a stoma

Loop diuretics

inhibit sodium chloride absorption ascends loop of henley need to give K+

Dysuria

painful voiding

Hematuria

presence of blood in urine e.g. amber, cloudy

Valsalva's maneuver

process of bearing down during defecation -Affects vagus nerve creates chest pain may pass out

Arterial venus(AV)

surgical implanted feel it and can hear it

guaiac test

to reveal the presence of blood in feces, also called hemocult why: to see if the person may have a GI bleed or have any rectal bleeding

Nocturia

voiding during normal sleeping hours

list 3 major risks of catheterization

Infection to the bladder, ureters and eventually the kidneys microorganisms can still get into the tube up into the bladder

Characteristics of normal feces

1-2 per day BM Consistency: soft, formed Composed of water, food residue, bacteria, & secretions Color: brown, from bile pigments, foods can affect color. If white or gray absent of bile or taking certain meds. If red or maroon from hemorrhoids. If black or tarry is from pep bismol or a GI bleed. -Make sure to ask about their bowel habits and assess their stools. -Ask the pt. is taking laxatives and how many are they taking

In the US, most children obtain daytime urinary continence by what age?

3-4 years of age

Urinalysis

Analysts of the urine; collection of urine

What helps get bowels moving?

Exercising, peristalsis kicks in sooner

in administering an enema, what position would you place the pt. and why?

Left Sims position, so they are not flexed and you can get a better look to where you need to go

If an NG is connected to function, is it low or high suction and intermittent or continuous? Why?

Low intermittent; reduces the risk of mucosal erosion, low so it does not suction to the stomach wall damaging it

What is a primary cause of abdominal distention, what would you inspect, auscultate and/or palpate upon assessment?

Upon assessment you would see: Inspect - stretched, convex, and rounded abdomen Auscultate - bowel sounds can be present as contents are trying to make there way out of the bowels Palpate- abdomen would be hard

what does the nurse do with pt.s following x-rays with ingestion of barium?

Pre-Op: Completely clean out bowel (laxatives, enemas, and NPO diet) Post-Op: Laxatives post procedure to clear barium (patients may also eat normal diet)

ileostomy

opening in the ileum onto the abdominal skin surface via a stoma; liquid no control

colostomy

opening of a part of the colon onto the abdominal skin surface; semi-solid to formed stool depending on area of colon involved trauma, birth defect, cancer

Paralytic Ileus

temporarily paralyzed, distention can occur

Bacteriuria

the presence of bacteria in the urine, diagnosis of UTI you will need a clean catch of urine

what nursing assessments and interventions are specific to colostomies and ileostomies?

- Stoma assessment and care - client education on placing and replacing appliance bag - assessment and care of skin around stoma - client education on diet, increasing fluids, and increasing vitamins and minerals

How do you determine proper placement of an NG tube?

- auscultate air bolus in LUQ of abdomen - pull back gastric contents and check pH - x-ray confirmation

List 10 things that could lead to altered bowel function

- diet - Medications - Fiber Intake - Pregnancy - Water consumption - Stress - Lack of exercise/activity - Illness - post surgery/general anesthesia - GI diagnostic procedures

Assessment techniques for abdomen

-Inspect: look for masses scars, distention, contour -Auscultate: listen for bowel sounds, note frequency and character (hyperactive, hypoactive), listen to all 4 quadrants. Listen at least 30 secs, 5-15 sounds normal, 15-30 sounds hypoactive, greater than 30 sounds or continuos is hyperactive. Listen 1-2 min in every quadrant. -Percuss: examine by taping the body surface with the fingertips and evaluating the sounds obtained -Palpate: use go the sense of touch to ascertain the size, shape, and configuration of underlying body structures. -Ask?: bowel habits, meds, anxiety, stress

Urinalysis (UA) p.1029

-color, clarity, odor -pH: 4.6-8 -Specific gravity: 1.015-1.025 -Protein: negative to tract -Leukocyte esterase: negative -Nitrites: negative -Ketones: negative -Glucose: Negative if positive may have infection Microscopic analysis -RBC: 0-3 (like to see 0) -WBC: 0-5 (like to see 0) -Bacteria/yeast: none -casts: none -crystals: negative

The Kidneys

Produces 45 gallons of fluid a day -filter blood remove waste products -regulate H2O, acid-base balance -vascular -Nephron: glomerulus and tubule system, functional unit of the kidney 1 million nephrons each kidney -tubular system controls reabsorption to maintain electrolytes buffers acids -glomerulus filters water, electrolytes from plasma -Ureters carry urine to the bladder

How to change a ostomy pouch

1: hand hygiene, don gloves 2: Identify the patient 3: close the curtains or door for privacy 4: place a waterproof pad by stoma site 5: start at the top of the appliance; gently remove old appliance by pushing skin away from appliance. If disposable discard, if reusable set aside for washing. 6: use toilet tissue to remove excess stool. Wash skin thoroughly around stoma with skin cleanser or soap and water. 7: Rinse skin thoroughly and blot dry 8: observe condition of peristomal skin, the stoma, and the sutures. Teach the patient to make these observations daily. 9: cover stoma with gauze while you prepare new appliance. prepare appliance and/or skin barrier; measure stoma using a measurement guide and tract stoma measurement on the adhesive paper backing of appliance or barrier. Cut the opening 1/8 inch larger than tracing. 10:If the stoma is located in an abdominal crease or the skin is irregular use a paste barrier to fill the irregularity 11: apply protectant as needed/desired. Allow protectant to dry completely 12: apply protective skin barrier. A)peel paper backing off water, and center stoma in hole. B) place on abdomen pressing highly over all areas of the barrier to promote adhesion with skin surfaces. C 13: attach drainable pouch to skin barrier, some equipment attaches by means of a plastic flange that snaps in place; other models adhere through self-adherent tape that is exposed after protective paper backing is removed. Tug gently or inspect for secure fit. 14: Fold over bottom edges of pouch and clamp 15: Dispose of old appliance, clean and store any reusable supplies. Wash hands, document observations Flange: this is where you cut out to measure and stick to stoma no more 1/8 inch of stoma

At what age does voluntary control of bowel elimination occur?

22-36 months

how many large volume enemas can be given in succession?

3 enemas can be given, and if no progress then call the doctor.

Urine output of less than _____ cc in 1 hour or ____ cc in 24hrs indicates inadequate blood flow to kidneys.

30ml, 1000ml

how much fluid is administered in a large volume enema?

500-700ml tap water or saline

Which statement is true regarding colostomy irrigation?

A patient has the ability to control output from the colostomy, a colostomy can function adequately with some irrigation

What are the different types of urinary diversions? What are specific nursing assessments and interventions you will need to perform on these pt?

A surgical procedure in which the normal pathway of urine elimination is altered. redirecting urine flow Assessment: palpating the stomach for maybe infection, know pt history and surgical plan, watch for bowel eliminations Interventions: teach the pt and family about the care of urinary diversion, testing the urine pH and note the color, odor

Anuria

Absence of urine; dehydration, shock formation and excretion of less than 100ml of urine in 24hrs

Cystitis

An infection in any part of the urinary system, the kidneys, bladder, or urethra. Wiping incorrectly

BRAT diet

Bananas, rice, applesauce, toast used with pt.s with cause diarrhea, vomiting. Reduces amount of stool, bowels will rest. Problem with it is low in protein and fat, not nutritious

What can pain meds/narcotics do to the BM?

Causes constipation

A bowel movement med would be?

Diluted

when assessing the abdomen what 4 things do you do and in what order? Why?

Inspect, Auscultate, Percussion and then Palpation - Auscultate before percussion and palpation, if you percuss and palpate before listening to bowel sounds you can create false sounds that are not actually there.

Nursing interventions, treatments and prevention for fecal impactions

Intervention: effective yet gentle insertion of the gloved index finger into the pt.s rectum when performing digital examination and manual removal of stool Treatments: manual removal of feces Prevention: drink tons of water, high fiber diet, exercising and creating a regular BM everyday

Ileo anal reservoir

J pouch or kock pouch use these control of evacuation of feces. Section of ileum used to create a pouch and connect to anus frequent watery stools but have control over their BM Kock pouch: portion of ileum stool drained through a stoma with outlet valve

What is a "clean catch" urine sample?

Meaning the urine was not diluted with any other bacteria, it was caught in clean equipment straight out of the body

What do you do if the ileostomy, stoma, stoma, or colostomy becomes white or gray?

Notify the doctor because it is not getting enough blood flow

problems with fecal diversions

Obstructions diarrhea skin irritations changing collection bag

What is the function of kidneys?

Remove waste from the blood to form urine

what is the function of the bladder?

Reservoir for urine until the urge to urinate develops

UTI's

S/S: -hematuria -pyuria -frequency -dysuria -urgency Treatment: -antibiotics -analgesics -pyridium(phenazopyridine hcl) -increase fluids Prevention: increase acidity of urine

colon

The large intestine from ileum to the anus there is the ascending, transverse, descending and sigmoid colon. The colon makes and forms your fecal matter while absorbing the rest of the water in the matter.

what is a nasogastric intubation? what is it used for?

This is a procedure that involves a tube going into your nose going dow into your stomach to suction gasses and juices out used for:to decompress the stomach or remove excessive fluids, remove toxic fluids

Ostomy, stoma, ileostomy and colostomies are created usually when getting...

Ulcerative colitis, crowns disease and other accidents

Urinary problems

Urinary Obstructions: calculi, kidney stones, uric acid magnesium -Diagnosis: intravenous pyelogram(IVP), Kidney ureters bladder(KUB), CT, MRI -Nsg interventions/treatments: strain urine, pain relief, diet modification, increase water intake, look into calcium intake, demerol (med) -Pictures of lithotripter(pulverizes stones by shock waves) & stent -ESWL: extracorporeal shock wave lithotripsy

Clean catch urine

Use a brand new clean hat, Clean the peri area very well with wipes

Normal urine

Volume: 250-400cc the urge/1000-1800cc a day Color: clear; if cloudy or odor they might have UTI Clarity: no sediment present Odor: aromatic Specific gravity: 1.015-.025, if dehydrated it will be higher if over hydrated will be decreased looks like water Acid-Base: pH=4.6-8 If there is a deficit in I&O need to report especially if pt. with CHF

Enemas

Why: constipation/fecal impaction, clean it out Small volume: Hypertonic (low osmotic pressure interstitial tissues, occurs slowly usually defecation will occur before water gets absorbed), "fleets" 120-250ml. Large Volume: Hypotonic (draws water from cells to rectum), Isotonic (draws water into intestine to increase bulk and lubricate the feces), 500-750ml (adults) max is x3, insert tube 2-3 inches. Immediate emptying takes about 10min. -If they have cramping lower the bag so goes in slower, encourage to hold it in as much as possible. -Uses normal saline or tap water. -Left sims position

Crohn's disease

a chronic relapsing inflammatory GI tract disorder, most commonly involving the terminal ileum (80%) non bloody stools Runs in families Treatments:Nonsteroidal anti-Inflammatory drug, Anti-Inflammatory, Steroid, Immunosuppressive drug, Vitamin, and Antibiotics. Bowel resections. taking in dietary fiber, and enemas.

laxative

a food or chemical substance that acts to loosen the bowels and prevent or treat constipation.

endoscopy

a procedure in which an instrument is introduced into the body to give a view of its internal parts.

Midstream

a urine specimen collected after the first few mL of urine are voided and discarded

Stool

aka; feces

Food that may loosen the stool

alcohol beans beer chocolate coffee fried foods prune or grape juice raw fruits and veggies spicy food spinach

Calculi

an abnormal concretion, usually composed of mineral salts, occurring within the body, chiefly in hollow organs or their passages.

Cathartic

an agent that causes catharsis, esp. evacuation of the bowel E.G. cascara sagrada, castor oil

Food that thicken stools

applesauce bananas bread cheese high-fiber foods marshmallows pasta peanut butter rice tapioca

Stoma

artificially created opening of bowel on the abdominal skin surface; fecal mass will pass

stress incontinence

associated with increased intra-abdominal pressure, such as coughing, laughing, sneezing, pregnancy or exertion

Foods that may cause gas

beans beer cabbage-family vegetables carbonated beverages cucumbers dairy products onions radishes

Foods that may cause odor

beans cabbage family cheese eggs fish garlic onions

K+ diuretics

block effects of aldosterone renal tubules cause loss of sodium and water retain need to give K+

occult blood(stool)

blood in the stool may indicate colon cancer or polyps in the colon or rectum — though not all cancers or polyps bleed.

Hemodialysis

blood is pumped from an artery through a dialysis machine AV shunt/fistula: feel a thrill, auscultate a bruit

feces

bodily waste such as food residue, bacteria, epithelium and mucus, discharged from the bowels

Amitriptyline

causes the urine to bluish greenish color, sedative

Food that may block an ileostomy

celery coconut coleslaw mushrooms corn nuts popcorn raisins raw veggies and fruits seeds stringy meats

Ulcerative colitis

chronic relapsing and remitting inflammatory disease of the bowel causing recurrent episodes of diarrhea that is often bloody and accompanied by abdominal pain, incontinence, fever, and weight loss. Runs in families Sigmoid and rectum Treatments:Nonsteroidal anti-Inflammatory drug, Antibiotics, Anti-Inflammatory, Immunosuppressive drug, Steroid, Analgesic, and Dietary supplement. Colostomy, Ileostomy, Colectomy, and Proctocolectomy. IV fluids and enemas.

what do you do if inserting a catheter 750cc comes out right away

clamp catheter so no more urine comes out wait 20min reopen catheter; causes bladder spasms

What nursing interventions would you perform on a pt with a foley catheter?

cleaning the peri area and foley tube every time they have a BM or once before the shift and the end of the shift, check the catheter to see how much they have had out to see if that equivalent to how much they have had in, make sure there are no kinks in the tubing or its not clogged

Stool analysis

collected in bedpan or clean hat if urinated in it can't be used. Looking for parasites, bacteria, bile, blood, and microorganisms.

What does the nurse assess with urine?

color, odor, sediment, blood, and amount

CBC

complete blood count, yields information on platelets, presence or absence of infection, oxygen-carrying capacity; used to diagnose anemias, nutritional deficiencies, and selected metabolic disorders -RBC diff: -WBC diff: -H/H: -Plt: platelet count

Paralytic Ileus

condition in which the bowel is temporarily paralyzed and distention occurs

What happens when you ignore a bowel movement?

constipation

Food that will increase urine acidity

cranberry juice, citrus foods

These 2 lab test on how well the kidneys are functioning

creatine & BUN

Narcotics

decrease glomerular motility rate and bladder fullness eg. morphine, hydrocodone, demerol(meperidine)

Oliguria

decreased scant amount of urine formation and excretion of less than 50cc an hour 500mL of urine in 24 hrs permanent kidney damage might see in diabetes caffeine, alcohol

Peritoneal dialysis

dialysate is infused into the peritoneal cavity by means of a catheter -water, glucose, and electrolytes are transferred from the body to the dialysate (removed)

what is the treatment of choice to promote evacuation of hardened stools?

diet changes, increased water consumption, and stool softeners (start with the least invasive treatments)

hydronephrosis

distention of the renal pelvis as a result of obstruction to urinary outflow

2 classifications affect urine output

diuretics & narcotics

What is an indwelling catheter?

drainage tube that remains inside the body for a prolonged time for unrination

Where does most absorption of nutrients and electrolytes occur?

duodenum and jejunum

Rectal surgery can cause....

edema, discomfort

hemorrhoids

enlarged or varicose veins in the anal canal

flatulence

excessive gas in the stomach and intestines, can cause abdominal distention, discomfort, and cramping Treatment(Nsg interventions): exercise, prevention(foods that cause gas), medications(Gas X) 150cc in GI tract they may be bloated

How does the nurse assess a pt. for urinary retention?

first use a bladder scanner and if their is urine you will need to straight cath. the pt.

X-ray abdomen

flat and upright, flat plate of abdomen. Pain, shadows of fluid, levels of fluid and gas

Complications of enemas

fluid and electrolyte imbalances tissue trauma vagus nerve stimulation Dependence

red urine can be from

food dyes, certain meds

diarrhea

frequent evacuation of watery stools Complications:poor absorption of H2O, nutrients, and electrolytes, dehydration, skin breakdown, causes metabolic acidosis from bicarbonate loss Treatment (nursing interventions): restore fluid and electrolyte imbalances IVF, manage symptoms with meds, explore the cause, maintain skin integrity. When getting stool sample if urine gets in the clean hat with the stool you can not use it.

flatus

gas in the GI tract

what is the care of indwelling catheters?

hand hygiene before and after handling clean gloves empty the drainage bag through the outlet port at the bottom of the bag at least every 8hrs, because if the urine starts to pool it starts to grow microorganisms

Urinary Hesitancy

happens in older men with a enlarged prostate, have trouble dribbling, weak urine stream, and starting urination

Cystoceal

herniation of bladder to vaginal canal causes stress incontinence

what types of foods help prevent constipation?

high fiber foods (raw fruits/vegetables, coffee, fruit juices)

The renal system excretes this to maintain a normal pH

hydrogen ions

Respiratory alkalosis

hyperventilation causes respiratory alkalosis which is present when a High pH is accompanied by a blood carbon dioxide concentration lower than 35 mmHg. Hyperventilation usually is caused by anxiety, fever, pain, high altitude or asthma increased carbon dioxide excretion, leading to a relative excess of blood base and an increase in pH.

When would a straight cath be preformed?

if they start to have urinary retention

Functional incontinence

inability of a normally continent person to reach the toilet in time to avoid unintentional loss of urine e.g. confused, physical limitations, mobility deficits

Urinary retention

inability to empty the bladder of urine has voided, bladder scan to see how much is left called residual bladder can handle2000-3000cc urine, 3 bags of fluids causes from pelvic surgery, trauma, child birth Diagnosis: bulge in control above central pubis over 700cc left in bladder, palpate for distention below belly button, bladder scanner Treatment: surgery, put warm water on there hands, have them sit up or stand, straight catheter, catheter

Hypotension

inadequate blood profusion to the kidney heart isn't beating enough to get blood to kidneys

Pyelonephritis

inflammation of the kidney and renal pelvis, usually due to a bacterial infection that has ascended from the urinary bladder

Ureteritis

inflammation of the ureters

Urethritis

inflammation of the urethra

constipation

infrequent, sometimes painful passages of hard, dry stool Assessment: laxative dependent, straining Treatment/Nsg Interventions: increase fluids if not contraindicated, increased fiber in diet(fresh fruits and veggies), increase activity (after bowel surgery get them up walking ASAP), stool softness, and laxatives/enemas (last resort)

enema

insertion of fluid into the rectum and colon

Urinary incontinence

involuntary loss of urine from the bladder

defecation

involuntary response of the intestinal contraction and anal sphincter relaxation to rectal distention

Nocturnal enuresis

involuntary urinating at night no underline problem, small bladder, UTI treatment: bladder training, meds (detrol), no caffeine, decrease intake in the evening

Enuresis

involuntary voiding with underlying pathophysiologic origin after the age that bladder control is usually achieved; nocturnal enuresis is bedwetting controlled by 4 or 5

do this if catheter is plugged

irrigate

what is a suprapubic catheter?

is a narrow loud tube with a curl at the end that helps prevent the bladder from expelling the catheter

rectal tube

is a short piece of plastic tubing similar to the tubing used for large-volume enemas, may be used if increased activity or medication does not relieve flatulence. Abdominal pain is the predominant adverse consequence of flatulence. This is better to do or give antiflatulence agents then to give pain medications.

Respiratory Acidosis

is indicated by a low pH accompanied by increased arterial concentration of carbon dioxide which is often is clinically defined as a PaCO2 of greater than 45 mmHg.

This part of the GI tract absorbs primary fluid and electrolytes and stores waste products?

large intestine

What is the difference between lavage and gavage?

lavage:washing out of a body cavity, such as the colon or stomach, with water or a medicated solution. Gavage:the administration of food or drugs by force, typically through a tube leading down the throat to the stomach.

Diet in dialysis

low protein, sodium, phosphorus and K+, high carb, fluid restriction

Chemistry diagnostic test

measures electrolytes and lipid levels; also determines creatine and BUN levels to asses the kidney function -BMP: basic metabolic panel -MGA: -CMP: complete metabolic panel -Chem 7: -Chem 12: -BUN: 8-25, if elevated dehydration. ARF, CRF, urinary retention (kidney function test) -Creatine: 0.5-1, measures amount of waste excreted by the kidneys. If elevated the kidneys aren't excreting it (kidney function test)

stool of newborns which is dark-greenish is called?

meconium

Suppository

medication inserted into the rectum or vagina

Cystoscopy

microscopic examination of cells for diagnostic purposes

peristalsis

motility and movement of the intestines

After taking out the foley catheter how long should it take for the person to void?

must void in 8 hrs, 4-6 hrs is ideal

Urinary Diversions

normal pathway interrupted; cancer effects bladder needs removed. Ileal conduit, continent cutaneous reservoir, orthotropic neobladder

Gastric decompression

nutrition lavage; bleeding ulcer -empty stomach contents -rest the bowel -obstruction -post surgical

metabolic acidosis

occurs either when excess acid is ingested or created (diabetic ketoacidosis) or when the kidneys are unable to retain enough bicarbonate ions to buffer free hydrogen ions in the blood. It is characterized by a pH lower than 7.35 and a plasma HCO3- concentration lower than 22 mEq/L.

reflex incontinence

occurs when the bladder muscle contracts and urine leaks (often in large amounts) without any warning or urge. This can happen as a result of damage to the nerves that normally warn the brain that the bladder is filling.no control when when volume is reached E.g. neurological impairment, spinal chord injury

Metabolic alkalosis

occurs when there is excessive loss of body acids or with unusual intake of alkaline substances, it can also occur in conjunction with an ECF deficit or potassium deficit. Vomiting or vigorous nasogastric suction frequently causes metabolic alkalosis.

Glycosuria

or glucosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the bloodstream.

Pyridium

orange urine, asset with pain and spasms urinary anergic

This procedure urine specimen from foley catheter clean urine sample

pinch off tube for 20min, clean port, use sterile syringe to pull back urine

pyuria

presence of pus in urine e.g strong smell, cloudy

Neobladder

pseuobladder created by portion of intestine to create pouch can urinate normally

Diverticulitis

sack like out pouching of mucosa through muscle layer of colon wall effects sigmoid colon, barium enema for test direct visualization of colon NO SEEDS; gets caught in pouching Treatments:Antibiotics, Penicillin antibiotic, and Dietary supplement. IV fluids, clear diet and rest.

hemocult

see Guaiac test Test to show hidden blood, the stool looks black

what are movements that assist with the transportation of waste products through the GI tract called?

segmentation and peristalsis

What is bladder training?

starts with scheduled voiding, pt.s void at scheduled times usually every 2hrs and suppress the urge to void before scheduled times. The interval between voiding is gradually increased to 4hrs. most successful

Urge incontinence

sudden uncontrollable loss of urine, preceded or accompanied by urgency or a sudden compelling desire to urinate that is difficult to delay. Urge incontinence may be associated with overactive bladder or detrusor overactivity. In the rest of this chapter, evaluation and treatment of overactive bladder will included under urge incontinence. e.g. diuretics, UTI, foley catheter taken out

ostomy

surgical opening through abdominal wall into intestine

fecal impaction

the accumulation of hardened feces in the rectum Indicator:passage of small amounts of liquid stool, occurs 3-5 days from not having a BM Treatment: oil retention enema, digital removal, prevention of constipation. It collects in the sigmoid colon After the treatments make sure to document what you did. -Abdominal distention, vomiting, liquid coming out

impaction

the condition of being or process of becoming impacted, especially of feces in the intestine.

rectum

the final section of the large intestine, terminating at the anus.

urolithiasis

the formation of kidney stones

Bowel Incontinence

the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. May be caused by physical, mental, or emotional impairments Treatment(nursing interventions): bowel training (half hour to hour after b-fast start training), prevent skin breakdown, investigate cause(did you eat something different? How long has this been happening?)

The more one urinates the ______ specific gravity

the lower specific gravity.....if one is urinating more it is because of hydration.

chyme

the mixture of partly digested food and digestive secretions found in the stomach and small intestine during digestion of a meal. It is a varicolored, thick, nearly liquid mass.

Urinary Frequency

the need to urinate many times during the day, at night (nocturia), or both but in normal or less-than-normal volumes. Frequency may be accompanied by a sensation of an urgent need to void (urinary urgency). Urinary frequency is distinguished from polyuria, which is urine output of >3 L/day.

Anus

the outlet of the rectum lying in the fold between the buttocks

steatorrhea

the presence of excess fat in feces. Stools may be bulky and difficult to flush, have a pale and oily appearance and can be especially foul-smelling. An oily anal leakage or some level of fecal incontinence may occur.

Urination

the release of urine from the body

Urinary Urgency

the subjective feeling of needing to void immediately e.g weak muscle tone

if the urine is concentrated what will it look like? Would the specific gravity be higher or lower?

the urine will look orange, the specific gravity will be increased

anastomosis

this a big surgery to reconnect after having a colostomy, ileostomy, stoma, and ostomy. They can be permanent by can also be reversed.

Sigmoid colon

this is below the descending colon, going into the rectum

Barium X-rays

upper and lower GI; contrast medium outline bowel, give barium by drinking or enema bowel needs cleansed -pre prep: clear liquid diet, NPO after midnight, take laxative before exam, enema the night before or few hours before procedure, and tell doctor about medications to see if you should stop taking them before the surgery. -Post orders: drink tons of fluids to decrease the chance of becoming constipated, high fiber diet, call doctor if you have not passed gas or BM in a about 2 days, you will need an enema or laxative.

Ileal Conduit

ureters is attached to portion of ileum then brought to surface of abdomen to form a stoma. Urine is drained continuous into a bag applied to skin.

The bladder

urge to void strong when 300-400ml urine in bladder -95% of urine is water -2-3 inch for female bladder from urethra -6-8 inch for a male bladder from the urethra

proteinuria

urinary protein excretion of >150mg/day

24hr creatine clearance

urinate in toilet start collection you keep on ice for 24hrs void 1 more time. Creatine, total urine protein, electrolytes are measured

Micturation

urination

residual urine

urine that remains in the bladder after urination.

Gastric lavage

used for Overdoses, bleeding ulcer, or ruptured esophageal varices Interventions:

Gastric gavage

used to Provides nutrients Interventions:

Direct Visualization

uses endoscope, EGD(esophagogastroduodenoscopy, sigmoidoscopy, colonoscopy Pre prep:Going to be NPO before 8hrs, signed consent, IV fluids, sedations consent Post orders: check for return of gag reflex prior to resuming diet or any fluids etc. Teach Pt/family patient is on NPO until they have a gag reflex (Tickle the back of the throat) conscious sedation need consent. Take a scope look at colons with EGD goes down throat. lay left side easy to see left sims position

What type of enema is used to treat fecal impaction?

warm mineral oil enema

Intravenous Pyelogram (IVP)

when contrast dye is used the procedure is sometimes called a CT intravenous pyelogram. The CT IVP can detect kidney stones, blockage in the urinary tract, and detail of surrounding arteries and veins.

What is micturition reflex?

when needing to urinate signals get sent to the brain to this reflex