Elimination ATI

Food that increases the risk of diarrhea:

-Alcohol -Caffeinated beverages -Dairy -Foods high in fat/greasy -Spicy foods -Apple peaches pears -Products that contain sweeteners and fructose

Medications that can cause constipation:

-Antacids, Anticholinergics, Antiseizure, Antidepressants -Calcium channel blockers -Diuretics -Iron supplements -Anti-Parkinson -Narcotic

Manifestations of Ulcerative Colitis:

-Diarrhea with blood or pus -Abdominal discomfort -Fatigue -Nausea -Fever -Anemia

What muscles help to support the urethra to prevent accidental urination?

-The urethra -Internal sphincter -Pelvic floor muscles and external sphincter

A nurse is caring for a group of clients who are at risk for an alteration in urinary elimination. Which of the following groups should the nurse identify as being at an increased risk? A. Uncircumcised infants B. School-age children C. Middle Adults D. Older adults E. Young adults

A, B, D Infants prior to age 1 who have not be circumcised are at risk for alterations in urinary elimination. School age children have trouble holding in urine and are at risk for UTIs, and elderly as well.

A nurse is reviewing the medical records of a client who has persistent diarrhea. Which of the following findings should the nurse identify as risk factors? A. History of irritable bowel syndrome B. A shortened urethra C. Cardiovascular disease D. Consumes large amounts of diary in their diet E. Currently taking antibiotics for an infection

A, D, E - A client with IBS is at an increased risk for developing diarrhea - A client with a short urethra would be at risk for developing a UTI - A client with cardiovascular disease is at risk for developing kidney failure - Consuming dairy increases risk for diarrhea and antibiotics as well.

A nurse is providing information to a client about what may happen if their urinary tract infection (UTI) is not treated. Which of the following statements by the client indicates an understanding of the information? A. "I can develop a kidney infection called pyelonephritis" B. "I might have urinary retention" C. "I might become incontinent" D. "I can develop functional incontinence"

A. "I can develop a kidney infection called pyelonephritis" If left untreated, UTIs can turn into kidney infection like pyelonephritis.

A nurse is caring for a female client who has a prescription for a clean catch urine specimen. Which of the following statements by the client demonstrates an understanding of how to provide a urine specimen? A. "I need to wipe from front to back with a sanitary wipe" B. "I should place the urine sample cup in the refrigerator" C. "I will begin the urination process in the specimen cup" D. "I will urinate in the urine tray for the nurse to collect"

A. "I need to wipe from front to back with a sanitary wipe" -During a clean catch patient needs to wipe front to back, urinate small amount first then the rest in the cup to ensure that urine from the bladder with less contaminants is being collected

A nurse is teaching a client about diagnostic urinary testing. Which of the following should the nurse include in the teaching about cystometric testing? A. Cystometric testing measures bladder capacity, pressure, and final capacity when the urge to urinate begins B. Cystometric testing measure speed and volume C. Cystometric testing measures bladder pressure when urinary leakage occurs D. Cystometric testing measures electrical activity of the muscles and nerves of the bladder and sphincters.

A. Cystometric testing measures bladder capacity, pressure, and final capacity when the urge to urinate begins -Uroflowmetry measures urine speed and volume, Leak point pressure measures bladder pressure, Electromyography measures electrical acitvity of the muscles and nerves of the bladder.

A nurse is preparing to collect a urine sample for urinalysis using a reagent strip. The nurse should identify that the reagent strip can detect substances that are consistent with which of the following conditions? A. Diabetes B. Colon cancer C. Pancreatitis D. Pregnancy

A. Diabetes Urine concentration, protein, glucose, ketones, bilirubin, leukocytes, nitrites and blood can also be tested with a urinalysis.

A nurse is planning care for a client who has a new colostomy. Which of the following complications should the nurse plan to monitor for? A. Hernia B. Gastroesophageal reflux C. Crohn's disease D. Ulcerative colitis

A. Hernia -Complications of fecal diversions include hernia, electrolyte imbalance, blockage, prolapse, diarrhea, and infection. Crohns disease and ulcerative colitis can be TREATED by a bowel diversion.

A nurse is planning care for a client who has an order for urinalysis. Which of the following tests should the nurse anticipate being ordered if the presence of white blood cells is detected on urinalysis? A. Urine culture B. Bladder scan C. 24-hour urine D. Stool culture

A. Urine culture Evaluates presence of bacteria and yeast, if a patients WBC are present in urine this can indicate infection.

A nurse is planning care for a client who reports blood in their stool. Which of the following tests should the nurse anticipate in the provider ordering? A. fecal occult blood test B. Stool culture C. Flexible sigmoidoscopy D. Endoscopic retrograde cholangiopancreatography (ERCP)

A. fecal occult blood test -Fecal occult is used to check stool for blood, sigmoidoscopy is to check for polyps, ulcers, or cancer. ERCP is used to diagnose problems associated with pancreatic and ball ducts.

Urostomy

AKA Ileal Conduit, is an ostomy that helps pass urine that uses a small part of the small intestine.

J Pouch

AN internal pouch formed within the ileum

What beverages increase urine production?

Alcohol, caffeinated beverages, coffee, tea

Medications that cause diarrhea:

Antibiotics and magnesium-containing antacids

What can increase a patients risk in developing peptic ulcer disease?

Aspirin or NSAIDS

A nurse is caring for a client who has a prescription or a vitamin K injection. The nurse should identify that Vitamin K is naturally produced in which of the following locations in the body? A. Small intestine B. Large intestine C. Esophagus D. Stomach

B. Large intestine -Bacteria in the large intestine produce vitamin K, a nutrient important for blood clotting and strong bones.

A nurse is caring for a client who reports occasionally having dark, tea-colored urine at home. The nurse identifies that which of the following activities can contribute to this findings? A. Attending a yoga class B. Consuming alcohol C. Drinking 2,000 mL of fluid in a day D. Consuming fish for dinner

B. Consuming alcohol Dark urine can be a sign of dehydration, C would be a good thing, Alcohol and caffeine can increase urine production and cause dehydration.

A nurse is caring for a client who has constipation and requires an enema. Which of the following actions should the nurse take when administering the enema solution? A. Instruct the client to lie on their right side with their left leg pulled up to their chest B. Instruct the client to lie on their left side with their right leg pulled up to their chest C. Instruct the client to lie on their left side with both legs pulled up to their chest. D.Instruct the client to lie on their right side with both legs pulled up to their chest.

B. Instruct the client to lie on their left side with their right leg pulled up to their chest For an enema clients must lie on their left side and place their right leg up to their chest.

A nurse is assessing a client who has an indwelling urinary catheter and determines that the catheter is in place and functioning properly. The nurse should expect which of the following findings? A. Dark yellow, cloudy urine B. Pale yellow, clear urine C. urine with a strong odor D. Urine with a slight red tint

B. Pale yellow, clear urine -This is a normal finding, everything else are unexpected findings that need to be corrected.

A nurse is assessing a client who has stress incontinence. Which of the following findings should the nurse expect with this client? A. Urine leakage prior to reaching the toilet B. Urine leakage following coughing C. urine leakage as a result of nerve damage D. Urine leakage due to not reaching the toilet in time from a physical impairment.

B. Urine leakage following coughing Urinating while coughing, sneezing, and laughing are signs of stress incontinence. A and D are functional and C is reflex incontinence.

A nurse is teaching a client about foods that can irritate the bladder. Which of the following statements by the client indicates an understanding of the teaching? A. "i will still be able to drink chocolate milk" B." I should avoid fruits that are acidic" C. "I will need to switch from regular soda to diet soda" D. "I can still use jalapeño peppers when cooking"

B." I should avoid fruits that are acidic" Chocolate, caffeine, alcohol, acidic foods are all bladder irritants

A nurse is educating a client about a new temporary ileostomy. Which of the following statements by the client indicates an understanding of the teaching? A. "My ileostomy has an internal reservoir that collects waste." B." My ileostomy is allowing my colon time to heal from the surgery." C."My ileostomy must be accessed with a catheter to drain the waste" D."My ileostomy is designed to be a permanent solution"

B." My ileostomy is allowing my colon time to heal from the surgery." Ileostomies can be reversed so are not only permanent. A J Pouch is an internal pouch that collects waste.

A nurse is teaching a newly licenses nurse about urinary retention. Which of the following clients should the nurse include as having an increased risk for this condition? A. A client who has an enlarged uterus B. A client who experiences frequent urinary tract infections C. A client who has an enlarged prostate D. A client who has chronic hypertension

C. A client who has an enlarged prostate -The male prostate wraps around the mouth of the bladder, this can cause the bladder to struggle sending urine through the urethra, causing urinary retention in the bladder.

A nurse is caring for a client with suspected dehydration. For which of the following findings should the nurse monitor for this client? A. Oral temp 97.5 B. Light yellow urine C. Dry mucous membranes D. Diaphoresis

C. Dry mucous membranes -Temp is normal, urine color is expected, diaphoresis is sweating so it would'nt be common for a dehydrated patient. Lack of hydration causes dryness.

A nurse is caring for a client who has constipation. Which of the following diets should the nurse encourage the client to follow? A. Low fat B. High protein C. High fiber D. Low carb

C. High fiber A patient with constipation will need to be on a low fat, low carb, high protein diet.

A nurse is reviewing a client's list of medications and supplements. Which of the following medication classifications increases the risk of constipation? A. Magnesium-containing antacids B. Antibiotics C. Narcotic pain medications D. Beta blockers

C. Narcotic pain medications Calcium channel blockers and medications to treat pain like narcotics can slow gastric motility. Magnesium and antibiotics both increase risk for diarrhea.

A nurse is caring for a client who has a colostomy and does not wear a colostomy pouch. Which of the following actions should the nurse anticipate performing on this client to maintain expected bowel function? A. Administer an enema B. Administe a laxative C. Perform colostomy irrigation D. Insert a rectal tube

C. Perform colostomy irrigation Rectal tube makes no sense because the client is not using the rectum anymore to eliminate. Enemas are also inserted through the clients rectum. A colostomy irrigation helps with bowel training to prevent passage of stool at other times reducing the clients need to wear a pouch.

A nurse is caring for a client who is receiving antibiotic treatment for a urinary tract infection and is experiencing diarrhea. Which of the following should the nurse identify as a potential cause of the diarrhea? A. The antibiotic dose is not correct, and the provider should be alerted B. The antibiotic interferes with the clients ability to absorb nutrients. C. The antibiotic eliminates the healthy gastrointestinal bacteria, allowing harmful bacteria to grow. D. The antibiotic decreases a clients immunity level, resulting in diarrhea.

C. The antibiotic eliminates the healthy gastrointestinal bacteria, allowing harmful bacteria to grow. -GI tract contains bacteria that live naturally to promote health. When antibiotics are needs to treat infection, a side effect may be the loss of healthy bacteria in the GI tract, allowing other bacterias to multiply. causing diarrhea.

A nurse is caring for a client who has a stone in the right ureter that is obstructing the flow of urine. Which of the following urinary diversions should the nurse anticipate the client will need? A. Urostomy B. Continent cutaneous reservoir C. Ureteral stent D. Neobladder

C. Ureteral stent A ureteral stent is used to allow passage of urine when a ureter is blocked from a stone or mass or infection.

A nurse is providing postoperative instructions for a client who had kidney stone removal and placement of a nephrostomy tube. Which of the following statements by the client indicates an understanding of the instructions? A. "This tube will keep my ureters open in case of another stone" B. "This tube will remain permanently because i cant empty my bladder" C. "This tube goes directly into my bladder" D. "This tube is only temporary"

D. "This tube is only temporary" - A nephrostomy tube is inserted directly into the kidney through the back to allow passage of urine when ureters are blocked. It is temporary and usually removed once the kidney has healed.

A nurse is caring for a client who has a history of IBS and reports that their last bowel movement was 5 days ago. The nurse should identify this as which of the following types of altered elimination pattern? A. Encopresis B. Diarrhea C. Fecal incontinence D. Constipation

D. Constipation -Encopresis is bowel incontinence is CHILDREN

A nurse is preparing to insert a nasogastric tube into a client for decompression. Which of the following actions would the nurse perform first? A. Measure the tube from the clients ear to the xiphoid B. Insert the tube while the client takes sips of water C. Connect the NG tube to suction D. Ensure the client is in a sitting position

D. Ensure the client is in a sitting position -This is the FIRST step, then you measure the tube, then you insert, THEN you connect to suction to check placement

A nurse is educating a client who has paraplegia about urinary catheter use. Which of the following catheter types would the nurse include in the teaching to help facilitate urinary elimination for this client? A. Suprapubic catheter B. Indwelling catheter C. Condom catheter D. Intermittent catheter

D. Intermittent catheter Clients with paraplegia will often use intermittent catheters to bladder train to avoid urinary accidents due to paralysis. Condom catheters can be used for these patients at night or when they have a long period without bathroom. Indwelling increases risk of infection, and suprapubic isnt an option

A nurse is caring for an older adult client who is experiencing urinary leakage. Which of the following is an expected age-related change that can contribute to this occurrence? A. reduced blood supply B. Loss of kidney tissue C. Loss of nephrons D. Loss of bladder tone

D. Loss of bladder tone With age, there is a loss of bladder tone which can lead to leakage. Loss of nephron, kidney tissue, and blood supply can lead to reduced amount of urine production.

A nurse is reviewing the primary function of the urinary tract with a group of newly licensed nurses. Which of the following information should the nurse include? A. The urinary tract regulates the production of red blood cells B. The urinary tract produces hormones for blood pressure regulation C. The urinary tract keeps bones strong D. The urinary tract eliminates waste and excess fluid from the body

D. The urinary tract eliminates waste and excess fluid from the body -A B and C are functions, but not the PRIMARY function.

A nurse is evaluating a client's bladder training program. Which of the following statements by the client indicates the bladder training was successful? A. "I am having accidents daily" B. " I am voiding a small amount when i visit the bathroom C. "I continue to visit the bathroom every hour" D." I am experiencing less than one urinary accident per week"

D." I am experiencing less than one urinary accident per week" -This shows that the clients accidents are improving, every other option is showing no improvement.

What color can urine turn after eating aloe or fava beans?

Dark brown

Changes in the digestive system related to aging...

Decreased peristalsis and decreased muscle tone in the bowel.

Nocturnal enuresis is

Nighttime bedwetting

Risk factors for kidney failure:

Diabetes. hypertension, cardiac disease, history

Ulcerative colitis

Disease that causes inflammation and ulcerations of the large intestine or colon.

What categorizes constipation?

Fewer than 3 bowel movements in a week. Slow peristalsis resulting in too much water absorption in the bowels.

Consumption of food like blackberries, beets, and rhubarb may turn urine what color?

Reddish

Old age causes...

Reduced amount of urine production due to loss of kidney tissue and nephrons

IBS

Irritable Bowl Syndrome: describes abdominal pain and changes to bowel elimination that can include diarrhea, constipation, or a mixture of both.

Cystometric test

Measures bladder capacity, or the amount of fluid or pressure inside the bladder as it is filling

Uroflowmetry

Measures urine speed and volume

Drinking a larger amount of fluid may result in...

More urine volume and a clearer color as well as a little odor

Continent urinary diversions=

Neo bladder and a Continent cutaneous reservoir

Ileostomy:

Ostomy created from the terminal end of the small intestine (ileum)

Colostomy:

Ostomy created through the colon -Can be temporary allowing healing and rest for the colon!!!

Functional incontinence:

Physical inability to reach the toilet in time due to a physical impairment.

Alternate functions of the urinary tract:

Regulates levels of electrolytes, the production of red blood cells, helps keep bones strong.

What foods can increase urine production?

Processed meals or snacks which tend to be high in sodium.

Crohns disease

Similar to UC but also commonly affects the SMALL INTESTINE

Cystostomy:

Similar to catheterization but is directly inserted into the bladder and attached to a drainage bag outside the client's abdomen.

Bristol Stool Chart...

Types 1 and 2=constipation Types 3 and 4= ideal stool Types 5 to 7= diarrhea

Reflex incontinence:

Urinary leakage as a result of nerve damage

Ureteroscopy

Uses an optical instrument to view the lining of the ureters and kidneys

Cystoscopy

Uses an optical instrument to view the lining of the urethra and bladder

Bacteria within the large intestine break down any remaining nutrients and produce...

Vitamin K --> a nutrient important for blood clotting and strong bones

Neobladder is

a NEW bladder that is created from a piece of bowel, attached to the ureters and urethra and placed in the pelvis

Kock Pouch

a continent ileostomy system

Continent Cutaneous Reservoir is

similar to neobladder BUT placed in the abdomen rather than the pelvis.

Permanent ileostomies are created when..

the entire colon, including the rectum and anus, must be removed or bypassed

Loss of tone of the bladder can cause...

urinary leakage, urinary incontinence, or urinary retention