B260-Exam 2

1 oz to mL = ?

30 mL

1 kg to lbs = ?

2\.2 lbs

6 rights of medication administration

right patient

right dose

right time

right route

right documentation

right medication

1st check of medication administration

getting med out of drawer

2nd check of medication administration

pouring med or putting med in med cup

3rd check of medication administration

before handing the med to the patient

NPO

nothing put orally

PO

by mouth

STAT

immediately

NOW

as soon as you can (stat is quicker than now)

PRN

as needed

AC

before meals

single order

only given one time

routine orders

given within 2 hours of being written and carried out on schedule

standing order

written in advance and carried out under specific circumstances (kind of like PRN)

desired/have method

D (desired amount) / H (what you have) x V (volume) = dose

HTN

hypertension

ad lib

as desired

FBS

fasting blood sugar

Hgb

hemoglobin

IM

intramuscular

IV

intravenous

IVP

IV push or intravenous push

IVPB

IV piggyback

PC

after meals

VO

verbal order

encorpresis

an abnormal elimination pattern characterized by recurrent soiling or passage of stool at inappropriate times by a child who should have achieved bowel continence

flatus or flatulence

gas in the digestive tract or expulsion of gas from a body orifice usually the anus

borborygmus

high pitched, tinkling, rushing or growling bowel sounds associated with diarrhea or at the onset of a bowl obstruction

ostomy

a surgically formed fistula connected to a portion of the intestinal or urinary tract to the exterior or abdominal wall

constipation

passage of fewer than 3 BM’s / week or difficulty in passing hard, dry stools

fecal incontinence

the loss of voluntary control of fecal or gaseous discharges through the anal sphincter

peristalsis

the wavelike muscular contractions that propel food and digestive products through the digestive tract

defecation

expulsion of feces from the anus and rectum (aka bowel movement “BM”)

fecal impaction

a mass or collection of hardened feces in the folds of the rectum or colon (results from prolonged retention of fecal material)

abnormal defecation patterns include:

diarrhea

incontinence

constipation

impaction

when does flatulence need to be documented?

after surgical procedures

what are factors that affect bowel elimination?

diet and physical activity

psychological factors

personal habits

posture

pain

pregnancy

surgery and anesthesia

mediations

diagnostic testing

health hx for bowel function:

surgeries

illness

family hx

GI tract and abdominal assessment:

IN THIS ORDER:

inspection

auscultation

palpation (ask about tenderness before)

lab tests for bowel function:

stool culture

fecal occult blood test

fecal occult blood test

special diet prescribed 48-72 hours before test

3 small stool samples are took 1 day apart

diagnostic examinations for bowel function

upper GI:

barium swallow

radiologic study

lower GI:

barium enema

radiologic study

others:

colonoscopy

endoscopy

supporting diagnosis for constipation:

narcotic pain med use

poor fluid intake

no stools for a few days

HYPOactive bowel sounds

firm and tender abdomen

supporting data for diarrhea:

soft abdomen

HYPERactive bowel sounds

reports of diarrhea

cramping increases after eating

nausea

belching

anorexia

loss of 5 lbs recently

liquid/mucousy stool

factors that affect urinary elimination:

age

medications

immobility

physchological factors

developmental factors

food and fluid intake

muscle tone

surgical and diagnostic procedures

pathologic conditions

UTIs

urinary diversion

importance of elimination:

cleans your system and keeps you comfortable

what types of medications can affect elimination?

opioids (constipation)

diuretics (increase urinary frequency)

urinary incontinence

involuntary urination

symptom not a disease

impaired bladder control

urinary retention

inability to empty bladder completely

what type of people are more at risk for urinary retention

men with benign prostate hyperplasia

chronic urinary retention

constant small residual volume of urine

acute urinary retention

sudden, painful, inability to void full bladder

what can cause urinary retention?

obstruction (mass, cancer, fecal impaction, vaginal prolapse)

infection (UTI)

neurological (spinal cord trauma, multiple sclerosis)

medications (opioids, NSAIDs, anti depressants)

reflex incontinence

inability to sense full bladder or initiate voiding

urge incontinence

loss of urine associated with strong urge to void

functional incontinence

loss of urine associated with physical impairments

stress incontinence

loss of small amount of urine when sneezing or coughing

overflow incontinence

loss of urine with an over distended bladder

bethahechol (urecholine) - used for urinary retention

MOA: stimulates cholinergic receptors

therapeutic results: contraction of urinary bladder

side effects: abdominal discomfort, diarrhea, nausea, vomiting, urgency, flushing

nursing considerations: monitor I&O’s, palpate abdomen for bladder distention

normal urinary elimination for infants:

5-40 times / day

normal urinary elimination for preschool age children:

possibly every 2 hours

normal urinary elimination for adults:

5-10 times a day

normal urinary elimination amount for males:

300-500 mL / time

normal urinary elimination amount for females:

around 250 mL each time

what should average urinary output be / hr and why?

approximately 30 mL / hr

why: want more than 30 mL / hr because 30 is the lowest you want it to be

what are the three steps in the kidneys?

filtration

reabsorption

secretion

what do ureters do?

carry urine to the bladder

what does the urethra do?

transports urine away from bladder for elimination

anuria

failure to produce or excrete urine

oliguria

reduced urine volume

polyuria

excessive volume of urine

nocturia

excessive urination at night

dysuria

painful urniation

hematuria

red blood cells in the urine

what is a frequent complain of pt’s with kidney disorders?

fatigue

frequent urination and a burning sensations are symptoms of?

UTI

specific gravity

balance of water and solutes in urine

pH

reflects the acidity of urine

protein

occurs with fever, exercise, pregnancy, diseases

glucose

screen for diabetes and assess glucose tolerance

ketones

indicates fat has been broken down for energy

supporting data for impaired urination:

microorganisms in the UT

urgency

frequency

reports of burning with urination

supporting data for urinary retention

absent urinary output

lower abdominal distention

residual urine evident on bladder scan

what do Kegel exercises strengthen?

pelvic floor muscles

on-call med

before pt leaves for procedure

routine med

everyday, scheduled, set time

routes meds can be administered

sublingual

oral

topical

nasal

respiratory

eyedrops

vaginal

rectal

what are the parts of a medication order?

licensed provider signature

patient name

date and time

drug name

dose and route of med

oral routes include:

PO, NG, OG, NJ, OJ, Gtube

things to check when giving oral meds:

if patient is able to swallow

HOB must be up

give meds with enough fluid

do not leave meds at bedside

do not leave meds unattended

properly poor meds into med cups

ensure client takes all meds

topical meds include:

transdermal patches

ointments

creams

lotions

things to know when giving nasal sprays:

use as directed

sniff in as spraying

press other nare close as taking med

be careful not to spray in face or eye

blow nose before using med

try not to blow nose after taking med

types of respiratory inhalations:

nebulizer (faster onset)

MDI

dry powder

things to know when giving eye drop medications:

must be sterile

if blink drop out-repeat

be sure to put in correct eye

wait 30 seconds in between

pressure on tear drop to prevent med from systemically spreading

how to give ear drops to an adult

pull ear back and up

how to give ear drops for a child

pull ear back and down for child under 3 years

what is the intradermal route mainly used for?

typically used for allergy and TB testing

what is the intravenous route mainly used for?

used for existing line or saline lock

gauge

the diameter size of a needle