Fundamentals Exam 2

Peristalsis

moves contents through GI tract and prevents regurgitation

Diarrhea

more frequent, liquid stool, abdominal pain and cramping

Causes of Diarrhea

c. diff, IBD (crohn’s), food poisoning

Constipation

less than 3 bowel movements per week, straining increases intracranial pressure,

Valsalva maneuver

bearing down to pass stool, elevates intraocular pressure

Impaction

loss of appetite, distention, cramping, digital exam

Barium

lower GI series, can contribute to impaction

Flatulence

can be because of bacteria in gut, or swallowed air, documented after surgical procedures, to know if peristalsis is working

Ostomy

surgical opening thats created in GI and urinary tract, classified by location and function

Temporary Ostomy

used to allow lower colors to rest/ heal, 1 or 2 openings

Permenant ostomy

surgical recection due to diseased tissue (cancer or crohn’s)

Stoma

opening in the body referring toa protuberance of mucosa

Colostomy

surgically created when a portion of large intestine or rectum is removed

Sigmoid colon

lower left, most common

Descending

left mid, colon cancer, common

Transverse

across, 1 or 2 openings, semi formed liquid stool

Ascending

right sided, rare

Illeostomy

liquid, frequent, strong odor, digestive enzymes, monitor electrolytes and surrounding skin

Ileoanal pouch

no stoma, color and rectum is removed, internal patch

Kock Pouch

reservoir pouch is created inside body, stoma gets drained with catheter

Factors affecting bowel elimination

diet, physical activity, personal habits, psychological factors, posture, pain, pregnancy, surgery and anesthesia, medications, diagnostic tests

Laboratory Tests For Bowel Elimination

stool culture, fecal occult blood test

Upper Gi diagnostic exams

barium swallow for ulcers and hernias, radiologic study

Lowe GI exams

barium enema-helps to diagnose cancers, can cause impaction

Radiologic study

Endoscopy- NPO 8 hrs before

Fiber-optic endoscope- biopsy, electro signal treatment, photographs

Colonoscopy

Nasogastric Intubation

decompression of the GI tract, administration of medication or enteral feedings, compression of internal hemorrhage, gastric lavage

Normal Urine Characteristics

sterile, free from bacteria, viruses, fungi

contains fluids, salts, waste products

Anuria

failure to produce or excrete urine

Ogliuria

reduced urine volume

Polyuria

excessive volume of urine

Nocturia

Excessive urination at night

Dysuria

painful urination

Hematuria

abnormal presence of RBC in urine, color of the urine does not reflect the degree of blood loss

Stress incontinence

loss of urine control during activity

Urge incontinence

a sudden urge to void, with rapid bladder constriction

Mixed incontinence

a combination of both stress and urge incontinence

Functional incontinence

lack of urine control in the absence of any abnormalities

Overflow incontinence

incomplete bladder emptying resulting in constant dribbling of urine

Temporary incontinence

cause by sever constipation, infection, or medications

Urinary retention

inability to empty the bladder, caused by UT obstruction or neurologic disorder

Specific Gravity Urine Test

balance of water and solutes in urine

pH Urine test

reflects the acidity or alkalinity of urine

Protein Urine Test

occurs with fever, exercise, pregnancy, and diseases

Glucose Urine Test

screen for diabetes, and assess glucose tolerance

Ketones Urine Test

indicate foar has been broken down for energy

Microscopic analysis Urine Test

checked for RBC, WBC, casts, plugs, or crystals

Suspected UTI Labs

nitrates and leukocyte esterase

IV pyelography

x-ray study of kidneys, bladder, ureters, and urethra

used to identify kidney stones, tumors, or infection, measure; urinary tract tumors; or look for damage after injury

Computed Tomography

diagnose kidney stones, bladder stones, or blockages of the UT

Cytoscopy

used to determine the cause of hematuria, dysuria, incontinence, frequency, urgency or retention

Prevention of UTIs

wear cotton lined underwear, avoid tight clothing, drink at least 64 oz a day, urinate when the urge is felt, practice good perineal hygiene, take showers instead of baths

Suprapubic catheters

placed with local or general anesthesia, urine drains from catheter to bag, encourage patients to drink fluids, clean site daily, assess for seepage or infection

External female catheters

collection bag and wall suction

Condom catheters

replace daily, assess for complications, provide hygiene between applications

High Specific Gravity

indicates dehydration

Low High specific gravity

overhydration

High pH

vomiting, kidney disease, UTIs

Low pH

lung disease, uncontrolled diabetes, dehydration

Billirubin present in the urine

liver disease or biliary obstruction

High Glucose

diabetes, liver damage, pregnant women

Ketones in Urine

diabetes, starving

Bethanechol

stimulates cholinergic receptors to contract the bladder

used for urinary retention

Bethanechol side effects

abdominal discomfort, diarrhea, nausea, vomiting, urgency, flushing

Normal Infant urination per day

5-40 times daily

Preschool urination per day

every 2 hrs

Adult urination per day

5-10 times daily

males urination amount

300-500 mLs daily

Females urination amount

250mL

Nurse Practice act

defines the functions and professional responsibilities of nurses

Therapeutic Effect

desired result of action of a medication, in order to achieve the med must be taken into the body, be absorbed and distributed in cells and tissues, and alter physiologic functioning

Medication Order Components

patient’s name, date and time, drug name, dosage, route, administration frequency, and signature of the provider

6 Rights of Medications Administration

right drug, right dose, right route, right patient, right time, right documentation

Sublingual and Buccal Medications

allow rapid absorption of medications, placed under tongue and inside cheek

Topical Medications

designed to be absorbed through the skin for a systemic effect, remove the current patch and clean skin before application, rotate patch sites

3 Medication Checks

1st- getting medication out of drawer

2nd- when you pour med into the cup

3rd- as you put the medication back into the drawer before giving to patient

Now abbreviaton

give as soon as you can, non emergent

STAT

immediately, emergent

On-call

when pt is being picked up for surgery, give medication

Adult otic medication considerations

pull ear back and up

Child otic medication consideration

pull ear back and down

Intradermal administration

given into the dermis, used for local anesthetics, allergy testing, and TB testing

Common Sites for ID

inner forearm, upper arm, scapular area

SUBQ administration

administered into the layer of fat below dermis

SUBQ common sites

abdomen, lateral upper arm, lateral upper thigh, scapular area of the back, upper ventrodorsal gluteal area

IM common sites

ventrogluteal, vastus lateralis, deltoid

IV administration

IVP or bolus medications, IVPB, IV pump

Filter Needle

type of needle used for pulling medications from ampules

IV route

used for existing line or saline lock

Gauge

diameter size of the muscle

IM site used for infants

vastus lateralis

Bevel

needs to face up in injections

Deltoid site

IM site where you can inject up to 1 mL

SUBQ routes

typically used with anticoagulants (heparin and lovenox)

Insulin syringe

orange caps,

Ventrogluteal

preferred IM site for meds with larger volumes, and meds that would irritate skin

Angle of insertion for ID route

10-15 degrees

ID max injection volume

0\.1 mL

SUBQ max injection volume

1mL

IM max injection volume (adult)

vastus lateralis-3 ml

ventrogluteal- 3mL

deltoid- 1 mL

IM max injection volume (child)

6-12 yrs vastus lateralis- 2mL

0-5 yrs vastus lateralis-1 mL

premature infant vastus lateralis- 0.5 mL

Benign Prostatic Hyperplasia

non-malignant enlargement of the prostate gland that decreases the outflow of urine by obstructing the urethra and makes it difficult to urinate