foundations exam 2

small intestine contraction to move food

peristalsis

bearing down when constipated can cause a drop in heart rate and syncope

valsalva maneuver

psychological variables, pathologic conditions, medications, diagnostic studies, surgery and anesthesia

variables influencing bowel elimination

medication that can turn stool red or black

aspirin and anticoagulants

medication that can turn stool black (normal)

iron salts

medication that can turn stool gray/green (normal)

antibiotics

esophagogastroduodenoscopy, colonoscopy, sigmoidoscopy, wireless capsule endoscopy

direct visualization studies

UGI, small bowel series, barium edema, abdominal ultrasound, MRI, abdominal CT

indirect visualization studies

true or false: always start with the least invasive tests first

true

true or false: kidney and urinary issues can lead to bowel issues

true

what position should someone be put in to facilitate elimination

high fowlers

true or false: nutrition and exercise help facilitate elimination

true

>3 loose stools per day

diarrhea

nursing response to diarrhea

food safety, restore fluid, antidiarrheals

inability of rectal sphincter to control discharge of fecal matter

bowel incontinence

going to the bathroom at a scheduled time every day

bowel/urinary training

placed in rectum and acts as a foley catheter

indwelling rectal tube

bedrest, reduce fluids, depression, CNS disease

risk factors

persistently difficult passage of stool or incomplete passage

constipation

high-fiber diet, encourage fluids, laxatives

managing constipation

why is reflux a concerning symptom of flatulence

gerd can cause esophageal cancer

abdominal pain, distention, vomiting, gerd

concerning symptoms of flatulence

laxative: absorbs water, adds bulk, stimulates peristalsis

bulk-forming (docusate sodium)

laxative: lowers surface tension with lubricant

stool softeners (colace)

laxative: increases intestinal motility

stimulant/irritant (dulcolax)

laxative: draws water into intestines to soften stool

osmotic (magnesium citrate)

laxative: coats stool

lubricant (mineral oil)

laxative: attracts water into stool (through rectum)

hyperosmotic agent (laculose)

laxative: cleanse entire bowel

bowel prep (golytley)

position for a rectal suppository

SIMS

true or false: the digital removal of stool can stimulate the vagus nerve

true

true or false: always prime tubing for an enema

true

enema: tap water

hypotonic - large volume

enema: normal saline

isotonic - large volume

enema: soap solution

hypertonic - small volume

true or false: an ostomy is always permanent

false

type of stool from an ileostomy

liquid

type of stool from an ascending ostomy and transverse ostomy

liquid and form

type of stool from a descending ostomy and sigmoid ostomy

form

how should the skin of an ostomy look

red and moist

tube to decompress stomach

nasogastric tube

how often to irrigate large bore ng tube

every 4 hours

average urine output

150-250mL every 3-4 hours

common cause of AKI

drug overdose

true or false: indwelling catheters should be a last resort

true

true or false: all urinalysis has to be sterile

false - sterile for catheter, non sterile for clean catch

true or false: if you miss any urine sample during a 24 hour specimen collection you have to start over

true

what does alkaline urine indicate

UTI

<50mLs in 24 hours

anuria

painful urination

dysuria

voiding more than usual

frequency

100mL in 24 hours

oliguria

excessive urination

polyuria

pus in urine

pyuria

target fluid intake

1200-3000mL per day

exercises to strengthen pelvic floor (pretend to pee and then stop)

kegel exercises

urinary incontinence: sudden, 6 mos or less, treatable factors

transient

urinary incontinence: coughing, sneezing, laughing (increased abdominal pressure)

stress

urinary incontinence: sudden urge to void (overactive bladder and UTI)

urge

urinary incontinence: stress incontinence and urge incontinence

mixed

urinary incontinence: chronic urine retention

overflow

urinary incontinence: unable to reach toilet

functional

urinary incontinence: empty bladder without feeling the need to void

reflex

urinary incontinence: continuous and unpredictable loss of urine

total

how much urine is left in bladder

post-void residual

true or false: catheter bag should be lower than bladder

true

drains bladder and can be used at home

intermittent urethral catheter

structural issue with urethra with long-term continuous drainage

suprapubic catheter

how to clean catheter

from meatus outward (most clean to least clean)

relieves ureter obstruction

urological stent

filters waste, electrolytes and fluid through a shunt in an artery

hemodialysis

catheter in abdominal wall that utilizes blood vessels to help with dialysis (can be done at home)

peritoneal dialysis

how an individual views and evaluates themselves

self-concept

true or false: self-concept evolves throughout the lifespan

true

the way an individual views their unique qualities; genetic and physical characteristics, intelligence, talent

self-image

true or false: self-image always aligns with reality

false

assessment of a person’s overall level of self-worth and how people feel about themselves

self-esteem

when does self-esteem stabilize

adolescence

“who am i;” composite of all basi facts, qualities, traits, images, and feelings

global self

“who do i desire to be;” developed in childhood

ideal self

emotional need to respond to the needs and ambitions of significant people

false self

ideal self is consistent with life experiences

congruence

ideal self is inconsistent with life experiences

incongruence

individual is able to perceive, understand, control, manage, and evaluate emotions

emotional intelligence

ability to see oneself clearly and objectively through reflection and introspection

self-awareness

true or false: higher self awareness = adaptable and resilient

true

one’s feelings, perceptions, behaviors, and attitudes toward one’s own physical appearance

body image

what age group is most vulnerable to body dissatisfaction

adolescents

a person’s perceived ability to successfully complete a task; determines how individuals feel, think, behave, and motivate themselves

self-efficacy

the learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group

culture

a set of expected behaviors determined by family, culture, and societal norms

role performance

eriksons stage: develop a sense of self and personal identity, ages 12-19

identity v role confusion

eriksons stage: form intimate, stable relationships with others and achieve successful role transition; ages 20-mid 40s

intimacy v isolation

eriksons stage: accept life changes, reassess life goals, create positive changes; ages mid 40s-mid 60s

generativity v stagnation

eriksons stage: reflect on life and feel a sense of fulfillment; ages mid 60s-death

integrity v despair

true or false: identity is fluid

true

stressor affecting self-concept: unclear sense of self; ex: gender dysphoria, end of relationship, change in employment

identity

stressor affecting self-concept: set of assigned or expected behaviors and obligations based on social position or one’s place in the world

role performance

stressor affecting self-concept: societal attitudes about physical attributes and appearance; ex: puberty, aging, chronic illness, weight stigmatization

body image

stressor affecting self-concept: evaluation of self; ex: disability, chronic illness, loss of career, change in finances, feeling irrelevant due to retirement

self-esteem