Foundations Exam 2

What muscle determines if urine is stored or eliminated

detruser

Define Anuria

kidney injury, less than 50ml a day

Define Bacteriuria

Bacteria in urine

Define dysuria

Difficult or painful urination

Define Enuresis

Involuntary voiding during sleep

Define hematuria

RBC inurine

Define Nocturia

waking during the night to urinate

Define Olgiguria

less urine output

Define polyuria

inc output of urine

4 Main diagnostic studies Urine

lab, imaging, scans, interventional

What test gives the GFR

Bun to creatinine ratio

What is the most accurate kidney function test

24hr creatinine clearance

What is critical to instruct patients with a UTI for a urine sample

midstream clean catch

3 types of urinalysis

complete, dipstick, 24hr urine

What on observation be telling (diagnostic wise) about urine

color

What to instruct patients to do for a 24 hr urine collection, 3

Start after the 1st morning pee, store in fridge, go to after next morning first pee

What should you tell a patient who missed 1 void in a 24 hour urine collection

start over

Urine culture vs sensativity

culture, what is causing it, sensitivity what medications to use to treat

What is used to determine type of drug prescribed form a urine sensativity

mic

4 diagnostic imaging for a kidney issue

x-ray, ultrasound, CT, MRI

What is a bladder scan, who does, and what does it evaluate

Non invasive measure of urine volume, done by a rn, assesses function

4 key considerations when giving a patient contrast dye

nephrotoxic, hydration before and after, shelfish allergy, not for pregnant women

3 Nursing consideration for post nuclear medicine scan

encourage fluids to promote excretion, urinate on own, ensure handwashing

What is a renal angiogram used to assess

vasular kidney issues

Nursing considerations after renal angiogram

lie flat after, pressure dressing

What is a cytoscopy, what used for

scope to visualize, bladder wall issues and obstructions

3 Nursing considerations pre-op cytoscopy

NPO, laxative, instruct about pain

3 Nursing considerations post-op cytoscopy

local trauma in men, monitor for bleeding and infection, asses urinary function

What is a renal biopsy used to assess

renal diseases and cancer

3 Pre-op nursing considerations Renal biopsy

Insure patient can lay flat, can hold breath on request, and NPO

4 Post-op nursing considerations Renal biopsy

Bed rest, risk of bleeding, pain and infection control

Those at risk of lower UTI

young adult women, over >80 all genders

What is seen on a urinalisis with a lower UTI

bacteriuria

S/S of a uncomplicated lower UTI

dysuria, inc frequency and urgency, pain and tenderness

Nursing considerations when observing urine for lower UTI

watch for cloudy or foul smelling urine

A-typical presentation of a lower UTI in older adults

Inc falls, and dec mental status

What can a nurse expect to be ordered if a patient is suspected of having a UTI

UA, microscopic studies, urine culture and sensativity

What are nursing considerations when treating lower UTI

review for allergies, educated of inc yeast infections, acetaminophen for pain managemnt

6 Patient education from nurse regarding a UTI

hydrate, hygiene, shower not bathe, voiding, elim spermicide use, topical estrogen for older women

If a lower UTI is left untreated it can commonly progress to a

Upper UTI, kidney infection

Why is pyelonephritis cruital to treat

can lead to sepsis or shock

S/S of pyelonephritis

sudden fever, chills, n/v, flank pain

4 Nursing considerations for treatment of pyelonephritis

replace catheter, hydrate, pain control, patient education

Is urinary incontinence normal with age

no

Stress urinary incontinence presents and is caused by

coughing, laughing, weakened pelvic muscles

Urge urinary incontinence presents and is caused by

Leak urine, contraction of detrusor muscle

Overflow urinary incontinence presents and is caused by

urine leaks to prevent rupture, detursor fails to contract

3 diagostic tests urinary incontence

bedside testing, UA, urine culture

Managing stress incontinence

Strengthen external sphincter: kegels, weight reduction, timed toileting, topical estrogen, e-stim

What is a pessaries and what is it used for

sling procedure, used for organ prolapse

Managing urge incontince

Relaxation techniques: anticolinergic agents, botox, timed toileting

Overflow incontinence management

Establish clear pathway: surgery if by obstruction, intermittent cather,

Functional incontinence management

adapt situations, timed voiding, external devices

Gen what is urinary retention

Cannot completely empty bladder after voiding

Clinical manifestations of acute retention

suprapubic discomfort, urgency, distended palpable bladder

Clinical manifestations of chronic retention

hesitancy, issue starting and maintaing flow, small and slow urine output

Nursing considerations using bladder ultrasound for PVR + proceudre

nurses will perform, order will tell what to do, empty bladder, ultrasound bladder

Treatment of acute urinary retention

catheter

Treatment of chronic urinary retention

scheduled voiding, double voiding

What is a nursing consideration for use of a bedpan

do not leave on for longtime

What is a nursing consideration for use of external urinary catheters

use cavi to avoid skin breakdown

What is a nursing consideration for use of internal cather

avoid if psosible

6 Nursing considerations for urinary cath

steril, provide hygiene every 8 hours, inc fluid intake, watch for warning signs of infection, bag below bladder, take out at first time possible

The key roles of the upper GI tract

digestion and absorption of nutrients

Key roles of the lower GI tract

process of waste formation and elimination

What is used to classify human species

bristol stool chart

What is a stool culture used for

infectious sources

What is a fecal occult blood test used to find

blood in stool

What is a fecal fat test used for

measures unabsorbed dietary fat from metabolic conditions

What is a nursing consideration for GI imaging

NPO, fasting or empty GI

What 2 conditions are breath tests used to find

h-pylori and bacterial overgrowth

What are GI motility studies used to evaluate

complex cases

Esophageal manometry is used for ?

dysphagia

Gastric empyting study sees and is used for?

how fast digestion is, gstroperisis

pH monitoring study sees and is used for?

acid and non from stomach, gerd

Anorectal manometry study sees and is used for?

fecal incontence, chronic constipation

Nursing considerations after a barium swallow

laxative to avoid constipation, educate on white and light colored stools, hydrate, asses for complications

Complications of concern after a barium swallow

Abdominal dissension, constipation, absent bowel sounds, no stool or gas 48 hr

Nursing considerations pre barium swallow

NPO 8-12 hrs, enema or diet prep, confirm with MD what meds to give or hold

Pre endoscopy patient education NC

goal of empy stomach, no solids 8-12hr, liquids 3-4, confirm about meds with MD

Post endoscopy patient education NC

ride home, no driving decisions or machines 24hr after

Generalization of a colonoscopy

minimally invasive, diagnostic procedure of lower GI

Pre colonoscopy patient education NC

Goal clean colon, multiday prep, no liquids 4-6hr, confirm meds with MD

Post colonoscopy patient education NC

Ride home, immediate eval for sever issues, no driving machines and decisions 24hrs

Clinical definition of constipation

less than 3 stools per week, hard and dry 1/2

Clinical presentations of constipation

Abdominal bloating, gas, cramps, pain, n/v

Complications of straining during constiapation

stims vaso-vagal response, caused BP to dec and can cause stroke

4 common constipation of constipations

fecal impaction, hemorrhoids, anal fissures, magacolon

How would a constipation related hemorrhoid present

bright red blood in stool

Worry regarding megacolon

can cause emergency, peritinitis

Nursing intervention of constipation

Slowly inc fiber, inc fluids, ambulation, squatty potty, stregnth training

Clinical definition of diarrhea

Loose stools more than 3 times a day, type 6/7

Clinical presentation of diarrhea

Abdominal and rectal pain, n/v can be associated with bleeding

Who should we worry about with diahrrhea

infants, immunocompromised, and older adults

What is the leading cause of death worldwide for infant and children

diarrhea

Diarrhea nursing assessment key concepts

find out if chronic or acute, and what is causing it, 24hr diet, meds, infection, or longer term disorder

NC observation of stool for diarrhea

Stool count, characteristics, color, hydration and diagnostic testing

4 main affects of diarrhea

skin breakdown, electrolyte loss, dehydration, affects adls

Nursing consideration for diahrrea in a bedbound patient,

preventive care, barrier creams