Exam 2

Foley insertion

The process of inserting a urinary catheter into the bladder, involving steps such as hand hygiene, patient identification, and proper equipment setup.

Bladder scan

A diagnostic procedure used to measure the amount of urine in the bladder, often used to assess conditions such as polycystic kidney disease, pyelonephritis, ascites, and pregnancy.

External female catheter

A type of catheter placed between the labia and gluteal folds, connected to low continuous suction to drain urine.

External male catheter

Called a condom catheter that is placed over the penis

Ways to reduce a UTI

Women are to wipe front to back, reduce the amount of bubble baths taken, and pee before and after sex

Bowel training

A process that involves establishing a schedule for bowel movements and using techniques such as Kegel exercises to improve bowel control.

How to put on an ostomy bag?

Make sure the hole is no bigger than 1/8 of an inch from the outside. Place hand over the bag to help it stay on

How to empty an ostomy bag?

Empty the bag when it is 1/3 full. Make sure the bag is changed every three days. Change before eating. Remove bag over the toilet if able to. Put warm water in the bag and swish it around. Wipe the bag down on the outside

Ostomy

a surgically created opening in a GI, urinary, or respiratory oran that is exited onto the skin

Colostomy

Surgically created when a portion of the colon of the rectum is removed and the remaining colon is brought through the abdominal wall at skin level to allow passage of stool waste

Ascending

Liquid and cause odor

Transverse

Proximal drains feces and distal drains mucus

descending

solid fecal matter

sigmoid

produce solid fecal matter

Loop

Reuse part of intestine

illeostomy

a surgically created opening in the small intestine, usually at the end of the ileum

Koch pouch

In surgical variation of ileostomy; a reservoir pouch is created, a valve is constructed at the pouch and a stoma is made at the abdominal wall

Ileoanal pouch

the colon and most of the rectum are surgically removed and an internal pouch is formed out of the terminal portion of the ileum

Prolapsed ostomy

part of the intestine is out

Enemas

A method of introducing fluid into the rectum to stimulate bowel movements, with different types such as cleaning, oil, and medicated enemas.

Prevention measures in the hospital

Bed rails up (only three at most, two at all times), call light within reach, personal belongings within reach, clean floors with no obstacles, 6 rights of medication administration, clean equipment throughly, fall risk scale, seizure pads/lines wrapped on side of rails, bed alarms for falls, patient sitter, hourly roundings, putting cords away

Education for elderly

Teach them to use their call light or ask for assistance when wanting to get up, movement to prevent pressure injures, high fiber diet, high protein diet, 2 L of fluid every day, using handlebars at home when going to the bathroom/bathing

Home safety education

Use of handlebars when going to the bathroom/bathing, have clean and dry floors with no obstacles, putting cords away, use an ambulatory aid, not using multiple appliances on same extension cord, turning straightners off, always supervising children around water, clear crib to avoid suffocation, throwing medication away properly, disposing of sharps correctly, turn off space heaters when not in use, blow candles out when leaving a room

Intentional safety concerns

Suicide, homicide, mass shootings, abuse

Unintentional safety concerns

Falls, suffocation, poisoning, drowning, fire

Food safety

throwing expired food away and not thawing meat in room temperature

What does RACE mean?

Rescue, activate alarm, contain, extinguish

What does PASS mean?

Pull, aim, squeeze, sweep

Restraints

must have physician orders for restraints, used to prevent falls but can cause injury, do not use chest restraints, tie to the bed frame and not the rails

What to do when a fall occurs?

assess the situation, call the provider, document and report the incident

Complication of immobility on respiratory

Heart disease and COPD can impact mobility. Atelectasis in lungs causes inadequate oxygenation due to impaired mobility. Bed rest affects this system. Cardiac workload is increased when the body is in supine position due to increased venous return to the heart. Lung expansion is decreased because the body’s weight against the bed puts pressure on the rib cage. Diaphragm has less room to expand them in upright position due to pressure from abd organs. Decreased lung expansion and dependent positioning of areas of lungs = pooling of secretions in lungs, pneumonia, or atelectasis. Circulatory stasis → pooled blood combined with weakened calf muscles can lead to DVT (especially in LE). Position changes in immobile pts = postural/orthostatic hypotension due to pooling of blood in LE and lack of vasoconstriction → heart suddenly has less blood to pump = drop in bp. Edema from decreased peripheral circulation. Activity intolerance due to bed rest. Impact of bed rest: SOB, DOE, fatigue c minimal activity.

Complication of immobility on skin

pressure injuries due to lack of mobility, skin breakdown due to poor nutrition, bony prominences contribute to pressure injuries.

Complication of immobility on musculoskeletal

weakness, decreased muscle tone, decreased bone et muscle mass, muscle atrophy, et contractures. Foot Drop, lack of physical activity = diminished muscle strength, resorption of bone (calcium reabsorbed into bloodstream), disuse osteoporosis and pathologic fractures, joint stiffness and pain with movement. Poor diet of calcium/vitamin D = fractures, injuries affect mobility.

Bony prominences affected by supine

back of head, coccyx, heels, elbows

Bony prominences affected by prone

Chin, clavicle, elbows, knees, toes, hip bones

Bony prominences affected by semi-fowler

coccyx and heels

Bony prominences affected by Sims

humerus, clavicle, hip, ankles

Bony prominences affected by side-lying

shoulder, ankles, ears

Range of Motion

The different types of joint movements, including lateral flexion, rotation, flexion, extension, abduction, adduction, supination, pronation, and more.

SCDs and TED hose

Sequential Compression Devices (SCDs) and Thromboembolic Deterrent (TED) hose to prevent blood clots.