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Unit 4 Exam E
Elimination
| Question | Answer |
|---|---|
| While receiving and enema, a PT complains of abdominal cramping. What should the nurse do? | Stop the fluid until the cramping stops |
| When assisting a male PT on bed rest to void, the nurse should place the PT in what position? | Lateral position |
| A PT has black, tarry colored stools. This is probably related to: | Gastrointestinal bleeding |
| A PT has stool that has white globules of fat and is foul smelling. This is most likely related to: | The absence or deficeincy of pancreatic enzymes. |
| The overproduction of bile will cause the stool to be what color? | Bile pigments color the stool brown. |
| The underproduction of bile will cause the stool to be what color? | Greyish, clay color. |
| Why does diarrhea causes skin irritation? | Because the stool is not in the intestines long enough for the digestive enzymes to be buffered, they break down the skin. |
| Urinary elimination depends on the normal functioning of what 3 body systems? | Urinary, CV and Nervous |
| What is the functional unit of the kidney? | the nephron |
| In what part of the kidney is urine first formed? | In the nephron |
| The normal process of urination is initiated when urine collects in the bladder and stimulates what? | Stretch receptors |
| How much urine must the bladder collect before urination occurs in a healthy adult? | 250 to 450 mLs |
| What is the failure of the kidneys to produce urine, resulting in a total lack of urination or output of less than 100 mL per day in an adult? | anuria |
| What is the term for when the client postpones voiding, resists or inhibits the sensation of urgency, and voids according to a timetable rather than according to the urge to void? | Bladder training |
| What is the test that uses 24-hour urine and serum creatinine levels to determine the glomerular filtration rate, a sensitive indicator of renal function? | Creatinine clearance |
| What is Credé's maneuver? | manual exertion of pressure on the bladder to force urine out |
| What are the Detrusor muscles? | the smooth muscle layers of the bladder |
| What is a technique by which fluids and molecules pass through a semipermeable membrane according to the rules of osmosis? | Dialysis |
| What is the the production of large amounts of urine by the kidneys without an increased fluid intake? | Diuresis |
| What are agents that increase urine secretion called? | Diuretics |
| What is the term for painful or difficult voiding? | Dysuria |
| What is Enuresis? | bedwetting |
| What is the tuft of capillaries in the kidney surrounded by Bowman's capsule? | Glomerulus |
| What is another term for timed voiding or scheduled toileting, attempts to keep clients dry by having them void at regular intervals? | Habit training |
| The external opening to the urinary system is called what? | Urinary meatus |
| When impaired neurologic function causes interference with the normal mechanisms of urine elimination in which the client does not perceive bladder fullness and is unable to control the urinary sphincters, the client is said to have a? | Neurogenic bladder |
| When a patient complains of having to get up to void two or more times at night, the patient has what? | Nocturia |
| What is Nocturnal enuresis? | involuntary urination at night |
| What is Nocturnal frequency? | the need for older adults to arise during the night to urinate |
| What is Oliguria? | The production of abnormally small amounts of urine by the kidneys |
| What is Polydipsia? | excessive thirst |
| What supplements habit training by encouraging the client to try to use the toilet and reminding the client when to void? | Prompted voiding |
| What does reflux mean? | an automatic response of the body to a stimulus |
| What is Residual urine? | the amount of urine remaining in the bladder after a person voids |
| Where is a Suprapubic catheter inserted? | through the abdominal wall above the symphysis pubis into the urinary bladder |
| What is the triangular area at the base of the bladder marked by the ureter openings at the posterior corners and the opening of urethra at the anterior corner? | Trigone |
| What is the feeling that one must urinate? | Urgency |
| What is the delay and difficulty in initiating voiding that is often associated with dysuria? | Urinary hesitancy |
| What are the 3 different terms for the process of emptying the bladder? | Urination, micturition, voiding |
| A client comes to the primary care provider's office with the complaints of urinating all the time, pain on urination, small amounts of urine being passed when voiding, and a foul smell to the urine. What is the likely cause? | Urinary tract infection |
| Eating foods that increase the acid in urine helps to reduce the risk of what problems? | urinary tract infections and stone formation |
| Eating foods that increase the acid in urine helps to reduce the risk of what problems? | urinary tract infections and stone formation |
| Large amounts of fluid ensure a large urine output, which keeps the bladder flushed out and decreases the likelihood of what problems? | urinary stasis and subsequent infection |
| When counseling a young mother who complains of having stress incontinence three months after her pregnancy, it is recommended that she practice pelvic muscle exercises to strengthen her bladder muscles. What should she do to practice this action? | Stopping the flow of urination midstream. |
| Why are women more prone to urinary tract infections? | Because they have shorter urethras |
| nursing interventions related to urinary elimination are generally directed toward what? | Facilitating normal functioning of the urinary system or assisting client with problems associated with the urinary tract. |
| What procedure is required for patients with urinary retention, but only as a last resort when all other measures fail? | Urinary catheterization |
| What are the two most important things to focus on when caring for clients with indwelling catheters? | Preventing infection and maintaining urine flow through the drainage system |
| What might clients with urinary retention be taught to do to maintain their independence, reduce infection and eliminate incontinence? | Clean intermittent self-catheterizations |
| What procedure is used to apply medication to the inner bladder walls? | Bladder irrigation |
| What procedure is performed when an indwelling catheter becomes clogged or blocked? | Catheter irrigation |
| What is formed to allow urine to be eliminated from the body if the bladder has to be removed due to cancer or injury? | Urinary diversion |
| What is the most common urinary diversion used when the urinary bladder must be removed? | The ileal conduit |
| During the catheterization of a female client, what should the nurse do if the catheter slips into the vagina instead of the urinary meatus? | Leave the catheter in place and get a new sterile catheter. |
| How much fluid must an adult ingest per day to be adequately hydrated? | 2000-3000 mL/day |
| What is the average daily urine output for a healthy adult? | 1,000-2,000mL/day |
| How much urine should be collected for a urinalysis? | at least 30 mLs |
| The normal pH of urine is.......? | 4.5 - 8 |
| What is the specific gravity of urine from a healthy adult? | 1.010 to 1.030 |
| What color should urine be? | straw or amber colored and transparent |
| How soon should urine be tested after collection? | Within 30 minutes; if not possible, put the specimen cup into a larger bag with ice to keep it cool. |
| What is the term for the amount of solutes in urine? | Specific gravity |
| What type of waastes are uric acid, urea, ammonia and creatinine? | Metabolic wastes |
| What percent of normal urine is water? | 96% |
| What percent of normal urine is solutes? | 4% |
| Does the specific gravity of urine increase or decrease as the concentration of solutes increases? | Increase |
| What are the electrolytes that are commonly found in urine? | Sodium, chloride, potassium, magnesium and phosphorus |
| What is the term for the acidity or alkalinity of urine? | Urine pH |
| Is urine normally acidic or alkaline? | Acidic |
| Urine pH is helpful because it helps determine the kidneys response to what? | acid-base imbalances |
| What could cause urine pH to be more acidic (<4.5)? | Starvation, diarrhea, high protien diet, cranberries |
| What would cause urine to be more basic (>8)? | Alkalosis, UTI, diet high in fruits and vegetables |
| In determining if a client has diabetes mellitus by a urine test, how much glucose would have to be found in the urine? | More than 180 mg/dL |
| A urine sample's specific gravity is tested and found to be < 1.010. What could this mean? | the urine is diluted, so there is either excess fluid intake or kidney disease |
| What can you tell about a patient who's urine has a specific gravity of >1.025? | The urine is concentrated, so there is definitly a fluid deficit and excess glucose. Could be caused by dehydration. |
| What do a Pt with uncontrolled diabetes mellitus, a man on a hunger strike, and a 15 year old girl that tried to overdose on aspirin have in common? | Ketones will be found in their urine |
| What type of exercises can be done by both men and women to strengthen the pelvic floor muscles and reduce stress incontinence? | Kegel exercises |
| What is an alternative to an indwelling catheter for males with urinary incontinence? | Condom catheter |
| Why might a condom catheter be preferred over an indwelling catheter? | Condom catheters are noninvasive, reduce the risk of UTI |
| How often should a condom catheter be changed? | Daily |
| What is the inability if a usually continent person of reaching the toilet in time to avoid unintentional loss of urine? | Functional urinary incontinence |
| What is the best nursing intervention for a client with functional urinary incontinence? | Prompted voiding |
| What is the loss of urine at somewhat predictable intervals when a specific bladder volume is reached? | Reflex urinary incontinence |
| What is the best nursing intervention for a client with reflex urinary incontinence? | Intermittent urinary catheterization |
| What is the loss of urine occuring with activities that increase abdominal pressure? | Stress urinary incontinence |
| What is the best nursing intervention for a client with stress urinary incontinence? | Pelvic muscle exercises that strenghen the levatator ani and urogenital muscles |
| What is the passage of urine soon after a strong sense of urgency to void? | Urge urinary incontinence |
| What is the best nursing intervention for a client with urge urinary incontinence? | Urinary bladder training |
| What does it mean to have a flaccid bladder? | To have weak, soft or lax bladder muscles |
| What is the loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter? | Bowel incontinence |
| What is an agent that promotes the passage of flatus from the colon called? | Carminative |
| What are drugs that induce defecation called? | Cathartics |
| What is the digested products that leave the stomach through the small intestine and then pass through the ileocecal valve? | Chyme |
| An opening into the colon is called a: | Colostomy |
| What is the passage of small, dry, hard stool or passage of no stool for an abnormally long time referred to? | Constipation |
| The expulsion of feces from the rectum and anus is medically referred to as: | Defecation |
| The defecation of liquid feces and increased frequency of defecation is known as: | Diarrhea |
| What is a solution introduced into the rectum and sigmoid colon to remove feces and/or flatus called? | An enema |
| What is the term for a mass or collection of hardened, puttylike feces in the folds of the rectum? | Fecal impaction |
| What are the body wastes and undigested food eliminated from the bowel called? | Feces |
| What would the presence of excessive amounts of gas in the stomach or intestines be referred to as? | Flatulence |
| What is the gas or air normally present in the stomach or intestines/ | Flatus |
| What is the increased peristalsis of the colon after food has entered the stomach, causing the urge to have a BM? | Gastrocolic reflex |
| What are the pouches that form in the large intestine when the longitudinal muscles are shorter than the colon? | Haustra |
| What is the movement of the chyme back and forth within the haustra in the large intestine called? | haustral churning |
| What is haustral churning also referred to as? | Shuffling |
| What are Hemorrhoids? | dDstended veins in the rectum |
| What is an ileostomy? | An opening into the ileum |
| What is another term for the ileum? | Small bowel |
| The act of taking in food or medication, usually by the mouth is called: | Ingestion |
| What are medications that stimulate bowel activity and assist fecal elimination? | Laxatives |
| What involves a wave of powerful muscular contraction that moves over large areas of the colon? | Mass peristalsis |
| When does mass peristalsis usually take place? | Usually occurs after eating |
| What is the first fecal material passed by the newborn? | Meconium |
| When does a newborn usually pass the meconium? | Normally up to 24 hours after birth |
| What is the suffix denoting the formation of an opening or outlet such as an opening on the abdominal wall for the elimination of feces or urine? | Ostomy |
| What are the wavelike movements produced by circular and longitudinal muscle fibers of the intestinal walls that propels the intestinal contents onward toward the anus? | Peristalsis |
| Stoma What is an artificial opening in the abdominal wall that may be permanent or temporary? | Stoma |
| What are the solid, cone-shaped, medicated substances inserted into the rectum, vagina, or urethra? | Suppositories |
| What does the presence of orange or green stools represent? | An intestinal infection |
| What could be the cause of red stool? | Bleeding from the rectum or the consumption of beets |
| What could be the cause of a narrow, string like stool? | An obstructive condition in the rectum |
| Normal stools are described as "aromatic". What could be the cause of foul, pungent stools? | An infection or blood in the stools |
| What is the average amount of feces produced by a healthy client per day? | Varies with diet, but from 100-400 grams |
| Normal feces is what percent water? | About 75% |
| What type of ostomy will produce a liquid fecal discharge that cannot be regulated, contains digestive enzymes and has low or no odor? | An ileostomy |
| What type of ostomy will produce a liquid fecal discharge that cannot be regulated, contains digestive enzymes but does produce an odor that must be controlled? | An ascending colostomy |
| What special precautions must be taken with an ileostomies and ascending colostomies? | The drainage contains digestive enzymes, so precautions must be taken to prevent skin breakdown |
| What is the surgery to reconnect the ends of a temporary ostomy sometimes called? | A take down |
| What type of ostomy produces a malodorous, mushy drainage that cannot be regulated? | A transverse colostomy |
| What type of ostomy produces increasingly solid fecal drainage with which discharge and odor can be regulated? | A descending colostomy |
| What is a descending colostomy also called? | A sigmoidostomy |
| Which type of stoma has an afferent (active) and an efferent (inactive) end? | A loop colostomy |
| What are the primary functions of the large intestine? | The excretion of digestive watse products and maintenance of fliud balance |
| Will the prolonged use of laxatives increase or decrease the absorption of vitamins? | It will decrease the absorption of vitamins. |
| True or False. Habitual use of laxatives eventually requires larger or stronger doses because the effect is progressively reduced. | True |
| How long should a rectal tube be left in the client to help expel flatus. | . The tube should not be left in the client for more than 30 minutes, to avoid irritation to the rectal mucosa. |
| True or False. The large intestine is 50 to 60 inches long in the adult; and includes the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anus. | T |
| True or False. The main functions of the colon include absorption of water & nutrients, mucoid protection of the intestinal wall, and fecal elimination. | |
| True or False. Constipation is the most common bowel management problem in the elderly due a variety of stressors including loss of abdominal muscle and loss of large intestine muscle tone. | |
| True or False. Stools for clients with upper gastrointestinal bleeding are black or tarry in color. | |
| True or False. The purpose of the hemoccult test with a stool sample is to determine if there are microscopic amounts of blood (occult blood) in the stool. | |
| Some stool specimens are temperature sensitive and must be sent to the lab | |
| immediately. | True |
| True or False. The best way to promote normal bowel habits is to use a laxative daily. | False |
| True or False. An important reason that the nurse discourages the client from straining when defecating is because straining stimulates the vagus nerve resulting in bradycardia (pulse <60/minute) and possible fainting. | True |
| True or False. A 69 y/o male at risk for constipation states he needs 500 ml of fluid, 20 to 35 grams of fiber, a regular exercise routine and a planned time to have a BM each day. | False |
| True or False. The degrees of reaction for a client with a “fecal impaction” include a history of no BM for several days, loss of appetite, nausea, abdominal distension and a small amount of loose stool. | True |
| True or False. The client with diarrhea might have a nursing diagnosis of risk for impaired skin integrity, acute pain, or risk for fluid volume deficit. | True |
| True or False. A low volume cleansing enema draws fluid into the colon by osmosis and stimulates peristalsis. | True |
| True or False. As the nurse inserts the enema tubing slowly into the rectum the nurse directs it toward the umbilicus. | True |
| What type of enema is used to prepare the client for some types of diagnostic tests and surgeries? | The cleansing enema |
| What type of enema lubricates the rectum and anal canal to facilitate stool passage? | oil retention enema |
| What type of enema is to help facilitate the expulsion of flatus? | Return Flow enema |
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cestes1001
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