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MB16
MB16 136-149
| Question | Answer |
|---|---|
| 136 A) Describe the 3 step process of urine formation: | •Glomerular filtration •tubular reabsorption •tubular secretion. |
| 136 B) Describe the processes of urine elimination: | •kidneys remove wastes •filter into the Bowmen’s capsule. •Some fluid excreted as urine, most reabsorbed back to plasma. •Urine output must be at least 30ml/hour |
| 137) Discuss factors that affect urinary elimination: | •Surgical Procedures •Medications- Diuretics (Lasix) •some change the color of the urine •Diseases •Calculi (stones) •BPH •Neurogenic bladder from impaired neurological function |
| 138) Describe the contents of a nursing assessment and physical examination focused on urinary elimination: | •History: usual pattern/ alterations •Bladder distension •I & O (Intake & Output) • UA (urinalysis) • Culture and sensitivity |
| 139) Accurately measure urine output: | • strict, use Pilgrim’s Hat to measure cc. • • not strict, note that the patient urinated (x3) or however much they went. |
| 140) Describe nursing interventions that promote normal urination; | •Position •Privacy •Fluid intake •Stimulation of reflexes |
| 141) Identify the basic structures and functions of the G.I. system: 23-26 feet long. | •Mouth, esophagus, stomach, S.I and L.I., rectum, anus. •Primary functions are food breakdown to the molecular form for digestion. •The absorption into bloodstream of small nutrient molecules via digestion •elimination of undigested unabsorbed foodstuf |
| 142) Discuss factors that affect bowel elimination; | •Age- cardiovascular effects •Diet •Fluid intake •Physical activity •Psychological factors- anxiety can cause increase in activity |
| 142 cont'd) Discuss factors that affect bowel elimination; | •Personal habits, Position •Pain, Pregnancy •Surgery/anesthesia- stops peristaltic waves •Manipulation during surgery •Medications- narcotics slow the GI tract (slowed peristalsis), laxatives |
| 143) Describe normal bowel elimination: | •75% fluid, 25% solid. Stool is light to dark brown. •Average frequency is once daily but this varies. (And they all stink no matter what anyone says...) |
| 144) Discuss common bowel elimination problems: | •Constipation- Valsalva maneuver can be a danger •Impaction- confused and debilitated patients are at risk. Loose stool can be a sign (with no recent formed stool) distension. Loss of appetite, N/V |
| 144 cont'd) Discuss common bowel elimination problems: | •Diarrhea- electrolyte imbalance •Incontinence •Flatulence, Hemorrhoids |
| 145 ?s to assess bowel elimination problems | -have you been experienceing pain?fear?nausea?vomiting? -what is your normal amount of BM? activity?daily rest? stress? |
| 146. Physical exam to focus on bowel elimination | See Lynn book for exam tips and lovely pics |
| 147. Nursing diagnosis associated with altered bowel elimination | 1.Bowel incontinence 2.Colonic constipation 3.Impaired skin integrity 4.Excess fluid loss |
| 148. Nursing interventions that promote normal bowel elimination | 1.Education on good nutrition 2.Promote physical activity 3.Encourage hydration |
| 149. Care for patients experiencing BM problems | 1.Provide privacy 2.Maintain nutritional regimen 3.Educate on valsalva maneuver 4.Provide stool softeners |
Created by:
Marshall3
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