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microalbumnuria
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microalbumnuria the presence of very small amounts of albumin in the urine that are not measurable by a unrine dipstick, usual urinalysis prcedures- specialized assay analyze freshly voided urine for microscopic levels of albumin
cystitis inflammation of the blader
bacteriuria bacteria in urine
urosepsis the spread of infection from the urinary tract to the bloodstreem, resulting in systematic infection accompanied by fever, chills, hypotension, alter mental status
dysuria painful urination
urethritias inflammation of urethra that causes symptoms similar to urinary tract infections
uretheral strictures narrowing of the uretha
stress incoontinence the involuntary loss of urine during activities that increase abdominal and detrusor pressure
urge incontinence the involutary loss of urine associated with a strong desire to urinate, patinent can not supress the sign from the bladder muscle to the brain
mixed incontinenec a combination of stress, urge, and overflow incontinence.
overflow incontinence the involuntary loss of urine associated with overdistention of the bladder (capacity=maximum)
functional incontinence leakage of urine caused by factors other than diease of the lower urinary tract.
urosepsis the spread of infection from the bladder to the blood stream - that can lead to organ failure, shock, and death.
etoglogy & genetics of incontinence may have temporary or permanent causes - surgical trauma= radical urologic, prostatic, gynologic, (injury to S2 - S4 causes incontinence) chronic infections, stones, chemotherapy, radiation therapy, diabetes melitus, syphilis,
urinary incontienece in older adults may have decreased mobiltiy, vision, and hearing impairments, (when using call light for assistance) getting out of bed to urinate is also a common cause of falls
nutrition therapy - incontinence weigth reduction, avoid alcohol, nicotine, artifical sweeteners, citrus and caffeine, stress the need for adequate water intake
drug therapy incontinence estrogen (menopausal women) increase blood flow and tone to the muscles. anticholinergics, tycyclic antidepressants
surgical managerment of incontinence vaginal, abdominal or retropubic surgeries, (sucess varies between 50 - 90%) 2% collagen or silaxone injection, 50% bladder neck suspension
urolithiasis the presence of calculi (stone) in the urinary tract
nephrolithiasis the formation of stones in the kidney
uroterolithiasis the presence of calculi (stone) in the urinary tract
hydroureter abnormal distention of the ureters
renal colic severe pain associated with distentions or spasm of the ureter, (stone) - radiations into parineal area, groin, scotum or labia, intermittent or continous pain, with pallor, diaphoresis, and hypotension
pyelonephritsis a bacterail infection in the kidney and renal pelvis, (upper UT)
pyelonephritsis can cause - tissue inflammation, tubular cell necrosis and possible abcess formations. usually cause by escherichia coli (fecalis)
fever can cause dehydration - due to excessive fluid loss - diaphoresis
fever can also increase metabolsim and the demand for O2
a person with LOSS of consciousness has depressed or absent gag reflexes and is suspeceptible to aspiration
risk factors for aspiration include oropharyngeal secretion, including alcoholics, anetsthetized individuas, those with brain injury, with drug over-dose, and stoke victims
when feeding (at risk for aspiration patient) raise HOB and position client on his or her side, not on the back!!!!
bronchial breath sounds are heard over area of density ot onsolidation
sound waves are easily transmitted over consolidated tissue
Hydration inables liquefication of mucus trapped in bronchioles and alveoli, and faciliate expectoration
hydration is essential for clients experienceing fever
300 to 400 ml of fluid is lost daily due to through the lungs through evaporation
Early signs of Cerebral Hypoxia is irritability and restlessness
Cerebral Hypoxia = the brain in not receiving enough O2
Pneumonia prevention in older adults include flu shots, pneumonia immunization,
pneumonia prevention in older adults inclue avoiding sources of infection and indoor pollutants = dust, smoke, aerosols - no cig smoking!!!!!!
the primary cause of COPD exposure to Tabacco Smoke (IN THE USA)
compensation occurs in time (Chronic Lung Dis) altering ABG's
As COPD worsens O2 in the blood decreases - hypoxemia CO2 in the blood increases - hypercarbia
COPD causes Chronic Respiratory Acidosis(increase in PaCO2) which in turn creates Metabolic Aldalosis (increased blood Bicarbonate)
not all COPD patients are CO2 retainers because (even with hypoxia) CO2 diffues more easily across lung membanes than O2
in Advance Emphysema (alveoli are effected) HYPERCARBIA is a problem
in Bronchitis airways are affected
with COPD clients is is important to obtain BASELINE data
With productive Cough and comfort use semi-Fowler's or high Fowler's position to lessen pressure on diaphragm (from abdominal organs)
Gastric distentions,a major problem/CAL, because it elevated the diaphragm which inhibits full lung expansion
Adult PH 7.35 - 7.45
Adult Pco2 35 to 45 mm Hg
Adult Po2 80 to 100 mm HG
Adults Hco3 21 to 28 mEq/L
Emphysema = "Pink" puffers, barrell chest,use of assesory muscles (client work harder)
Chromic Bronchitis "blue" bloaters, insufficent O2, generalized cyanosis, often right-sided heart failure(cor Pullmonale)
Lack of Arterial Oxygenation leads to cyanosis and slow capillary refill(>3 sec)
Chronic lack of O2 leads to clubbing of the fingernails, and a late sign is clubbing of the FINGERS!
COPD patients - do not recieve more than 1-2L of O2/min !!!
COPD client's drive to breath is bases on hypoxia (not hypercapnia) too much O2 - client stops breathing !!!!
healthy patients drive to breath is bases on hypercapnia (too much CO2)
look, listen, if breath sounds are clear, but patient is cyanotic oe lethargic oxygenation is not occuring!!!!!!
Key to respiratory status is assement of breath sounds as well as visualization
breath sound are better discribed (not named) crackles,wheezes,high-pitched whistling sounds
o2 must buble through some type of water-humidification if given at >4L min or Delivered DIRECTLY to the trachea
o2 given at 1 - 4 L or by mask/nasal prongs DOES NOT need humidificaton - oropharynx and nasal pharynx provide enought
trachea care involves cleaning inner cannula, suctioning, & applying clean dressing
air entering the lungs is humidified naturally but is gone for the client who has had a laryngectomy
IF AIR IS NOT HUMIDIFIED BEFOR ENTERING THE LUNGS - secretions tend to thicken and become crusty
laryngectomy tube has a larger lumen and is shorter than the tracheostomy tube
observe for signs of bleeding or occlusion which are greatest 24 hours postoperative
teach the patient who fears choking the glottal stop technique - take a deep breath, momentraliy occlude the tracheostomy tube, cough and simultaneously remove the finger (from the tube)
A positive TB test is exhibited by induration of 10 mm or more, 48 hoursa the skin test
Anyone who has a bacillus Calamette-Guerin (BCG) will test positive for TB, and must be evaluated with a chest X-ray
TB drug therapy usually last 9 month or longer
TB medications must be taken as prescribed because or t skipping doses or terminating therapy could result in a public health hazzard!!!
if a chest tube becomes disconnected do not clap, but immediately place the end of the tube in sterile saline water (until new system can be connected)
If chest tube is accidentally removed from patient the nurse should apply pressure immedicately with an occlusive dressing and notify the health care provider
Nursing diagnosis of "inabiblity of air sacs to fill/empty" Emphysema, or Cystic fibrosis)
Nursing diagnosis of "Obstruction of the air passages" Asthma, or Chronic Bronchitis
Nursing diagnosis of "Acummulation of fluid in the air sacs Pneumonia
Nursing diagnosis of "respiratory muscle fatigue" COPD or pneumonia
Four common symptoms pneumonia the nurst might note with physical exam. Tachypnea, fever with chills, productive cough, bronchial breath sounds
Four (4) Nursing interventions for assisting the client to cough productively encourage Deep Breathing, increase fluids to 3L/day, use humidifier to loosen secretions, suction airyway to stimulate coughing
Symptoms of Pnuemonia found in Older Adults - Confussion, Lethargy, anorexia, rapid respiratory rate.
what is the O2 flow rate for patients with COPD between 1 - 2L per nasual cannula, (COPD client has hypoxia drive to breath)
How does the Nurse prevent Hypoxis during suctioning? deliver O2 at 100% before and after suctioning endotrachea
What are the three (3) major nursing intervention with Mechanical Ventilation Monitor respiratory status & scure connections Establish a communication mechanism/client keep airway clear with suctioning & coughing
what physcial findings if the nurse expected to see with Emphysema Barrel Chest, Dry or productive cough, decreased breath sounds, dyspnes, crackles in lungs
Most common risk factor associated with lung cancer SMOKING
what are pre-operative nursing intervention (care) for client undergoing laryngectomy involve family and client in manipulating tracheostomy equip b/4 swurgery, plan acceptable communication, refere to speech therapist, discuss rehabilitation therapy
What are (5) five nursing interventions after chest tube insertion maintain dry occlusive dressing; monitor VS; encourage client to breath deeply; monitor fluid drainage, mark fluid
sulfonamides - trimethoprim, bactrim,septra use sun protection measures
quinolones - ciprofloxacin, levofloxacin, ofloxacin.... swallow whole, do not crush; take pulse - cardiac dysrhythmias, keep out of sum
penecillins- amoxicillin.... allergies, with food, use another oral contraceptive
cephalosporins - duricef, suprax diarrhea develops? pseudomembraneous,
baldder analgesic with or immediately after a meal
phenazopyridine urine is orange or red
Created by: bcreasy
 

 



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