Urinary and Bowel Elimination NP1 Test 4
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| What amount of urine is considered normal when performing a bladder scan? | less than 450 mL
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| What factors make up urinary elimination assessment? | -Inspect abdomen, urinary meatus and urine
-Palpate
-Percuss
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| What to consider in nursing notes concerning urinary elimination... | - Stressors (causes of urinary retention?)
- Degrees of reaction
- Short term goal?
- Nursing orders/rationale?
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| What is considered "adequate hydration"? | 2000-3000mL per day
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| What are three keys ways to decrease stressors and increase lines of defense concerning urinary retention? | 1. Provide privacy
2. Positioning
3. Sufficient time
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| What is the best position to encourage urination in males? | standing
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| How is bladder training performed? | Intermittently clamp the catheter for specific periods of time prior to catheter removal.
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| After catheter removal... | - attempt to void every 2 hours while awake
- drink 8-10 glasses of liquid per day
- May experience stress incontinence (Kegel exercises)
- Plan regular trips to the bathroom
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| How much urine is needed for a urinalysis? | 30 mL
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| In what time frame should urine samples get to the lab? | 30 minutes unless on ice
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| What is the normal range for specific gravity of urine? | 1.010-1.030
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| The normal pH range for urine is: | 4.5-8
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| The normal range for output of urine is... | 1000-2000mL per 24 hrs
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| Men struggle more with: A- urge incontinence B- stress incontinence | A- urge incontinence
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| Women struggle more with: A- urge incontinence B- stress incontinence | B- stress incontinence
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| Male incintinence may stem from: A- Parkinson's Disease B- Overactive bladder C- Enlarged prostate D- Diabetes E- All of the above | E- All of the above
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| What can the following factors cause? Injury due to childbirth or trauma, Emotional legacy of trauma and anger, Atrophy of bladder muscle and tissue due to loss of estrogen. | Female incontinence
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| Choose all that apply. Female incontinence can be caused by: A- insufficient fluid intake B- uterus pressing on the bladder C- Irritants and inflammation D- spicy foods | B and C
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| T or F. When collecting a 24 hour urine specimen, never collect urine when the client first wakes, as it is contaminated. | False. Only the urine of the FIRST morning is skipped.
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| When collecting urine specimens, it is good nursing practice to only collect the minimal amount of urine necessary for the procedure to minimize client embarrassment. | False. It is a good habit to collect at least 30mL of urine for all procedures.
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| To get the most untainted specimen, waste NO urine when collecting a clean catch. T or F | False. Client should start voiding, and sample should be collected midstream, then client should finish voiding.
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| How much urine is necessary for a creatinine clearance study? A- 1mL B- 30mL C- Everything after the first morning D- 3mL | C- All urine except the very first morning urine must be collected for a creatinine clearance procedure.
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| What does specific gravity indicate about a urine sample? | urine concentration
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| _________ exercises are common use for reducing stress incontinence in men and women. | Kegel
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| polyuria | production of abnormally large amounts of urine by kidneys
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| polydipsia | excessive fluid intake
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| oliguria | low urine output usually <500mL per day
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| anuria | lack of urine production
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| nocturia | voiding 2 or more times per night
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| frequency | voiding more than 4-6 times per day
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| Sudden strong desire to void | urgency
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| painful or difficult urination | dysuria
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| The client's bladder is over distended with urine. The client is experiencing: A-anuria B-urinary incontinence C-polyuria D-urinary retention | D- urinary retention
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| The client tells you they have no control over urine passage. The client is experiencing: A-anuria B-urinary incontinence C-polyuria D-urinary retention | B- urinary incontinence
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| What equipment is typically used with male urinary incontinence? | condom catheter
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| When applying a condom catheter to an uncircumcised client, the best nursing practice is to retract the foreskin. | False. Never retract the foreskin of an uncircumcised client when applying a condom catheter.
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| How much space should be between the condom tip and the connecting tube and penis when applying a condom catheter? | 1 inch
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| What nursing practice is best when caring for a client that has a condom catheter? | Assess 30 minutes after application
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| T or F. Condom catheter changes follow the same procedures as foley catheter changes. | False. Condom catheters should be changed daily and skin care provided.
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| Condom catheter use carries a lower chance of infection than foley catheters. T or F. | True
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| What is rebound tenderness? | When client experiences no pain under the pressure of palpation, but does experience pain when pressure is released.
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| Choose the urinary incontinence: Involuntary loss of urine associated with over distention of the bladder. A- functional B- overflow C- reflex D- total E- urge | B- overflow
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| Choose the urinary incontinence: Involuntary passage of urine occurring soon after a strong sense of urgency to void. A- functional B- overflow C- reflex D- total E- urge | E- urge
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| Choose the urinary incontinence: Continual and predictable loss of urine. A- functional B- overflow C- reflex D- total E- urge | D- total
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| Chooses the incontinence: Inability of usually continent person to reach toilet in time to avoid unintentional loss of urine. A- functional B- overflow C- reflex D- total E- urge | A- functional
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| Choose the urinary incontinence: Involuntary loss of urine at somewhat predictable intervals when specific bladder volume is reached. A- functional B- overflow C- reflex D- total E- urge | C- reflex
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| Define constipation. | Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard stool.
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| return flow enema | enema to facilitate expulsion of flatus
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| cleansing enema | enema to prepare intestine for some diagnostic test and surgeries
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| What is the correct heights for an enema bag for a high cleansing enema? | 18 inches
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| What distance should an enema tubing be inserted? | 3-4 inches
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| oil retention enema | enema that lubricates rectum and anal canal to facilitate stool passage
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| left lateral Sim's | correct position for a low cleansing enema
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| 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 or F | True
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| The main functions of the colon include absorption of water & nutrients, mucoid protection of the intestinal wall, and fecal elimination. T or F | True
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| 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. T or F | True
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| Stools for clients with upper gastrointestinal bleeding are black or tarry in color. T or F | True
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| 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. T or F | True
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| Some stool specimens are temperature sensitive and must be sent to the lab immediately. T or F | True
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| The best way to promote normal bowel habits is to use a laxative daily. T or F | False
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| An important reason that the nurse discourages the client from straining when defecating. | straining stimulates the vagus nerve resulting in bradycardia
(pulse <60/minute) and possible fainting.
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| The nurse just completed discharge teaching with a 69 year old male at risk for constipation. He states he needs 500 ml of fluid/day, 20 to 35 grams of fiber/day, a regular exercise routine and a planned time to have a BM each day. Which part is false? | The suggested fluid intake is more than 500mL per day
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| 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.
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| What does a low volume cleansing enema do? | draws fluid into the colon by osmosis and stimulates
peristalsis.
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