Foundations Module #3

BUN test

Urea, the major nitrogenous end-waste product of metabolism, is formed in the liver. The bloodstream carries urea from the liver to the kidneys for excretion. When the kidneys are diseased, they are unable to excrete urea adequately, and urea begins to ac

Urinary casts

proteins secreted by damaged kidney tubules
- Indicate inflammation of kidney tubules

stress incontinence

the inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing

reflex incontinence

caused by damage to motor and sensory tracts in the lower spinal cord secondary to trauma
- emptying without the sensation of need to void

urge incontinence

state in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void
- caused by bladder irritation secondary to infection

functional incontinence

urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation
- caused by impaired mobility, impaired cognition, or an inability to communicate

Which symptom is a known side effect of antibiotics?

diarrhea

Stool produced from an ileostomy is,

liquid and contains large quantities of electrolytes.

natural intestinal deodorizers

Buttermilk, parsley, and yogurt

foods that produce odor

Dried lentils, asparagus, turnips, fish, onions, and garlic

Enema

the placement of a solution into the rectum and colon to empty the lower intestine through bowel activity

FOBT (fecal occult blood test)

test that is done to detect if there is blood in the stool that is not visually visible; a smear of stool is tested

Colonoscopy screenings,

should start at 50 years old and continue every 10 years thereafter.

Lentils, onions, and cabbage are

known to produce gas

Mineral oil can,

interfere with absorption of fat-soluble vitamins

Large-volume enemas should be given over a

5- to 10-minute time frame

Opioids have a very high potential to cause

constipation

Fresh fruits are high in fiber and should be avoided in a

low fiber diet

Low fiber diets

avoid high fiber foods like whole-grain breads and cereals, raw fruits and vegetables.
-reduces frequency and volume of fecal output
-slows transit time of food through digestive tract

sequence that bowel tests must be performed

Fecal occult blood test, barium studies, and then endoscopic examination

Barium studies

Reveals anatomic abnormalities, such as esophageal spasm and possibly reflux

The tube is in the airway if the client shows signs of

distress and cannot speak or hum

Excessive coughing and gagging may occur if the tube has

curled in the back of throat

A vasovagal reaction is typically manifested by

lightheadedness and fainting, not by gasping and an inability to vocalize

The incidence of constipation tends to be high among clients whose dietary habits lack

sufficient raw fruits and vegetables, whole grains, seeds, and nuts, all of which contain adequate fiber

A common side effect of iron supplements is

constipation

Large volume enemas that result in rapid colonic emptying

Hypotonic (tap water) and isotonic (normal saline solution) enemas

Oil-retention enemas,

lubricate the stool and intestinal mucosa, making defecation easier.

Some of the reasons for administering a cleansing enema include

- Relieving constipation or fecal impaction
- Preventing involuntary escape of fecal material during surgical procedures
promoting visualization of the intestinal tract by radiographic or instrument examination
- Helping to establish regular bowel functio

If within 2 hours after NG tube removal, the client's abdomen is showing signs of distention,

notify the health care provider

If epistaxis occurs with removal of the NG tube,

occlude both nares until bleeding has subsided and ensure the client is in an upright position

When administering an enema, the client's vagus nerve may be stimulated,

causing a decrease in the heart rate. The client will exhibit nausea, lightheadedness, dizziness, and clammy skin. The procedure should be stopped, heart rate and blood pressure monitored, and the health care provider notified.

Diagnosis (ADPIE)

Use Problem RT Etiology AEB Symptoms

Nocturia

urination at night

transient incontinence

appears suddenly and lasts for 6 months or less

mixed incontinence

urine loss with features of two or more incontinence types

overflow incontinence

overdistention and overflow of bladder

Functional incontinence

urine loss caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation
- caused by factors outside the urinary tract

Reflex incontinence

emptying of the bladder without the sensation of the need to void

Total incontinence

continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation

Inctontinent patients can experience,

- Odor
- Embarrassment
- Social isolation

Incontinence factors

- Developmental considerations
- Food/Fluid intake
- Psychological variables
- Activity and Muscle tone
- Pathologic conditions
- Medications

Incontinence pathologic conditions

- UTIs
- Renal Failure
- Kidney Stones
- Heart failure

Anticoagulants can turn urine

red

Diuretics can turn urine

pale yellow

Pyridium (Phenazopyridine) can turn urine

orange to orange-red

Elavil (B comlex Vitamins)) can turn urine

Green or blue-green

Levodopa can turn urine

brown or black

Common incontinence diagnostics

- Urodynamic studies
- Cystoscopy
- Intravenous Pyelogram
- Retrograde Pyelogram
- Renal Ultrasound
- CT scanning

retrograde pyelogram (RP)

x-ray image of the renal pelvis and ureters after injection of contrast through a urinary catheter into the ureters from the bladder

intravenous pyelogram (IVP)

x-ray of kidney following injection of dye into vein to visualize renal pelvis as kidney filters dye out of bloodstream and puts it into urine

Urine Specimens

-Routine urinalysis
- Clean-catch or midstream specimens
- Sterile specimens from Indwelling catheter
- 24-hour urine specimen
- Specimens from infants and children

CAUTI

catheter associated urinary tract infection

intermittent urethral catheter

straight catheter used to drain the bladder for short periods (5-10 minutes)

indwelling catheter

remains inside the body for a prolonged time based on need

suprapubic catheter

catheter inserted into the bladder through a small abdominal incision above the pubic area

external condom catheter

- An alternative to indwelling catheter
- A soft, pliable sheath made of silicone that is applied externally to the penis
- Most are self adhesive
- The catheter is connected to drainage tubing + a collection bag + can be used with a leg bag
- Remove cond

Hemodialysis

dialysis of the blood to remove toxic substances or metabolic wastes from the bloodstream
- Fistula
- Graft
- Central venous catheter

Peritoneal dialysis

dialysis in which the lining of the peritoneal cavity acts as the filter to remove waste from the blood

Normal urine output

30 mL/hr

Impacted stool

Distended, painful abdomen with continuous oozing of diarrhea.

Primary constipation

Related to lack of dietary fiber and exercise

secondary constipation

consequence of pathologic disorder such as a partial bowel obstruction surgery cancer

Iatrogenic constipation

A consequence of other medical treatments.
(ex: prolonged use of narcotic analgesia tends to cause constipation).

Antacids can cause

speckling or a white discoloration of stool

Anticoagulants can cause stool to be

light pink to red to almost black

Consuming large quantities of red meats may cause

the stool to be almost black