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NUR215 Exam #4
Enema Administration
Types
Tap Water/Soapsuds
Normal Saline
Hypertonic Solution
Medication
Oil Retention
Administration
Procedure Education
Wear PPE
Put Patient in Sims Position
Insert Tip
Start Flow Slowly
Stop With Discomfort
Potential for Vagus Response
2 mins
Ileostomy Care
Antibiotics
Monitor Skin Breakdown
Drains Continuously
Fluid and Electrolyte Imbalance
Low Fiber Diet
2 mins
Colostomy Care
Wash with Warm Water
Cut 1/8 inch Around Stoma
Decreases Skin Irritation
Empty When 1/3 to 1/2 Full
Change 3-7 Days
Considerations
Avoid Odor Causing Foods
Irrigate at Same Time
2 mins
Functional Incontinence
Symptoms
Increased Urinary Volume
Unable to Timely Urinate
Pathophysiology
Dementia
Excessive Alcohol Consumption
Immobility
Treatment
Scheduled Voiding
1 min
Overflow Incontinence
Symptoms
Increased Residual Urine Volume
Involuntary Urine Dribble
Urinary Frequency
Pathophysiology
Nerve Lesions Cause Bladder Atony
Bladder Outlet Obstruction
Weak Detrusor Muscles
Treatment
Bethanechol
Catheterization
Sacral Neuromodulation
2 mins
Stress Incontinence
Symptoms
Urine Leak with Movement
Cough or Sneeze
Increased Intra-abdominal pressure
Pathophysiology
Laxity of Pelvic Floor Muscles
Urethral Sphincter Insufficiency
Treatment
Kegel Exercises
Pessaries
Alpha-adrenergic Agonists
Surgery
Associations
History of Vaginal Birth
Cystocele
2 mins
Urge Incontinence
Symptoms
Strong Urge To Void
Unable To Void Quickly Enough
Nocturia
Increased Frequency
Small Volume Voids
Pathophysiology
Increased Detrusor Muscle Activity
Treatment
Avoid Caffeine & Alcohol
Anticholinergics
Mirabegron
Botox
Sacral Neuromodulation
2 mins
Urinary Excretory Anatomy
Characteristics
Renal Medulla
Renal Cortex
Nephron
Bowman's Capsule
Glomerulus
Proximal Tubule
Loop of Henle
Distal Tubule
Collecting Duct
Ureter
Urinary Bladder
Urethra
2 mins
Male Urinary System Assessment
Health History
Past Medical History
Medications
Urination Pattern
Physical Examination
Inspection
Palpation
Auscultation
Percussion
Assessment of Urine
Intake and Output
Characteristic of Urine
2 mins
Urinary Tract Infection Symptoms
More Common in Elderly
Most Common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethral Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
2 mins
Female Urinary System Assessment
Health History
Past Medical History
Urination Pattern
Medications
Urine Collection
Assessment
Inspect Areas Over Kidney and Bladder
Percuss Kidneys
Palpate Kidneys and Bladder
Note Abnormal Findings
Assessment of Urine
Intake and Output
Characteristic of Urine
2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
2 mins
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
40 secs
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
1 min
Total Protein Lab Values
6.4 - 8.3 g/dL
1 min
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
1 min
Urine Specific Gravity Lab Value
1.003-1.030
1 min
GI Absorption
Stomach
Alcohol
Duodenum
Iron
Jejunum
Folate
Terminal Ileum
Vitamin B12
Bile Resorption
1 min
Blood Acid-Base Control
Characteristics
In a State of Acidemia
Medullary Chemoreceptors Control Ventilation Rate
Expulsion of CO2 through Lungs Increases pH
Bicarbonate Reabsorption from the Kidney Increases pH
Kidney Excretion of H+ Increases pH
2 mins
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
1 min
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