Catheterization and Incontinence Care

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Questions and Answers

What is a common risk associated with catheterization?

Insomnia

Urinary Retention

Urinary Tract Infection (CAUTI) (correct)

Kidney Stones

Which of the following is essential for catheterization care?

Removing the catheter without caution

Cleaning the meatus with soap and water (correct)

Inserting the catheter with force

Using non-sterile technique

What defines urge incontinence?

A sudden, intense urge to urinate leading to involuntary leakage (correct)

Involuntary leakage due to pressure on the bladder

Dribbling or leaking from an overfilled bladder

Complete inability to urinate

What is the expected minimum urine output per hour for a healthy individual?

30 mL Signup and view all the answers

Which of the following is not recommended for managing stress incontinence?

Restricting fluid intake Signup and view all the answers

How far should a catheter be inserted for a male patient?

7-9 inches Signup and view all the answers

What is the maximum FiO2 percentage that can be delivered using a Non Rebreather Mask?

100% Signup and view all the answers

Which nursing diagnosis is associated with systemic lupus erythematosus (SLE)?

Risk for impaired skin integrity Signup and view all the answers

In the context of TB infections, what characterizes a latent TB infection?

Bacteria are inactive and cannot spread Signup and view all the answers

What is the flow rate range for a Simple Mask?

5-10 LPM Signup and view all the answers

What is a common characteristic of Stage 3 pressure ulcers?

Full thickness ulcer involving muscle or bone Signup and view all the answers

Which of the following is a primary symptom of primary TB infection?

Low grade fever Signup and view all the answers

What is functional incontinence?

Inability to reach the bathroom in time due to limitations. Signup and view all the answers

Which of the following correctly describes the term 'dry weight' in the context of dialysis?

Weight after dialysis when the patient is free of excess fluid. Signup and view all the answers

Which laboratory findings are crucial for assessing kidney function in chronic kidney disease?

Serum creatinine, eGFR, and urine microalbumin. Signup and view all the answers

What are common symptoms of hyperthyroidism?

Heat intolerance and tachycardia. Signup and view all the answers

What is a significant risk factor for developing diabetes?

Sedentary lifestyle. Signup and view all the answers

What does the presence of a 'thrill' indicate when assessing an AV fistula?

Significant vascular pathology. Signup and view all the answers

What are some common clinical presentations of hyperosmolar hyperglycemic state?

Severe dehydration and confusion. Signup and view all the answers

Which medication is commonly used to manage hypothyroidism?

Levothyroxine. Signup and view all the answers

What is a symptom commonly associated with hyperglycemia?

Increased thirst Signup and view all the answers

Which type of lung cancer is characterized by rapid growth and a tendency to metastasize quickly?

Small Cell Lung Cancer (SCLC) Signup and view all the answers

What is the leading cause of lung cancer?

Cigarette smoking Signup and view all the answers

Which condition is associated with the presence of Reed-Sternberg cells?

Hodgkin's Lymphoma Signup and view all the answers

What is a common symptom of hypoglycemia?

Shaking Signup and view all the answers

In which stage of Hodgkin's Lymphoma is the disease found in lymph nodes on both sides of the diaphragm?

Stage III Signup and view all the answers

What is a typical intervention for managing hyperglycemia?

Administering insulin Signup and view all the answers

Which dietary recommendation is crucial during sick days for diabetes management?

Hydrate sufficiently Signup and view all the answers

What is a common side effect of chemotherapy?

Nausea and vomiting Signup and view all the answers

What is a key risk factor for hypertension?

Obesity Signup and view all the answers

Study Notes

Elimination & Catheterization

Risks of Catheterization: CAUTI (most common), bladder spasms, periurethral abscess, chronic pyelonephritis, urosepsis, urethral trauma/erosion, fistula/stricture formation, kidney stones.
Catheterization Care: Sterile technique; follow Table 50.22 (p. 1224). Clean meatus and tubing with soap and water. Prevent UTIs, maintain urine flow, prevent infection, promote normal urine output, and maintain skin/mucosal integrity. (Wilkenson pp. 737-739)
Teaching: Emphasize cleanliness and reporting infection symptoms. (Wilkenson p. 740)
Expected Urine Output: 1500 mL/day. Minimum: 30 mL/hr. Normal range: 800-2000 mL/day.
Catheter Insertion:
- Female: Gently insert 2-3 inches until urine flows, then advance another 1-2 inches.
- Male: Gently insert 7-9 inches until urine flows, then advance almost to catheter bifurcation (Y-connector). Hold catheter at meatus with non-sterile hand.

Incontinence

Stress Incontinence: Involuntary urine loss due to pressure on the bladder.
Urge Incontinence: Sudden, intense urge to urinate with involuntary leakage.
Overflow Incontinence: Bladder unable to fully empty, leading to frequent dribbling or leaking. Often caused by bladder obstruction or nerve damage.
Reflex Incontinence: Involuntary urine loss due to reflex action, often from neurological conditions.
Functional Incontinence: Inability to reach the bathroom due to physical or cognitive limitations.

Dialysis

Peritoneal Dialysis: Dialysate (cleansing fluid) passed into the abdomen via catheter. Absorbs waste from abdominal blood vessels, then fluid is removed. Can be done manually or using a machine.
Hemodialysis: Machine filters blood pumped out of the body via an artificial kidney. Cleaned blood is returned to the body. Usually done 3-5 times a week in a center, but can be home-based.
AV Fistula Assessment:
- Thrill: Palpable vibration (buzzing) on skin, indicating turbulent blood flow.
- Bruit: Audible whooshing/rumbling sound (heard with stethoscope), also indicating turbulent blood flow,
Dialysis Purpose: Correct fluid/electrolyte imbalances and remove waste in kidney failure.
Dialysis Assessment (Before/After): Assess dry weight, vital signs, blood electrolytes, creatinine, BUN, blood glucose. (See ATI p. 421)
Dry Weight: Patient's weight after dialysis.

ACE Inhibitors

Purpose: Slow kidney damage progression by lowering blood pressure, reducing kidney stress.
Adverse Effects: Dry cough, hyperkalemia, hypotension; discontinue if cough persists.
Patient Teaching: Regular follow-up appointments, continue medication even if blood pressure is normal, take medication at the same time daily.
Nursing Considerations: Monitor blood pressure and pulse before administering the medication. Watch for signs of heart failure (e.g., edema).

Blood Glucose Monitoring

Method: Finger prick before meals and at bedtime.
Abnormal Electrolyte Concerns: Life-threatening. Monitor ECGs and frequent lab tests (e.g., potassium)

Chronic Kidney Disease (CKD) Labs

eGFR: Estimated Glomerular Filtration Rate (normal 90-120 ml/min; decreased in CKD). Indicates kidney function.
BUN: Blood Urea Nitrogen (increased in CKD). Normal = 6-24 mg/dL
Serum Creatinine: (Increased in CKD). Normal = 0.74-1.35 mg/dL (men).
Urine Microalbumin: Indicates kidney damage.
Electrolytes: Serum potassium should be carefully monitored; check for imbalances. (Potassium is important)

Cancer

Lung Cancer: Smoking is the leading cause. Common symptoms: persistent cough, hemoptysis, weight loss.
Lung Cancer Types: Non-Small Cell (NSCLC), Small Cell.
Diagnosis: Chest X-ray, MRI, CT scan, biopsy.
Treatment: Radiation, chemo, surgery, palliative care, hospice.
Prognosis: Dependent on staging; poor in stage 4.
Paraneoplastic Syndromes: Lung tumors can inappropriately secrete ACTH, causing a tanned appearance.

Blood Glucose Management, Hyperglycemia. Hypoglycemia

Hyperglycemia Symptoms: Increased thirst, frequent urination, fatigue, potential risk of Hyperosmolar Hyperglycemic State.
Hypoglycemia Symptoms: Shaking, confusion, sweating. Treated with quick source of glucose.
Sick Day Education: Continue insulin, frequent glucose checks, hydration.

Hodgkin's vs. Non-Hodgkin's Lymphoma

Hodgkin's: Characterized by Reed-Sternberg cells.
Non-Hodgkin's: Can involve cancerous B cells, T cells, or NK cells

Hypertension Risk Factors

Sodium Intake, Sedentary Lifestyle, Unhealthy Diet, Alcohol Consumption, Chronic Stress, Chronic Pain, Obesity

Peripheral Artery Disease Risk Factors

Unhealthy Diet, Sedentary Lifestyle, Smoking, Diabetes, High LDL cholesterol

Medications and IV Fluids

Isotonic: 0.9% NaCl, 5% Dextrose (hydration)
Hypotonic: 0.45% NaCl, D2.5W (rehydration)
Hypertonic: 3-5% NaCl, 10-50% Dextrose (fluid overload)
IV Site Assessment: Cool/swollen= infiltration; Warm/swollen = infection
IV Medication Adminstration: Hang medication bag above primary IV bag.

Mobility

Chronic Conditions Affecting Mobility: Rheumatoid Arthritis (RA), Osteoarthritis (OA), fibromyalgia, muscular dystrophy, multiple sclerosis (MS).

TB

Primary TB: Bacteria spread through lungs, can infect others, within first two years. Symptoms- Low-grade fever, night sweats, weight loss, fatigue.
Post-Primary TB: Two or more years after infection; still infectious.
Latent TB: Bacteria inactive, no symptoms; can progress to TB disease, requires treatment.

Systemic Lupus Erythematosus (SLE)

Nursing Diagnoses: Disturbed body image, fatigue, ineffective health maintenance behaviors, acute pain, powerlessness, impaired religiosity, chronic sorrow, spiritual distress. Risk for decreased cardiac tissue perfusion, impaired resilience, and impaired skin integrity. Monitor for butterfly rash.

Pain Assessment

PQRST: Provocation (what makes it better or worse), Quality, Region/Radiation, Severity, Timing. Pain scale: 0-10.

Wound Care Assessment

Stages of Pressure Ulcers (Decubitus Ulcer): 1,2,3,4,unstageable, deep tissue injury.
Wound Drainage: Serous, serosanguineous, sanguineous, purulent.
Abnormal Findings: Redness, warmth, bad odor, infection like drainage, maceration, pain, etc..
Unusual Wound Characteristics: Dehiscence (wound opening). Evisceration (internal organs exposed.) Sloughs and eschars are non-healing wound characteristics.

Medical Terminology

Asterixis: Neurological jerking movements (cirrhosis, liver failure).
Hemoconcentration: Blood cell concentration increase due to plasma loss.
Orthostatic Hypotension: Blood pressure drop when moving from lying to standing
Thyroidectomy: Thyroid gland removal.
Microalbuminuria: Slightly elevated urine albumin.
Arteriovenous Fistula (AVF): Surgical connection between artery and vein
Hemoptysis: Coughing up blood.
Mental Fogginess: Difficulty thinking clearly, focusing, or remembering. (brain fog)
Inguinal: Groin or lower abdomen regions
Exophthalmos: Bulging eyes (Graves disease).
Cobblestone Wound: Granulation tissue present
Maceration: Skin softening and breakdown due to moisture.
Slough: Yellow, white, or tan, moist wound material
Eschar: Dead tissue after injury or infection.
Exudate: Fluid, cells, etc. leaking from blood vessels into tissue.

Kahoot! Answers

(Provided answers directly from the Kahoot! questions).

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Description

This quiz covers essential topics related to catheterization and incontinence care, including risks, care techniques, and expected urine output. Emphasis is placed on maintaining a sterile technique and understanding the importance of cleanliness to prevent infections. Test your knowledge on proper catheter insertion methods and incontinence management strategies.