Urinary System and Kidney Function

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Questions and Answers

Which of the following is a potential cause of overflow incontinence?

  • Weakness of the urinary sphincter
  • Increased intraabdominal pressure
  • Bladder outlet obstruction (correct)
  • Urethral hypermobility

Stress incontinence is characterized by a large-volume loss of urine.

False (B)

What is the underlying cause of stress incontinence related to pressure in the bladder?

The urethra cannot stay closed as pressure increases in the bladder because of increased abdominal pressure

A distended bladder palpation and high post void residual are characteristics of ______ incontinence.

<p>overflow</p> Signup and view all the answers

Which of the following is a nursing intervention for overflow incontinence with mild retention and some bladder function?

<p>Timed voiding (A)</p> Signup and view all the answers

Using elastic-waist pants without buttons or zippers is an appropriate nursing intervention to help mitigate toilet access restricted by cognitive impairments.

<p>False (B)</p> Signup and view all the answers

Match the type of incontinence with its primary cause:

<p>Stress incontinence = Weakness or injury to the urinary sphincter Overflow incontinence = Bladder outlet obstruction Altered mobility = Environmental barriers Incontinence interventions = Individualized toileting program</p> Signup and view all the answers

Which nursing intervention is least appropriate for addressing urinary retention?

<p>Encouraging increased fluid intake (D)</p> Signup and view all the answers

Which section of the small intestine primarily absorbs water, fats, and bile salts?

<p>Ileum (C)</p> Signup and view all the answers

The large intestine is longer than the small intestine.

<p>False (B)</p> Signup and view all the answers

What are the three primary functions of the colon?

<p>absorption, secretion, and elimination</p> Signup and view all the answers

Digestive enzymes and bile enter the small intestine from the pancreas and the ______.

<p>liver</p> Signup and view all the answers

Which of the following conditions can disrupt peristalsis, reduce absorption, or block the passage of fluid in the small intestine?

<p>All of the above (D)</p> Signup and view all the answers

The duodenum and jejunum absorb most nutrients and electrolytes in the small intestine.

<p>True (A)</p> Signup and view all the answers

Match the following sections of the large intestine with their description:

<p>Cecum = The pouch at the beginning of the large intestine Ascending Colon = The part of the colon that travels upward Transverse Colon = The part of the colon that travels across the abdomen Descending Colon = The part of the colon that travels downward</p> Signup and view all the answers

Which type of food helps remove fats and waste products from the body more efficiently?

<p>Bulk-forming foods (C)</p> Signup and view all the answers

What happens to fecal matter when peristalsis is abnormally fast in the large intestine?

<p>It becomes watery. (B)</p> Signup and view all the answers

Physical inactivity promotes peristalsis.

<p>False (B)</p> Signup and view all the answers

What is the usual position during defecation?

<p>squatting</p> Signup and view all the answers

During emotional stress, the digestive process is ______, and peristalsis is increased.

<p>accelerated</p> Signup and view all the answers

What is the recommended daily fluid intake for men to support healthy bowel elimination?

<p>3.7 L (B)</p> Signup and view all the answers

Which of the following is a common effect of opioid medications on bowel elimination?

<p>Constipation (B)</p> Signup and view all the answers

Patients who receive a local or regional anesthetic are more at risk for elimination alterations.

<p>False (B)</p> Signup and view all the answers

Match the following:

<p>Opioids = Constipation Antibiotics = Diarrhea Pregnancy = Hemorrhoids Surgery = Temporary cessation of peristalsis</p> Signup and view all the answers

Which of the following is a potential cause of constipation?

<p>Low fluid intake (C)</p> Signup and view all the answers

Diarrhea is characterized by a decrease in the number of stools and the passage of formed feces.

<p>False (B)</p> Signup and view all the answers

What is fecal impaction?

<p>unrelieved constipation and is unable to expel the hardened feces retained in the rectum</p> Signup and view all the answers

Patients should avoid overuse of stimulant laxatives because the intestine can become __________ on them.

<p>dependent</p> Signup and view all the answers

Match the bowel elimination problem with its description:

<p>Constipation = Infrequent bowel movements and hard, dry stools Diarrhea = Increase in the number of stools and passage of liquid, unformed feces Fecal Incontinence = Inability to control the passage of feces and gas Hemorrhoids = Dilated, engorged veins in the lining of the rectum</p> Signup and view all the answers

Increased venous pressure can cause which of the following?

<p>Hemorrhoids (C)</p> Signup and view all the answers

Following a diagnostic procedure involving visualization of GI structures, changes in elimination, such as increased gas or loose stool, are uncommon.

<p>False (B)</p> Signup and view all the answers

Name three signs of dehydration in adults.

<p>thirst, less frequent urination than usual, dark-colored urine</p> Signup and view all the answers

Which of the following is NOT a common reservoir for microorganisms?

<p>Sterile saline solution (D)</p> Signup and view all the answers

MDROs are viruses?

<p>False (B)</p> Signup and view all the answers

What is the primary purpose of healthcare workers using personal protective equipment (PPE)?

<p>To protect themselves from contact with infectious materials, sharps injuries, and exposure to communicable diseases</p> Signup and view all the answers

The ability of a microorganism to grow and multiply, enter tissue, and cause disease is called its ______.

<p>pathogenicity</p> Signup and view all the answers

Match the following routes with relevant examples:

<p>Respiratory tract = Droplets produced during coughing or sneezing Gastrointestinal (GI) tract = Contaminated food or water Skin and mucous membranes = Direct contact with infected lesions Blood = Needle stick injury</p> Signup and view all the answers

Which of the following is an example of a vehicle mode of transmission?

<p>Contaminated surgical equipment (A)</p> Signup and view all the answers

A fomite is a living organism involved in disease transmission.

<p>False (B)</p> Signup and view all the answers

Which of the following is a crucial step in breaking the chain of infection at the 'port of entry' stage?

<p>Wearing PPE (A)</p> Signup and view all the answers

During the alarm stage of the general adaptation syndrome, what physiological change occurs?

<p>Increased basal metabolic rate (B)</p> Signup and view all the answers

Increased erythrocyte sedimentation rate indicates the presence of an inflammatory process.

<p>True (A)</p> Signup and view all the answers

What is the normal range for white blood cell (WBC) count in an adult?

<p>5000-10000/mm3</p> Signup and view all the answers

Adrenocorticotropic hormone increases ______ levels.

<p>serum glucose</p> Signup and view all the answers

Match the following laboratory tests with their indication of infection:

<p>White blood cell (WBC) count = Increased in acute infection, decreased in certain viral or overwhelming infections Erythrocyte sedimentation rate = Elevated in presence of inflammatory process Iron level = Decreased in chronic infection Cultures of urine and blood = Presence of infectious microorganism growth</p> Signup and view all the answers

Which of the following findings in a urine culture indicates the presence of an infection?

<p>Presence of infectious microorganism growth (D)</p> Signup and view all the answers

Increased iron levels indicate the presence of a chronic infection.

<p>False (B)</p> Signup and view all the answers

Patients with what medical condition are at particular risk for infection?

<p>Diseases of the immune system (A)</p> Signup and view all the answers

Flashcards

Chyme

A thick liquid resulting from food digestion mixed with enzymes.

Small intestine

The part of the digestive system where most nutrient absorption occurs.

Duodenum

The first section of the small intestine, about 20-28 cm long, processing stomach fluid.

Jejunum

The middle section of the small intestine, about 2.5 m long, mainly absorbs carbs and proteins.

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Ileum

The last section of the small intestine, about 3.7 m long, absorbs water, fats, and bile salts.

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Large intestine

The larger-diameter intestinal section for waste elimination, approximately 1.5 to 1.8 m long.

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Functions of the colon

The colon's primary roles: absorption of water, secretion, and elimination of waste.

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Peristalsis

Wave-like muscle contractions that move contents through the digestive tract.

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Toilet Access Restrictions

Barriers preventing access include sensory, cognitive, mobility, dexterity issues.

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Overflow Incontinence

Involuntary urine loss due to an overdistended bladder, often from obstruction or weak contractions.

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Characteristics of Overflow Incontinence

Includes distended bladder, high post void residual, frequency, and nocturia.

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Nursing Interventions for Overflow Incontinence

Individualized plans like timed voiding or catheterization based on retention severity.

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Stress Incontinence

Involuntary leakage due to increased abdominal pressure from activities, linked to pelvic floor weakness.

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Characteristics of Stress Incontinence

Small-volume urine loss during activities like coughing, laughing, or exercising.

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Underlying Causes of Stress Incontinence

Weakness or injury to urinary sphincter or pelvic floor leads to inability to control leakage.

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Nursing Interventions for Stress Incontinence

Interventions focus on pelvic floor exercises and addressing underlying weaknesses.

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Bulk-forming foods

Foods like whole grains, fruits, and vegetables that promote bowel health.

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Fluid intake recommendations

Recommended fluid intake is 3.7 L for men and 2.7 L for women per day.

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Impact of physical activity

Physical activity promotes peristalsis and helps prevent constipation.

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Effects of psychological factors

Emotional stress can speed up digestion and increase peristalsis.

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Defecation position

Squatting is the normal position; sitting aids elimination in bed.

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Pain during defecation

Pain can cause individuals to suppress the urge to defecate, leading to constipation.

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Medications affecting bowel elimination

Certain medications like opioids can slow down peristalsis, causing constipation.

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Stimulant Laxative Dependency

Regular use can lead to intestinal dependence on laxatives.

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Bowel Preparation for Diagnostics

Preparation required to ensure an empty bowel for procedures.

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Constipation

Infrequent bowel movements, less than 3 per week, with hard stools.

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Fecal Impaction

Inability to expel hardened feces due to unrelieved constipation.

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Diarrhea

Increased stool frequency with liquid, unformed feces.

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Signs of Dehydration in Adults

Symptoms include thirst, less urination, dark urine, fatigue.

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Fecal Incontinence

Inability to control passage of feces and gas.

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Hemorrhoids

Dilated, engorged veins in the rectum, can be internal or external.

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Personal Protective Equipment (PPE)

Gear used by health care workers to protect against infections.

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Chain of Infection

The series of events allowing infection to spread.

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Infectious Agent

Microorganisms like bacteria or viruses that can cause disease.

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Reservoir

The habitat where pathogens live and reproduce.

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Port of Exit

The route through which a pathogen leaves its reservoir.

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Mode of Transmission

How pathogens spread from one host to another.

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Port of Entry

The way a pathogen enters a new host.

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Susceptible Host

An individual lacking immunity to infections.

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Stress Response

The body's reaction to emotional or physical stress through general adaptation syndrome.

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General Adaptation Syndrome

The three-stage process of the body's response to stress: alarm, resistance, exhaustion.

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White Blood Cell Count

A laboratory test that indicates infection; normal range is 5000-10000/mm3.

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Erythrocyte Sedimentation Rate

A test measuring inflammation; normal values are up to 15 mm/hr for men and 20 mm/hr for women.

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Iron Level

Normal iron levels in adults: 80-100 mcg/mL for men, 60-160 mcg/mL for women; decreased in chronic infection.

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Cultures of Urine and Blood

Tests done to check for infectious microorganism growth; normally sterile without growth indicates no infection.

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Assessing Risk Factors for Infection

Involves reviewing vaccinations, illnesses, medication history, and recent travel for potential infection risk.

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Symptoms of Possible Infection

Common signs to check include fever, pain during urination, cough, or wounds with drainage.

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Study Notes

Urinary Elimination

  • Elimination is a physiological need, as per Maslow's hierarchy, vital for removing excess water and metabolic byproducts.
  • Adequate elimination relies on coordinated kidney, ureter, bladder, and urethra function.
  • Kidneys filter waste from blood; ureters transport urine from kidneys to bladder; bladder stores urine until full; and urethra expels urine.
  • Micturition is the act of urination, which involves bladder contraction, relaxation of the urinary sphincter, signaling from the brain, and expulsion through the urethra.

Nephron Function

  • Nephrons are the functional units of the kidneys.
  • They remove waste from blood and regulate fluid and electrolyte balance.
  • A glomerulus, a capillary cluster within each nephron, filters water, glucose, amino acids, urea, uric acid, creatinine, and electrolytes.
  • Urine volume held by the kidneys ranges from 300 to 500 mL.

Kidney Functions Continued

  • Kidneys also produce erythropoietin stimulating red blood cell production, and play a central role in maintaining blood pressure via renin-angiotensin system.
  • Kidneys produce a hormone that transforms vitamin D into its active form.

Urinary Elimination Problems

  • Common urinary problems include storage or emptying issues from irritable/overactive bladder, obstructions, impaired bladder contractility, nerve dysfunction.
  • Urinary retention (acute or chronic) is the inability to fully/partially empty the bladder, causing feelings of pressure.
  • Specific problems include frequent urination, urgency, difficulty controlling urination, or inability to urinate.

Urinary Incontinence

  • It is defined as the involuntary loss of urine.
  • Transient incontinence is caused by medical conditions. Reversible causes include delirium, confusion, medications, excessive urine output, and mobility impairment. Functional incontinence relates to issues outside the urinary system. It arises out of deficits in mobility, dexterity, cognition, motivation, or environmental barriers.
  • Stress incontinence is an involuntary leakage associated with increased intra-abdominal pressure.
  • Overflow incontinence is caused by an over-distended bladder often linked to outlet obstruction or weak bladder contractions.
  • Urge incontinence is an involuntary loss of urine accompanied by a strong urge to urinate, often affecting individuals due to neurological problems, bladder inflammation, or obstruction.
  • Reflex incontinence is involuntary loss of urine originating from spinal cord damage.

UTI (Urinary Tract Infection)

  • UTIs are the fifth most common healthcare-associated infection.
  • They are virtually all caused by Escherichia coli, a bacteria present in the colon.
  • Common contributing risk factors include an indwelling catheter or urinary instrumentation, urinary retention, and poor hygiene.

Bowel Elimination

  • Digestive processes include chewing, salivation, swallowing, peristalsis, and sphincter function.
  • The stomach stores, mixes, and prepares food for the small intestine.
  • The small intestine absorbs nutrients, electrolytes, and water.
  • The large intestines absorbs water, creates solid waste, and facilitates bowel elimination.
  • Common issues include constipation, impaction, and diarrhea.
  • Age, psychological factors, personal habits, medication, and disease can impact elimination.

Bowel Diversions

  • Certain diseases or surgical alterations can necessitate bowel diversion.
  • Two types are continent urinary reservoir and orthotopic neobladder.

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