by the location and cause of the urinary tract problem
how are the type and size of urinary catheter determined?
_____ is used to maintain urinary flow to divert it to facilitate healing postoperatively, to introduce medications by irrigation, and to dilate or prevent narrowing of some portions of the urinary tract.
introducing a rubber or plastic tube through the meatus and the urethra and into the urinary bladder
patient with: surgical procedures of the bladder, prostate or vagina; with primaryurologic problems such as urethral stricture, and those with multisystemic problems
patients at risk for difficulty with urine elimination
catheters that has a tapered tip; selected for ease of insertion when enlargement of the PROSTATE GLAND is suspected
catheter that is used to assist the physician in the INSERTION OF A URETHRAL CATHETER IN A MALE PATIENT
catheter designed with a balloon near its tip that is possible to inflate after insertion, holding the catheter in the urinary bladder for continuous drainage.
malecot and de pezzer or mushroom catheters
catheter that is used to drain urine from the RENAL PELVIS OF THE KIDNEY.
catheters that has a slanted, larger orifice at its tip to be used if there is blood in the urine
cystostomy, vesicostomy, or the suprapubic catheter
catheter that is introduced through the abdominal wall above the symphysis pubis to create a temporary urinary diversion; inserted via surgical incision or puncture of the abdominal and bladder walls with a trocar cannula
using suprapubic catheter, when the measured residual urine is consistently less than ___, the catheter is usually removed and a sterile dressing placed over the wound
main drawback for using this condom catheter or a Texas catheter device is that it sometimes becomes too _____
condom catheter or a Texas catheter
device is not a catheter but rather a drainage system connected to the external male genitalia; it is used for the incontinent male to keep skin irritation from urine to a minimum
employing number of principles to prevent and detect infection and trauma
nursing interventions for the patient with a urinary drainage system include...
check the drainage system for proper placement and function
if urine output falls to less than 50 mL/hr, what should the nurse do?
to irrigate the catheter and/or with a specific order from the physician
when is the only time you should open the drainage system after it is in place?
how many times do you perform catheter care and what type of precautions is used?
twice daily and as needed; and standard
cause urine to reenter the drainage system and contaminate the urinary tract
placing the urinary drainage bad above the level of the catheter insertion will...
prevent tension on the system or backflow of urine
what is important to know while transferring a patient with the drainage system?
kinks or compression of the drainage tube
what tend to cause pooling of urine within the urinary tract?
blood or exudate
what do you inspect in the entry site of the catheter that can indicate possible trauma or infection?
withdraw the urine by using a sterile needle and a sterile 10 mL syringe using standard precautions
what do you do next after collecting the specimens from the catheter and cleansing the drainage port with alcohol?
bladder tone and sensation returns
after the urinary catheter is removed, some patients have difficulty voiding until...
running water, placing the patient's hands in water, or pouring water over the perineum
how will you stimulate urination?
possibly the intervention of choice for the patient who experiences spinal cord injury or other neurologic disorders that interfere with urinary elimination
an adequate oral fluid intake of 2000 mL/day and assisting pt to toilet on a regular, timed basis
what will help the bladder retrain and prevent the need for excessive catheterization?
self-catheterization has been shown to be successful in maintaining continence and results in fewer infections than with the use of _____
urgency, frequency, hesitancy, burning and bladder spasms
signs and symptoms of urinary tract infection
perineal hygiene every 8 hours and cleansing of the first 2 inches of the catheter to remove any secretions or encrustations
to prevent UTIs, it is important that patients receive ____
loop tubing and secure it to the bed linen
before hanging the collection device from the bed frame, make sure to..
occurs because pressure in the bladder is too great or because the sphincters are too weak
pelvic floor exercises (kegel exercises)
involves tightening of the ring of muscle around the vagina and the anus for several seconds
involves applying manual pressure over the lower abdomen to express urine from the bladder at regular intervals
often involves developing the use of the muscles of the perineum to improve voluntary control over voiding
involves establishing a voiding schedule and provides cooperative patients with opportunity to achieve continence by voiding at regular intervals (every 1.5-2 hours)
following surgery, the indwelling cathter will usually be removed after ____ , depending on the type of surgery
after the removal of catheter, patients will need to drink atleast __ of fluids to reduce risk of infection
serves either to remove gastric contents or to administer fluids or nutrient into the sotmach
helps prevent vomiting and distention caused by reduced peristalsis resulting from general anesthesia, manipulation of the viscera during surgery, or obstruction of the operative site by edema
Salem sump tube
double-lumen tube, one provides an air vent and the other is for removal of gastric contents
a tube fixation device using a shaped adhesive patch to the nose and then to the gown with a pin to prevent unnecessary movement
every 2 hours
when will you provide mouth care after inserting NG tube to keep dehydration to a minimum
do not swallow any water
it is important to ensure that the patient ___ after insertion of the NG tube
maintaining patient comfort and patency of the tube
what are two of the greatest challenges when inserting NG tube to a patient?
who is permitted to reposition the tube when certain surgical procedures have been performed?
tip of nose to earlobe to xiphoid process of sternum
how will you measure the total distance when inserting the NG tube?
apply gentle downward pressure to advance tube
what do you do when resistance is felt while inserting the NG tube?
withdraw tube, allow patient to rest, relubricate tube and insert into the other nostril
what do you do when resistance continues while inserting the NG tube?
advance tube 1-2 inches
what do you do with each swallow of the patient while inserting the NG tube?
unless physician orders otherwise, elevate the patient's head of bed ___ to prevent esophageal reflux and keeps to a minimum irritation caused by tube against posterior pharynx
if you hear no hissing sounds
when do you instruct the patient to cough or reposition patient in the right or left Sims' or the supine position?
gastric contents are aspirated with cone-tipped syringe
after inserting the NG tube, it is possible to be certain it is in the proper place if...
iron and calcium, vitamins A and C, and folic acid
common dietary inadequacies in adolescence include..
____ sometimes cause harm by suppressing development and even leading to eating disorders
limiting TV viewing and computer usage
ways to help increase physical activity and thus increase the amount of energy expended
water, dietary fiber and adequate physical activity
what plays an important role in preventing constipation in older adults?
protein, riboflavin, vitamin B6, folic acid, vitamin B12, vitamin D and calcium
what certain nutrients do older adults may have a greater need for?
increased incidence of chronic medical conditions
this often necessitates the use of therapeutic diets in older adults
what is a common problem among nursing home residents and profoundly influences physical health and quality of life?
excessive sodium or fat restrictions
this often reduce the palatability of food and thereby contribute to poor nutritional intake
inadequate fluid intake and dehydration
what decrease thirst sensation, decreased independence, dysphagia, and incontinence?
what occurs in many nonambulatory residents, increasing kilocalorie, protein, and nutrient needs?
liberalized older adult diet
what diet has mild salt, fat, and concentrated sweets restrictions, but avoids severe restrictions?
liquid nutritional supplements
what often help to increase kilocalorie, protein, and nutrient intake?
medical nutrition therapy
what is the use of specific nutrition techniques to treat an illness, injury, or condition?
the most common type of carbohydrate-modified diet serves in the treatment of ____
a hormone that is needed to convert sugar, starches, and other food into the energy needed for life
type I diabetes
a disease in which the body does not produce any insulin; this is most often occuring in children and young adults
type II diabetes
a metabolic disorder resulting from the body's inability to make enough or properly use insulin
limit saturated fat and dietary cholesterol to help control blood lipid levels
what is the primary dietary fat goal for people with diabetes?
balancing carbohydrate intake with insulin administration
what is the goal of diet in type I diabetes?
provide nutritionally adequate meal plan that achieves and maintains desirable weight, normal blood cholesterol concentration, and normal blood glucose levels
what is the primary goal of diet in people with type II diabetes?
this is often used in diabetic meal planning and are often used in weight reduction programs as well
a meal-planning approach that focuses on the total amount of carbohydrates eaten at meals and snacks
possible after surgery in which a portion or all of the stomach is removed (partial or total gastrectomy) or after bariatric surgery for weight reduction
this occurs as a result of a lack of the digestive enzyme lactase which causes the GI tract to unable to break down lactose
___ possible diet modifications include high kilocalorie ad protein; dietary adjustments made based on symptoms; possible tube feeding or TPN
what is the administration of nutritionally balanced liquefied foods or formula through a tube inserted into the stomach, the duodenum, or the jejunum by way of nasoenteric tube or a feeding ostomy?
this involves giving a specific volume of formula over a short time, about 20-30 minutes and will usually be done 4-6 times daily
this is giving a 4-6 hour volume of formula in a matter of minutes but most patients tolerates this poorly
___ is the process of removing poisonous substances through gastric intubation by way of suction
checking for placement of a feeding tube before administering medication or tube feeding
what is critical to safe patient care?
____ is insufflating air with a syringe through a tube and then using a stethoscope to listen for a gurgling sound over the epigastric region
patients with a history of ____ should never be placed an NG tube in because it could cause uncontrolled bleeding and the patient could die
every 4 hours
when will you check residuals and verify tube placement with patients who receive continuous drip feedings?
feeding via infusion pump
administering the tube feeding as a continuous drip via infusion pump and lasts for no more than 8 hours
usually gastrostomy and jejunostomy feedings are give continuously to ensure proper absorption
every 6 hours
monitor fingerstick blood glucose ___ until maximum administration rate is reached and maintained for 24 hours
parenteral nutrition or hyperalimentation
term that is used to describe intravenous feedings and possible to administer through peripheral veins
total parenteral nutrition
refers to the administration of a hypertonic solution into a large central vein
infusing the solution into the superior vena cava via a catheter threaded through either the subclavian or the internal jugular vein
those needing 3000 kcal/day or less, those needing supplementation to oral diet, or those requiring short term therapy (less than 3 weeks)
who are the candidates for PPN?
those who need more kcal than can be administered peripherally or those requiring fluid restriction and those who have to be on IV feeding for more than 3 weeks
TPN is indicated for patients needing a highly concentrated formula such as...
only one-third full
how much will you fill the spoon so that the patient can easily chew and swallow the mouthful?
an abnormal circulatory condition in which an embolus travels through the blood stream and becomes lodged in a blood vessel
it will sometimes increase excretion of vitamin C and possibly lead to loss of iron from the GI tract
what effect does aspirin sometimes have on nutritional status?
fat and cholesterol controlled diets
this diet helps reduce the risk of atherosclerosis and certain cancers
fat controlled diet
desirable for the prevention and treatment of atherosclerosis, heart disease, and hyperlipidemia and diabetes
the first step in treatment of patients with elevated blood lipids and existing cardiovascular disease
inclusion of monosaturated fats in the diet
this often helps lower blood cholesterol and triglyceride levels
omega 3 fatty acids
a particular type of unsaturated fat found in fatty fish, flaxseed oil, and soy products
a constellation of metabolic risk factors including abdominal obesity, dyslipidemia, elevated blood pressure and insulin resistance
oral enzyme therapy
use of this before meals and snacks helps reduce malabsorption, allowing CF patients to consume a diet higher in fat
plant products such as dried beans and whole grains
incomplete proteins include food products such as
dysrhythmias and sudden cardiac arrest
if dietary intake is not controlled, blood potassium levels will potentially increase to the point of causing _____
fluids, electrolytes, and protein
after a severe burn, these are given intravenously rather than orally because burn patients experience a temporary loss of bowel function
tube used to maintain a patent airway that is indicated when the client needs mechanical ventilation
triple lumen gastric tube with an inflatable esophageal balloon, an inflatable gastric balloon and a gastric aspiration lumen
300-400 mL of formula over a 30-60 minute period every 3-6 hours
administration of intermittent or bolus
reinstill the residual and administer the feeding
the nurse aspirates 90 mL of residual tube feeding. what should the nurse do with the aspirated feeding?
discontinue suctioning until the client is stabilized and monitor VS
a nurse is providing endotracheal suctioning to a client who is mechanically ventilated when the client becomes restless and tachycardic. what should the nurse do?
clamp the NG tube for 30 mins after medication administration
a nurse is preparing to administer medication through a NG tube that is connected to suction. which of the following indicates the accurate procedure for medication administration?
inserts the catheter 2.5-5 cm and inflates the balloon
a nurse is inserting an indwelling urinary catheter into a male client. as the catheter is inserted into the urethra, urine begins to flow into the tubing. at this point, the nurse:
continue to monitor because this is an expected finding
a nurse is assigned to assist with caring for a client who has a chest tube. the nurse notes fluctuations of the fluid level in the water seal chamber. based on this observation, which action would be appropriate?
perform valsalva's maneuver
a nurse is assigned to assist the physician with the removal of a chest tube. the nurse instructs the client to do which of the following during this process?
hold the feeding
a nurse is preparing to administer an intermittent tube feeding to a client with a NG tube. the nurse checks the residual and obtains an amount of 200 mL. the nurse would :
a bolus of air enters the vein through an inadequately primed IV line, from a loose connection, or during a tubing change or the removal of the IV