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by French system

how are catheters measure?

by the location and cause of the urinary tract problem

how are the type and size of urinary catheter determined?

physician

who's responsible for the insertion of ureteral catheters?

nurses

who's responsible for the insertion of urethral catheters?

urinary catheters

_____ 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.

irrigation

___ is gentle washing of an area with a stream of solution delivered through a syringe

catheterization

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

14-24F

urethral catheters range from ___ for adults

4-6F

ureteral catheters range from ___

coude catheter

catheters that has a tapered tip; selected for ease of insertion when enlargement of the PROSTATE GLAND is suspected

curved stylet

catheter that is used to assist the physician in the INSERTION OF A URETHRAL CATHETER IN A MALE PATIENT

foley catheter

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.

robinson catheter

has MULTIPLE OPENINGS IN ITS TIP to facilitate intermittent drainage.

ureteral catheters

catheters that are long and slender to pass into the ureters

whistle-tip catheter

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

50 mL

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

condom catheter or a Texas catheter

condom-styled drainage systems are sometimes referred to as...

constrictive

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?

closed system

what is important to prevent urinary infections?

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...

daily

when will you assess the drainage system for leaks?

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?

color and composition

what do you observe of the urine to note any blood or sediment?

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?

self-catheterization

possibly the intervention of choice for the patient who experiences spinal cord injury or other neurologic disorders that interfere with urinary elimination

clean technique

the self-catheterization procedure can be modified by ____ at home

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?

indwelling catheters

self-catheterization has been shown to be successful in maintaining continence and results in fewer infections than with the use of _____

external catheters

catheter that is recommended for patient's with prostatic obstruction

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..

urinary incontinence

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

crede's

what method is helpful when paralyzed patients have overflow incontinence?

crede's method

involves applying manual pressure over the lower abdomen to express urine from the bladder at regular intervals

bladder training

often involves developing the use of the muscles of the perineum to improve voluntary control over voiding

habit training

involves establishing a voiding schedule and provides cooperative patients with opportunity to achieve continence by voiding at regular intervals (every 1.5-2 hours)

clamp-unclamp routine

what does the physician sometimes order to improve bladder tone?

8-24 hours

following surgery, the indwelling cathter will usually be removed after ____ , depending on the type of surgery

8 hours

patients are expected to void adequately no more than ___ after catheter removal

UTI

one of the most common type of iatrogenic infections

2 L/day

after the removal of catheter, patients will need to drink atleast __ of fluids to reduce risk of infection

NG tube

flexible, hollow tube that is passed into the stomach via the nasopharynx

NG tube

serves either to remove gastric contents or to administer fluids or nutrient into the sotmach

NG tube

its primary purpose is for decompression or removal of flatus and fluids from the stomach

NG tube

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

Levin tube

one lumen and several openings near the tip

Salem sump tube

double-lumen tube, one provides an air vent and the other is for removal of gastric contents

Levin and Salem sump tube

tubes most commonly used for decompression

nose guard

a tube fixation device using a shaped adhesive patch to the nose and then to the gown with a pin to prevent unnecessary movement

decompression tube

tube that prevents nausea, vomiting, and abdominal distention

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?

normal saline and Asepto syringe

what do you irrigate the nasogastric tube with regularly?

physician

who is permitted to reposition the tube when certain surgical procedures have been performed?

sterile procedure

inserting a catheter is a ____

supine with thighs slightly abducted

what position do u put male patients for catheter insertion?

dorsal recumbent with knees flexed

what position do u put female patients for catheter insertion?

high Fowler's

in what position is the patient supposed to be when inserting NG tube?

the one with the greater airflow

which nostril will you put the NG tube in?

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?

4 pH or less

gastric aspirates have decidedly acidic ____?

intermittent suction

most effective for decompression

30 degress

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

120 mm Hg

pressure indicated on gauge above ___ leads to gastric bleeding

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...

adolescents

this group's diets are often filled with kilocalorie-rich and nutrient-poor snack foods

fast-food

this type of diet often completely lacks fruits and vegetables and sometimes milk

iron and calcium, vitamins A and C, and folic acid

common dietary inadequacies in adolescence include..

iron

____ needs increase with the onset of menstruation in girls, and anemia is a common problem

restrictive diets

____ 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

energy needs

what decrease with age?

decreased energy needs and reduced physical activity

combining this often result in weight gain

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

malnutrition

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?

pressure sores

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?

caffeine

a type of drug that is a central nervous system stimulant and a diuretic

300 mg/day

general recommendation for caffeine intake is less than ___

medical nutrition therapy

what is the use of specific nutrition techniques to treat an illness, injury, or condition?

therapeutic diet

what diet is used as a medical treatment?

dietitian

who instructs and plans the therapeutic diet?

nurse

who often serve and monitor the therapeutic diet?

diabetes mellitus

the most common type of carbohydrate-modified diet serves in the treatment of ____

diabetes mellitus

a disease in which the body does not produce or properly use insulin

insulin

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 I diabetes

which type of diabetes is required to take daily insulin injections to stay alive?

type II diabetes

a metabolic disorder resulting from the body's inability to make enough or properly use insulin

whole grains, fruits, vegetables and low-fat milk

what types of food contains carbohydrates?

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?

exchange lists

this is often used in diabetic meal planning and are often used in weight reduction programs as well

carbohydrate counting

a meal-planning approach that focuses on the total amount of carbohydrates eaten at meals and snacks

15 g

one carbohydrate choice is equal to ___ of carbohydrate

hypoglycemia

a person experiencing ___ gives the mistaken impression of being intoxicated

dumping syndrome

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

lactose intolerance

this occurs as a result of a lack of the digestive enzyme lactase which causes the GI tract to unable to break down lactose

cancer

___ possible diet modifications include high kilocalorie ad protein; dietary adjustments made based on symptoms; possible tube feeding or TPN

tube feeding

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?

enteral nutrition

what is the administration of nutrients in to the GI tract?

feeding ostomies

what are surgical openings through which a feeding tube passes?

continuous drip pump

what administers the formula slowly over 16-24 hours?

intermittent feedings

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

intermittent feedings

___ is preferred by many long-term tube-fed patients

Bolus feedings

this is giving a 4-6 hour volume of formula in a matter of minutes but most patients tolerates this poorly

dumping syndrome

this is possible with rapid and concentrated formula delivery

lavage

___ 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?

radiologic confirmation

the most dependable means of checking tube placement is through ____

pH measurement

what is the second best method for confirming feeding tube placement?

auscultatory method

____ is insufflating air with a syringe through a tube and then using a stethoscope to listen for a gurgling sound over the epigastric region

esophageal varices

patients with a history of ____ should never be placed an NG tube in because it could cause uncontrolled bleeding and the patient could die

gastric

green, brown, or tan to off-white secretions

interstinal

fluid is medium golden brown or bile stained

pleural

fluid is pale, clear yellow, and watery

0 to 4

gastric contents will usually have a pH range of ___

6

tracheobronchial and pleural secretions will usually have a pH greater than ___

7 or greater

intestinal contents will usually have a pH of __

bolus or intermittent feedings

administering the tube feeding with 60 mL bulb or plunger syringe

continuous drip method

administering the tube feeding with gavage bag

every 4 hours

when will you check residuals and verify tube placement with patients who receive continuous drip feedings?

30-60 minutes

usually continuous drip method infuses for ____ three to six times per day

feeding via infusion pump

administering the tube feeding as a continuous drip via infusion pump and lasts for no more than 8 hours

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