Urinary & Bowel
Name 3 questions a prudent nurse would ask to assess urinary patterns and elimination.
1. How often do you urinate during the day?
2. Do you awaken at night to urinate?
3. Do you urinate when you laugh or sneeze?
Nursing interventions that promote adequate sleep in an older adult include what?
1. Limiting fluids 2 to 4 hours before sleep.
2. Ensuring that the room temperature is comfortable.
3. Providing warm covers.
4. Clustering nursing care.
These involuntary muscle contractions in the digestive system are responsible for the movement of food and waste.
What is peristalsis?
An older adult patient is admitted following a hip fracture and surgical repair. What would be most important to assess before ambulating the patient postoperatively on the evening of surgery?
Preadmission activity tolerance
Baseline HR
This pain is felt in a tissue, organ, or damaged part of the body or as referred pain.
What is nociceptive pain?
This is a measure of the density of the chemicals and particles in the urine and a measure of the kidneys abilities to concentrate urine. (1.015-1.025)
What is specific gravity?
A nurse is providing education in a senior center on sleep and sleep hygiene in older adults. What teaching point will the nurse include?
Eating a bedtime snack high in tryptophan and carbohydrates improves sleep.
This diet consists of restrictions on sodium, potassium, phosphorus, and/or fluids.
What is a renal diet?
Name 3 nursing interventions the that are used to prevent complications of immobility.
Turn patient q 2 hours
Place SCD/compression stockings
Perform ROM exercises
Incentive Spirometer/Deep breathing
What would the nurse anticipate when administering pain medication to an elderly patient?
Reduced metabolism and excretion of drugs
A greater peak effect and longer duration of pain medication
These drugs can cause urine to change color.
What are phenazopyridine (orange or orange red), amitriptyline or B-complex vitamins (green or blue green), and levodopa (brown/black)?
As part of interprofessional rounds, a nurse in a skilled facility assesses for sleep deficits. Patients with which health problems would the team identify as higher risk for sleep disturbances?
Uncontrolled hypothyroidism
Anxiety
GERD
A patient who has uncontrolled hypothyroidism tends to have a decreased amount of NREM sleep, especially stages II and IV. Worries and anxiety can interfere with sleep, as can pain. A patient who has GERD may awaken at night with heartburn pain.
When administering parenteral nutrition, the nurse should monitor which laboratory values?
Electrolytes, blood sugar, albumin, BUN, and creatinine
Describe how to properly use a walker
move walker a short distance in front of you
ensure all 4 tips are on the group before step
step forward with weak leg
step forward with strong leg
A patient is being discharged home on an around-the-clock (ATC) opioid for postoperative pain. Because of this order, the nurse anticipates an additional order for which class of medication?
Stool softeners
The nurse performs these actions for a patient who has undergone abdominal surgery and now has an NG tube attached to low suction.
1. Irrigation of the tube with 30-mL normal saline
2. Confirming tube placement via pH testing
3. Positioning the air vent at the level of the patient's umbilicus
4. Monitoring the patient's abdomen for distension
Describe three independent nursing interventions to promote sleep.
Promote comfort (pain relief, environmental comfort)
Support bedtime routines
Offer bedtime snacks
This diet consists of low salt, cholesterol, caffeine, and high potassium.
What is a cardiac diet?
A patient has been on bed rest for over 5 days. What findings during the nurse’s assessment may indicate a complication of immobility?
Decreased peristalsis
Joint stiffness
While educating the patient about the use of cold therapy for joint pain relief, the nurse instructs the patient to apply the cold for no longer than how many minutes?
5 minutes or until numbness
A patient tells the nurse that they are feeling dizzy and nauseated and then vomits during digital removal stool for fecal impaction. What is the nurse's next action?
The nurse should stop the procedure, assess vital signs, and notify the HCP due to possible vagus nerve stimulation.
A nurse in a rehabilitation facility develops a plan to help promote patients’ sleep. What interventions will the nurse include in the plan?
Maintain a consistent bedtime and time to awaken.
When evaluating whether a patient tolerates enteral feedings, which criteria should be considered?
Absence of nausea, vomiting
Absence of diarrhea and constipation
Absence of abdominal pain and feelings of fullness
Absence of distention
Name 3 ways immobility affects the cardiopulmonary system.
Decreased cardiac output
Pooling of blood (increased risk for DVT's, PE)
Pooling of secretions (increased risk for pneumonia)
Decreased depth of respirations (increased risk for atelectasis)
A new medical resident writes an order for oxycodone CR 10 mg PO q2h prn. Which part of the order does the nurse question?
The time interval