Term
| RBC's are done in a CBC (Complete Blood Count). _________________ is a hormone produced by the kidney that promotes generation of RBC's. THe body needs more oxygen, you have to be able to oxygenate self & will need RBCs to do so. |
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Definition
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Term
| Females RBC range is from ____ to ____. |
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Definition
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Term
| Males norm RBC range is from ____ - ____ |
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Definition
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Term
| What is the most common reason for ELEVATED RBCs? |
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Definition
| excessive production of erythropoietin. It is elevated b/c the body is trying to respond to make more oxygen & is making more erythropoietin. |
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Term
| What 3 of the most common reason for DECREASED RBCs? |
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Definition
| Anemia, Hemmorhage (excessive bleeding) & Hemolysis |
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Term
| A normal total WBC count is: |
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Definition
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Term
| What are the common reasons for elevated WBCs? |
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Definition
| Infection or Inflammation |
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Term
| What are the common reasons for decreased WBCs? |
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Definition
| Overwhelming Infection, an Autoimmune Disorder or Immunosuppressant therapy. |
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Term
| What is the most accurate way to monitor a patients oxygen saturation? |
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Definition
| Their ARTERIAL BLOOD GASES (ABGs) - this includes Partial Pressures of Oxygen, Carbon Dioxide, pH and Bicarbonate (HCO3) saturation. |
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Term
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Definition
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Term
| What's a common reason for elevated PaO2? |
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Definition
| Excessive oxygen administration. So a pt who has a respiratory disorder may actually have elevated PaO2 b/c they're getting extra oxygen in their therapy. Usually it's decreased tho b/c they're hypoxic (not getting enough oxygen). |
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Term
| What's a common reason for decreased PaO2? |
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Definition
| HYPOXIA - some causes of not enough oxygen could be: COPD, respiratory distress syndrome, they're choking, etc... |
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Term
| What's the norm range for PaCo2? |
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Definition
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Term
| What's the common reason for elevated PaCO2? |
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Definition
| Respiratory ACIDOSIS (elevated carbon dioxide is resp acidosis!) |
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Term
| What's the common reason for decreased PaCO2 levels? |
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Definition
| Respiratory ALKALOSIS (decreased carbon dioxide in the blood leads to respiratory alkalosis) |
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Term
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Definition
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Term
| What's the most common reason for elevated pH? |
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Definition
| Respiratory ALKALOSIS - causes elevated pH |
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Term
| What's the common reason for decreased pH? |
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Definition
| Respiratory ACIDOSIS (low pH = resp. ACIDOSIS - makes sense b/c we know the low pH #'s are more acidic) |
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Term
| What is the normal Bicarb (HCO3) range? |
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Definition
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Term
| What's the most common reason for elevated Bicarb? |
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Definition
| Respiratory Acidosis as compensation for Metabolic Alkalosis. |
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Term
| What's the most common reason for decreased Bicarb? |
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Definition
| Respiratory Alkalosis as compensation for Metabolic Acidosis |
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Term
| Respiratory Acidosis happens b/c of Carbon Dioxide _________. |
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Definition
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Term
| What are some reasons for carbon dioxide retention (that causes the Respiratory Acidosis)? |
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Definition
| Respiratory Depression, Inadequate chest expansion, an Airway Obstruction and/or reduced Alveolar-Capillary Diffusion. |
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Term
| What are the ABGs of Respiratory Acidosis? |
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Definition
| Low pH (acidic pH), Elevated PaCO2 (elevated carbon dioxide levels), Low PaO2 (Low oxygen levels) |
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Term
| Respiratory Acidosis occurs with Hyper or Hypokalemia? |
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Definition
|
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Term
| Respiratory Alkalosis happens b/c of ___________ ____ of carbon dioxide |
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Definition
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Term
| Some things that cause the excessive loss of carbon dioxide that leads to respiratory Alkalosis are: |
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Definition
| HYPERVENTILATION d/t anxiety and/or improper ventilator settings. HYPOXEMIA d/t asphyxiation, high altitudes and shock. |
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Term
| The ABG's of Respiratory Alkalosis look like: |
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Definition
| High pH (more acidic), Low HCO3 (low bicarb), Low PaCO2 (low carbon dioxide) |
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Term
| How do we determine the ABGs? |
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Definition
| 1st assess the pH, 2nd assess the PaCO2, 3rd assess the HCO3. Draw a vertical line through the value that is in the same column as the pH. Determine the level of compensation. |
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Term
| ____________ is an inflammation of the nasal mucosa. It can be any one of these: allergic, chronic or acute viral. |
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Definition
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Term
| The common cold is likely to last 7-10 days & it is most likely to spread when? |
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Definition
| the infection is usually spread during the first 2-3 days. Which is unfortunate b/c we don't go to the doctor to get antibiotics until much later. |
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Term
| _________ is inflammation of the sinuses. Usually happens in the maxillary and the frontal sinuses. |
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Definition
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Term
| ________ often follows rhinitis. |
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Definition
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Term
| _______________ is inflammation of the mucous membranes of the pharynx. |
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Definition
Pharyngitis - symptoms are a Sore or red, raw throat
Difficulty speaking or swallowing, Tender, swollen lymph nodes (glands) in the neck, Fever, Headache, Earache |
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Term
| The big issue with pharyngitis is whether it is _______ or _________. most cases are... |
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Definition
| viral or bacterial. Most cases are "viral" and are caused by the common cold. The difference is whether you get an antibiotic. You should advise the pt with a sore throat to gargle with salt water, increase fluids, have lozenges, take pain relievers to ease the discomfort - things like this clear up most cases in 3-10 days. Pharyngitis caused by viruses clears up on its own, but pharygitis caused by bacteria requires an antibiotic |
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Term
| Pharyngitis can lead to this. It is most commonly caused by Strep. What is it? |
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Definition
| Tonsillitis - an infection of the tonsils that will cause a sore throat and often a fever. |
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Term
| What do we treat tonsillitis with? |
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Definition
| Penicillin or Erythromycin |
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Term
| It can be treated with a ______________ if tonsillitis is chronic |
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Definition
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Term
| The problem with tonsillitis is it causes airway swelling, bleeding and obstruction. What does the nurse need to teach the pt in order for them to stay safe? |
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Definition
| Do not eat anything red so bleeding is identified if it's occuring. Do NOT suck through a straw b/c of risk of hemorrhage. |
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Term
| Influenza is a HIGHLY contagious _______. |
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Definition
| VIRUS. It's caused by one of many viruses... Influenza=viral |
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Term
| How do we treat influenza? |
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Definition
| Antiviral agents, but they must be taken within the first 24 hours of conception of influenza. Influenza vaccinations too (the flu shot). Teach good handwashing. Getting a flu shot is on the test - you're pro flu shot (influenza vaccination). It is an inactivated - killed form of it. Recommended for anyone over 6 months of age. Nasal spray is also done. This is a Live Attenuated Influenza Vaccine (LAIV). Recommended for people 4-49 years old. |
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Term
| Why is it untrue that when people get a flu shot they are getting injected with a bit of the flu? Why should you be pro vaccinations? |
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Definition
| It is an inactivated virus, you should not get the flu from the influenza vaccine. However, you can have a reaction to putting something not you into your body. Like a kid reacting to vaccinations. It is now even recommended that kids should get the flu shot b/c flus can get so bad now. It is especially recommended that HC workers get a flu shot. |
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Term
| Sleep apnea is now more of a problem than ever b/c of __________ in the population. |
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Definition
| obesity. However, you do NOT need to be obese to have it. |
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Term
| What is the diagnosis for sleep apnea? |
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Definition
| Lasts atleast 10 seconds and happens 5 times an hour. You don't need to memorize - just know about. What happens is when sleeping the muscles relax & fat covers the airway or the tongue falls back & covers the airway. People with a large uvula, short necks and smokers are all risk factors for apnea. |
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Term
| What interventions are done for people with sleep apnea? |
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Definition
| nonsurgical mgmt includes: Weight Loss, change their positioning while sleeping helps and position-fixing devices. Most people with sleep apnea have NPPV (Non-invasive positive pressure ventilation). This keeps positive pressure in the airway to keep the tongue back & keep them breathing. 2 machines of these are: BiPAP (bilevel positive airway pressure) and CPAP (continuous positive airway pressure). |
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Term
| There are surgical interventions done for sleep apnea... what are they? |
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Definition
| Adenoidectomy (removal of adenoids. they help fight ear, nose & throat infections in children, but after age 3 are unneeded). Uvulectomy (removal of the uvula). Uvulpalatopharyngoplasty (UPPP): is where the tissue in the throat is surgiaclly removed. May or may not include the uvula, soft palate, tonsils, adenoids and pharynx. |
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Term
| Why is the surgeries discussed SO high risk? |
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Definition
| They're high risk surgeries on the airway & they're usually obese patients. They're high, high risk surgeries. |
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Term
| Why is an upper airway obstruction a life threatening emergency? |
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Definition
| There is an interruption of airflow through the nose, mouth, harynx or larynx. any of these places ca be obstructed. |
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Term
| What do you do for an upper airway obstruction? Specifically, the tongue falling back? |
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Definition
| Need to take their tongue out so they're able to breath again. If the tongue is falling back then extend the head & neck... reposition their airway. |
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Term
| What about if the upper airway is obstructed b/c of an accumulation of secretions? |
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Definition
| Suction the mucous plugs out |
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Term
| What intervention needs to be done for a foreign body clogging the upper airway? |
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Definition
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Term
| When the less invasive procedures do not work & their O2 sats are still dropping... emergency procedures are implemented. What is a cricoidthyroidotomy? |
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Definition
| ER procedure where they stab between the cricoid cartilage & the thyroid in order to bypass the obstruction & get oxygen. |
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Term
| What is endotracheal intubation? |
|
Definition
| Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure. |
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Term
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Definition
| surgical procedures on the neck to open a direct airway through an incision in the trachea (the windpipe). Can be an emergency procedure, but is often scheduled. There is a balloon to keep air in & not let the tube move. It can cause tissue erosion. Trachs can be temporary or permanent. |
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Term
| In a trach, the __________ canula fits into the stoma on the exterior of the throat. |
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Definition
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Term
| The disposable _________ canula fits into the outer canula & clicks into place. This acts as an adapter. |
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Definition
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Term
| What is safe to have at the bedside with a trach? |
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Definition
| obturator - it should be taped at the HOB |
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Term
| What keeps the trach in place? |
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Definition
| THE BALLOON CUFF. The pilot balloon inflates the cuff. The cuff keeps the trach in place. The cuff can case eroded tissue, but its necessary. |
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Term
| One trach complication that occurs is "tube obstruction." how do you know? what do you do? |
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Definition
| you know b/c the pt is having difficulty breathing, is having noisy respirations, such thick secretions. You will assess the tube, maybe they can cough it up... ask them to give you a big cough & then look out. So have them cough & deep breath. Then you can also suction. |
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Term
| The other problem with trachs is it can become dislodged or fall out. 1. What do you do if it is in the first 72 hours post-op? 2. What do you do if it is after 72 hours and the tube falls out? |
|
Definition
1. Ventilate patient & call for help
2. Replace the tube: extend their neck, insert obturator in the tube, replace tube and remove obturator |
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|
Term
| What are the examples of Chronic Airflow Limitation (CAL)? |
|
Definition
| Asthma, Chronic Bronchitis, Pulmonary emphysema & COPD |
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Term
| Asthma is intermittent and _____________. |
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Definition
| REVERSIBLE. Asthma is reversible (test worthy) |
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Term
| What is asthma caused by? |
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Definition
| it's caused by inflammation in hyper-responsive airways. There are more than 5,000 deaths d/t acute asthma.... it's a huge problem in emergency depts. The hyper-responsive airways can cause bronchospasm (narrowing of bronchiole tubes) - when the smooth muscle in bronchioles constricts around the bronchiole walls. It's an airway obstruction - tightens up & nothing gets through. |
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Term
|
Definition
| it is a sudden constriction of the muscles in the walls of the bronchioles. It causes difficulty in breathing which can be very mild to severe |
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Term
| What are the 3 Pulmonary Function Tests? |
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Definition
| 1. FVC=FORCED VITAL CAPACITY(Vital capacity measured with subject exhaling as rapidly as possible) 2. FEV1=FORCED EXPIRATORY VOLUME IN THE FIRST SECOND (The volume of air that can be forced out in one second after taking a deep breath, an important measure of pulmonary function) 3. PERF=PEAK EXPIRATORY RATE FLOW (measures how fast a person can breathe out (exhale) air. It is one of many tests that measure how well your airways work.) |
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Term
| What are the 3 pharm solutions for asthmatics? |
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Definition
| Bronchodilators (dilate the bronchioles), Methylxanthines (stimulant that stimulates the drive to breathe. drug=Theophylline), Anti-inflammatories (reduce inflammation, drug is NSAIDs) |
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Term
| There is a difference between maintenance inhalers (like Advair) & what they need when they're having an acute attack. What is it? |
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Definition
| The maintenance inhalers are used 3-4x/week and the rescue inhalers are just for emergencies. Really need to educate people about both. Many people die b/c they use maintenance inhalers for an acute attack. Explain the importance & reason so they don't just think they can save money on one they don't really use. Might need to label them for them. Really important to teach this! |
|
|
Term
| How is COPD different from asthma? |
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Definition
| COPD, like its name implies is "chronic", it is progressive & is NOT REVERSIBLE. |
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|
Term
| COPD is characterized by what? |
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Definition
| dyspnea & bronchospasms. It's progressive & pt's die from respiratory failure. |
|
|
Term
| What is the #1 risk factor for developing COPD? |
|
Definition
|
|
Term
| What is happening in COPD? |
|
Definition
| Airway inflammation leads to alveolar problem. The exchange of gas that's very important is not happening with COPD. COPD pt's suffer from loss of gas exchange. COPD pt's lungs are not moving up & down. Their breathing is not symmetrical, they've lost elasticity. They have airtrapping & their lungs hyperinflate & stay that way. COPD pt's breathe out & some of the air will stay in (air trapping). COPD pts are sick a lot with respiratory infections. |
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Term
| Emphysema is COPD. What occurs is: |
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Definition
| Loss of lung elasticity & Hyperinflation of the lung |
|
|
Term
| What is happening with Chronic Bronchitis in COPD patients? |
|
Definition
| Inflammation of bronchi & bronchioles. There is an increase in the number and size of the mucous glands. |
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Term
| COPD pts are diagnosed first with a chest x-ray. What does the CXR find? |
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Definition
| HYPERINFLATION of the lungs & a FLAT DIAPHRAGM. |
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Term
| Pulmonary Function Tests (PFT) on COPD pts will find: |
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Definition
| INCREASED RESIDUAL VOLUME (RV) and AIR TRAPPING (they're unable to release inhaled air completely on exhalation. |
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Term
| COPD pt's can have pulse oximetry as low as __%. |
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Definition
| 91 All the oxygen doesn't do anything - know your patients baseline. |
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Term
| Oxygen therapy for COPD management can be via oxygen tanks. Clients who are hypoxemic & have hypercarbia require ... |
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Definition
| LOWER levels of oxygen. Only get 1-2 L/min. These LOW ARTERIAL LEVELS ARE THEIR PRIMARY DRIVE FOR BREATHING. If we give them too much oxygen, we will eliminate their drive to breathe. |
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Term
| What's the difference between HYPOXEMIA and HYPOXIA? |
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Definition
| Always think of hypoxemia (emia - blood) and hypoxia as deficient tissue oxygenation |
|
|
Term
|
Definition
| abnormally high level of carbon dioxide in the circulating blood |
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|
Term
| What is the pharm therapy for COPD patients? |
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Definition
| the same as for asthma, some inhaled & some systemic. COPD is more likely to take systemic drugs than the patient with asthma. In addition, the COPD may take a mucolytic to thin secretions. (Like Mucomyst (actylecysteine) - a nebulizer or Guaifenesin - taken orally) |
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|
Term
| What kind of breathing positions/techniques are common with COPD pts? |
|
Definition
| 'tripod' breathing (sitting forward with elbows on table & legs spread to open up lungs) in advanced lung disease |
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|
Term
| Techniques to teach COPD pts to help breathing... |
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Definition
| Diaphragmatic breathing is therapeutic to release trapped air (To breathe diaphragmatically, or with the diaphragm, one must draw air into the lungs in a way which will expand the stomach and not the chest). Also teach pursed lip breathing: we want them to exhale twice as long as they inhale. Breathe out twice as long as you breathe in. |
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|
Term
| Cor Pulmonale is ____ sided heart failure. |
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Definition
| RIGHT. It occurs secondary to he air trapping. |
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Term
|
Definition
| Right-sided heart failure d/t respiratory disease. It is an enlargement of the right ventricle due to high blood pressure in the lungs usually caused by chronic lung disease. Right sided ventricular hypertrophy is the predominant change. |
|
|
Term
| What are the signs of cor pulmonale or right sided heart failure? |
|
Definition
Shortness of breath
Swelling of feet and ankles
Urinating more frequently at night
Pronounced neck veins
Palpitations (sensation of feeling the heart beat)
Irregular fast heartbeat
Fatigue
Weakness
Fainting |
|
|
Term
| Right sided heart failure symptoms... |
|
Definition
| congestion in the peripheral tissues, dependent edema & ascites, liver congestion, GI tract congestion, anorexia, GI distress, weight loss, signs related to impaired liver function (jaundice, cholestasis). |
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|
Term
| Left sided heart failure symptoms... |
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Definition
| decreased cardiac output ->activity intolerance and signs of decreased tissue perfusion. Pulmonary congestion->impaired gas exchange->cyanosis & signs of hypoxia. Pulmonary edema->cough with frothy sputum, orthopnea, paryoxysmal nocturnal dyspnea. |
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Term
| What are the three Thoracotomy (means incision into the chest) that we looked at? |
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Definition
| Segmentectomy: removal of a portion of the lung. Lobectomy: removal of a lobe (the right lung has 3 lobes, the left lung has 2 lobes & is slightly smaller). Pneumonectomy: removal of an entire lung (usually b/c of tumor/lung cancer). |
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Term
| What do chest tubes allow for? |
|
Definition
| allows for reexpansion of the lungs & also functions to drain air, fluid or pus. Its a flexible tube inserted into the pleural space. The puncture wound is covered with airtight dressings. Want to keep the device below the chest to allow gravity to drain. Want to keep the tubing clear & be sure the patient is not laying on the tubing. |
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Term
| Chest tubes have a drainage system with 3 chambers, what for? |
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Definition
| 1st part measures how much blood they have, 2nd part is the water seal (bubble allow us to know if there is an air leak + tells the pts status) & the last is the suction control connected to the wall. |
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Term
| What does 'continuous' bubbling in a chest tube drainage system mean? |
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Definition
| There is an air leak. If there's continuous bubbling - get a physician's order to clamp the tubing. Do first closest to the dressing: if the bubbling stops there is an air leak at the insertion site or within the chest. If bubbling does not stop: the air leak is between the clamp and the drainage system. |
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|
Term
| What if there is bubbling during forcible expiration & coughing? |
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Definition
| intermittent bubbling is normal |
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Term
|
Definition
| Excess fluid in the lungs resulting from inflammatory process. |
|
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Term
|
Definition
| Community Acquired Pneumonia vs Hospital Acquired Pneumonia |
|
|
Term
| What are the findings for pneumonia? |
|
Definition
| POSITIVE SPUTUM SPECIMEN, elevated WBC's, Abnormal ABGs, Chest x-ray will reveal INCREASED DENSITY (CONSOLIDATION) |
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|
Term
| pneumonia is an _____________ illness of the lung. |
|
Definition
|
|
Term
| What is auscultated on pt's with pneumonia? |
|
Definition
|
|
Term
| Whats the fluid associated with pheumonia? |
|
Definition
This happens when fluid builds up in the space between your lungs and the wall of your chest. This makes it hurt when you breathe in and out. Doctors call it a pleural effusion.
Sometimes the fluid gets infected. Doctors call this empyema. If this happens, it might be necessary for the fluid to be drained off. This is done with a needle or a thin tube that is inserted between your ribs. |
|
|
Term
| The decreased gas exchange that occurs with pneumonia can result in... |
|
Definition
| hypoxemia (deficient oxygen in blood) |
|
|
Term
| What pharm therapy is done for pneumonia? |
|
Definition
| There is a pneumococcal vaccine: it's suggested that everyone over 65 have it. Can be treated with ANTIBIOTICS: usually CAp can be treated with them, but HAP is a little different. Just know they're going to be on an antibiotic. |
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|
Term
| Is TB easily spread? How's it transmitted? |
|
Definition
| TB is highly communicable. It's transmitted via AEROSOLIZATION. |
|
|
Term
| How many of those infected with TB will develop TB? |
|
Definition
| Only a small percent (5-15%) that are exposed to TB will develop active TB. |
|
|
Term
| What are the manifestations of TB? |
|
Definition
| Cough, Afternoon Fever, Weight Loss, Blood Stained Sputum, Night Sweats. |
|
|
Term
|
Definition
| The lab test for TB is: Acid-Fast Bacillus, do a Sputum Culture, Mantoux Test (skin test) and maybe a Chest X-ray |
|
|
Term
| Does receiving a positive TB result mean that you have it? |
|
Definition
| No, it just means you've been exposed. They will test you again to see if you actually have it. |
|
|
Term
| What is the only treatment for TB? |
|
Definition
| Drug Therapy. COMPLIANCE is HUGE b/c they're on the drugs for at least 6 months. |
|
|
Term
| What are the hospital precautions for positively tested TB patients? |
|
Definition
| Well ventilated rooms (negative pressure rooms), HC workers must weak N95 or HEPA respirators and hand hygiene is absolutely essential. |
|
|
Term
| Precautions at home for TB: |
|
Definition
| Airborne precautions are unnecessary, but all members of the household should be tested. Teach to cover mouth/nose when sneezing & coughing. Wear a mask when in crowds. |
|
|
Term
| Acute Respiratory Distress Syndrome (ARDS) often occurs when? to who? |
|
Definition
| Often occurs AFTER A TRAUMATIC EVENT. but they have had NO PREVIOUS LUNG DISEASE. It's a serious reaction to various forms of injuries to the lung. ARDS can occur within 24 to 48 hours of an injury or attack of acute illness. ARDS could possibly follow septic shock & possibly aspiration of gastric contents. The mortality rate is 50-60%... it's very high. |
|
|
Term
| Acute Respiratory Distress Syndrome findings are: |
|
Definition
| decreased oxygen in the blood (decreased PaO2) and also REFRACTORY HYPOXEMIA. Their chest x-ray will look WHITED OUT. You give them more oxygen, but they're not responding to it. |
|
|
Term
| How is Acute Resp Distress Syndrome (ARDS) treated? |
|
Definition
| Intubation & mechanical ventilation. |
|
|
Term
| How is Acute Respiratory Distress Syndrome treated pharmacologically? |
|
Definition
| Give ARDS pts CORTICOSTEROIDS & ANTIBIOTICS. For Nutrition: give enteral via PEG tube or G tube - means it's inside feeding them) and HYPERALIMENTATION (parental through central IV - giving them TPN)... This is a procedure in which nutrients and vitamins are given to a person in liquid form through a vein. "hyperalimentation" just means a state where quantities consumed are greater than appropriate. |
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|
Term
| What is the most imp thing to take from ARDS? |
|
Definition
| They're usually healthy individuals with NO previous pulmonary problem. Then some traumatic event spirals them into this. |
|
|
Term
| Initial approaches for a chest trauma (usually blunt trauma & they don't know it). |
|
Definition
| Airway, Breathing, Circulation. |
|
|
Term
|
Definition
| aka collapsed lung, is a potential medical emergency caused by accumulation of AIR or gas in the pleural cavity. Lung is collapsed & not expanding. |
|
|
Term
| What assessment findings occur in pneumothorax? |
|
Definition
| breath sounds are going to be decreased & diminished on the collapsed side. There is asymmetrical chest expansion, the trachea deviates to the opposite side of the injury. Pneumothorax is diagnosed with chest x-ray and is treated with chest tubes. |
|
|
Term
| How is a Tension Pneumothorax different from just a Pneumothorax? |
|
Definition
| The timing which it happens. Tension Pneumothorax is different because it is rapid developing & life threatening. |
|
|
Term
| What are the signs of Tension Pneumothorax? |
|
Definition
| There is asymetrical chest expansion, TRACHEAL DEVIATION TO THE UNAFFECTED SIDE (is the hallmark of tension), absence of respiratory sounds on affected side also. A complete collapse of the lung decreases cardiac output & that is why it's so important. |
|
|
Term
| What is the management of Tension Pneumothorax? |
|
Definition
| Large bore needle is done & is put in the 2nd Intercostal Space. Goes in & whew air comes out. This is necessary with tension pneumothorax b/c there may not be time for a chest tube. Then a chest tube is done after the large bore needle. |
|
|
Term
|
Definition
| hemo = blood. There is blood in the chest cavity. This is common after a blunt trauma. People on Aspirin or Plavix are at increased risk for bleeding. |
|
|
Term
| How is hemothorax diagnosed? |
|
Definition
| by CHEST X-RAY. Also may then do a THORACENTESIS (go into chest cavity, take off fluid & it's going to be blood). If it is not an overwhelming amount of blood then can do a chest tube. If it is an overwhelming amt of blood they'll need a THORACOTOMY (incision into the chest) |
|
|
Term
| What does AC mean on a ventilator? |
|
Definition
| Assist Control (the most acute). When the vent is taking over breathing for the client. The pt is sedated. It's programmed to respond to the pt's efforts. If they don't breathe on own then the machine is going to do it for them. |
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Term
| What does SIMV on a ventilator mean? |
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Definition
| Synchronized Intermittent Mandatory Ventilation (SIMV). It allows for spontaneous breathing at client's own tidal volume and rate between ventilator breaths. A lot of time the mode used when trying to wean the patient off the vent. |
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Term
| What is Bi-PAP on a ventilator? |
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Definition
| it is a NONINVASIVE pressure support done via nasal or face mask. Can be forcing the air in at night. They just don't have it in them to take deep breaths right now. So we'll use this positive pressure to keep some breaths in them. Ex/ is CPAP |
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Term
| _______________ is the amount of air the patient receives with each breath. |
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Definition
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Term
| How can you figure out what a patients Tidal Volume likely is? |
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Definition
| Just add a zero to the end of the pt's weight = their tidal volume. Their weight is 50 kg? Then their TV is 500. Be able to figure both ways. |
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Term
| The _________ is the number of ventilator breaths per minute. Average on vent is 10-14. Depends on ABGs for each patient though. |
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Definition
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Term
| The ______ is how fast the ventilator delivers each breath. |
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Definition
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Term
| The ______ is the oxygen level that is delivered to the client. |
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Definition
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Term
| __________________________ is the pressure needed by the ventilator to deliver the tidal volume (amt of air pt receives with each breath). |
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Definition
| Peak Airway Pressure (PIP). PIP is the HIGHEST PRESSURE DURING INSPIRATION. What would cause an increased PIP? A cough (something to keep air from going on), bronchospasm, pinched tubing, increased secretions. |
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Term
| ____________________ is the positive pressure exerted during the expiratory phase of ventilation. |
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Definition
| Positive End-Expiratory Pressure (PEEP). PEEP is trying to prevent atelectasis (when alveoli collapse) - we're keeping the lungs partially inflated. They have poor gas exchange. The need for PEEP indicates the pt has a severe gas exchange problem. |
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Term
| What causes HIGH PRESSURE ALARMS heard on vent machines? |
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Definition
| Secretions or mucous plugs. (the client coughs, gags or bites on the ET tube, decreased lung compliance) |
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Term
| What causes LOW PRESSURE ALARMS on vent machines? |
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Definition
| Leak in the ventilator circuit. Leak in the cuff of ET or tracheostomy tube. |
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Term
| What are the risk factors for TB? |
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Definition
| being immunosuppressed (HIV or chemo for cancer), living in shelters or prisons, immigrants have higher ratios, living in close contact with someone who has TB, HC workers |
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Term
| How do you calculate a smokers "pack years"? |
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Definition
| The # of years smoked X the # of packs per day |
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Term
| When can a person who is positive for TB return to work? test worthy... |
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Definition
| they need 3 negative sputum cultures |
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Term
| What does 1, 25 dihydroxy-cholecalciferol have to do with your kidneys? |
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Definition
| The physiologically active form of vitamin D. It is formed primarily in the kidney by enzymatic hydroxylation of 25-hydroxycholecalciferol (CALCIFEDIOL). Its production is stimulated by low blood calcium levels and parathyroid hormone. Calcitriol increases intestinal absorption of calcium and phosphorus, and in concert with parathyroid hormone increases bone resorption. Kidneys = PRODUCE THE ENZYMES NECESSARY TO CONVERT VIT D TO THE ACTIVE FORM WITHIN OUR BODIES. |
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Term
| Kidney produces Epopoeitin (Erythropoietin), what does that do? |
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Definition
| regulates RBC production in the kidneys. Pts that have chronic kidney disease require Erythropoietin injections + iron injections when they're on dialysis. |
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Term
| The kidneys regulate the body's fluid volume, therefore, having an effect on BP. Kidney disease is the most common cause of secondary hypertension. What systems/hormones in the kidney regulate this? |
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Definition
| Renin-Angiotensin System (RAS) & Aldosterone (Renin Angiotensin Aldosteron System = RAAS) is a hormone system that regulates blood pressure and water (fluid) balance. |
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Term
| How does the RAAS system work to regulate BP? |
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Definition
| When blood pressure is low, the kidneys secrete renin. Renin stimulates the production of angiotensin. Angiotensin causes blood vessels to constrict resulting in increased blood pressure. Angiotensin also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the tubules of the kidneys to retain sodium and water. This increases the volume of fluid in the body, which also increases blood pressure. |
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Term
|
Definition
| are one of two bean-shaped organs that filter wastes from the blood. The kidneys are located near the middle of the back. They create urine, which is delivered to the bladder through tubes called ureters. |
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Term
| How do the kidneys regulate the bodies electrolytes? |
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Definition
| The kidneys control the amount of electrolytes in the body. Mainly Sodium, Potassium, Magnesium & Chloride. When the kidneys fail, electrolytes get out of balance, causing potentially serious health problems. Dialysis can correct this problem. |
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Term
| What surrounds the kidneys? |
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Definition
| The kidneys are in the RETROPERITONEAL space, on back side, right under ribs. There is a lot of supportive tissue around them. Kidneys are about 1 inch thick. They filter the blood about 60 times/day. The right kidney is lower then the left because of the liver. |
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Term
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Definition
| It's the Fundamental Unit. There are approximately 1 million nephrons in each kidney. Each nephron makes urine. The water & solutes that are not reabsorbed become urine. |
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Term
| The kidneys are very well vascularized. By what though? |
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Definition
| The renal vein & the renal artery. The renal artery delivers into the afferent arterioles --> which lead into the glomerulus --> which lead into the efferent arteriole. The efferent arteriole goes to either the peritubular capillary system or the vasa recta. |
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Term
| How many Liters does the Glomerular Filtration Rate (GFR) filter & reabsorb a day? |
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Definition
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|
Term
| What's the normal GFR/min? |
|
Definition
| 125 mL/min (imp to remember!) |
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Term
| If the GFR is filtering & reabsorbing 180 L/day, how much urine is normally put out? What's this tell us? |
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Definition
| 1-1.5 L/day. There is a huge amount that is reabsorbed & put back into the body. Actually 1-3 L/day is normal. Don't need to know these #'s prob, but know a ton is reabsorbed through GFR. GFR is r/t blood pressure. When systolic BP goes below 70, the renal blood flow is compromised & this is why we worry when someone crashes. |
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Term
| What's the Bowman Capsule? The point of the picture is just to show how well vascularized it is. |
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Definition
| Bowman's capsule is is a cup-like sac at the beginning of a nephron in the kidney. A glomerulus is enclosed in the sac. Fluids from blood in the glomerulus are collected in the Bowman's capsule (i.e., glomerular filtrate) and further processed along the nephron to form urine. This process is known as ultrafiltration. The process of filtration of the blood in the Bowman's capsule is ultrafiltration (or glomerular filtration), and the normal rate of filtration is 125 ml/min. |
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Term
| There are 2 types of tubular reabsorption. What are they? |
|
Definition
| There is both water & solute reabsorption. Tubular reabsorption is the process by which solutes and water are removed from the tubular fluid and transported into the blood. It is called reabsorption (and not absorption) because these substances have already been absorbed once (particularly in the intestines). |
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|
Term
| What are the hormonal functions of the kidney? |
|
Definition
| Renin production, Prostaglandin production, Bradykinin production, Erythropoietin production, Vitamin D activation. |
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Term
| How does Renin production function? |
|
Definition
| It controls the BP with aldosterone. It increases the reabsorption of Na+ & water in the distal tubules. |
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Term
| How does the Prostaglanding Production effect the kidneys? |
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Definition
Prostaglandins (PGs) are important physiological modulators of vascular tone and salt and water homeostasis in the kidney. Some Prostaglandin functions are: cause constriction or dilation in vascular smooth muscle cells, cause aggregation or disaggregation of platelets, sensitize spinal neurons to pain
decrease intraocular pressure, regulate inflammatory mediation
regulate calcium movement, control hormone regulation, control cell growth. "NSAIDs work on prostaglandins & this is why less than 4 G/4000 mg Aspirin is allowed/24 hrs" |
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Term
| What does the production of hormone Bradykinin do? |
|
Definition
| It's a powerful vasodilator |
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Term
| We know that erythropoietin production will: |
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Definition
|
|
Term
| A hormonal function of the kidneys is Vitamin D activation. How does it do this? |
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Definition
| We need it converted to the active form in the kidneys |
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Term
|
Definition
| It is a muscular sac. The bladder has a body & then a bladder neck. There are 3 linings to a bladder. When there are infections, we want to know how deep the infection goes in the bladder wall. The function of the bladder is the temporary storage of urine. |
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Term
| The bladder is innervated by the ___ & ____ nerves off the spinal cord. |
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Definition
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|
Term
| Anatomically the rectum & the bladder sit very close to one another. How do they affect eachother? |
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Definition
| Because if you're very constipated - this can affect the bladder. Similarly, a very full bladder can affect the rectum. Also becomes an issue in people with Crohn's Disease b/c their intestine can form fistulas to their bladder & they'll be urinating feces. surgery is required. |
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Term
| What is the difference of urethra length in males vs. females? What effect will this have? |
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Definition
| male urethra is 6-8 inches. female urethra is 1-1.5 inches (much shorter). Infections are much more common in women b/c of the shorter length. |
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Term
| How does the renal/urinary system change with age? |
|
Definition
| DECREASED GFR (more prone to renal toxicity - why there is altered drug amounts), NOCTURIA (there is not as concentrated of urine = more urine at night = increased risk for falls), DECREASED BLADDER CAPACITY (can't hold it as long), WEAKENED URINARY SPHINCTER MUSCLES AND SHORTENED URETHRA IN WOMEN (increased incontinence), A TENDENCY TO RETAIN URINE (greater chance to grow bacteria). |
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|
Term
| What questions are asked to assess the urinary system? |
|
Definition
| Take a thorough history, get the patients demographic data, get personal & family history, Diet history, Socioeconomic status, current health problems. |
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Term
| What Diet History questions are asked? |
|
Definition
| Any changes in diet? Is patient on a diet: what type? (important for kidney stones) Any changes in appetite? Alterations in taste acuity? Thirst? (pt's will have a decreased appetite d/t increased toxins in renal failure) |
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|
Term
| How does socioeconomic status affect the urinary system? |
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Definition
| it influences HC practices, the info that a client has about the disease and its symptoms may relate to their education level, cultural background or religious affiliations may influence the health belief, the language used by the patient may be different than that of the HC worker. |
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|
Term
| When assessing Current Health Problems it is very important to ask... |
|
Definition
| About their urine, pattern of urination, and possible incontinence. (Esp with men b/c prostate enlargement being so common). |
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|
Term
| What kind of physical assessment is done for renal? |
|
Definition
| inspect, auscultate, percuss & palpate |
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|
Term
| What can you tell from a general assessment about the renal system? |
|
Definition
| Assess the pt's general appearache, look for yellowish skin, rashes, BRUISING, or other discolorations. Is there any edema? Pedal (foot edema)? or pretibial (shin) edema? edema around the eyes? Are there any changes of consciousness? The patient can have so much toxins that they're having effects in their mental status. |
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Term
| During an inspection you should look at.. |
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Definition
| insect the abdomen and the flank regions especially around the costovertebral angle (CVA), assess for symmetry, discoloration, visually assess the urethra. |
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|
Term
| During auscultation listen to... |
|
Definition
| assess for bruits over each renal artery at the midclavicular line. (increased bruits=narrowing=likely it's renal artery stenosis. |
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|
Term
| What can you palpate with the kidneys? |
|
Definition
| renal palpation identifies masses & areas of tenderness near in or around the kidney. You really can only feel though if the person is very thin & the mass is very large. Often, don't want to be feeling when it's really large with things like polycystic kidney disease b/c you can burst the cysts. |
|
|
Term
| What does a distended bladder sound like when percussed? |
|
Definition
|
|
Term
| What is a normal serum creatinine for males & females? |
|
Definition
| males=0.6-1.2 mg. females=0.5-1.1 mg |
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|
Term
| What is the a normal BUN? |
|
Definition
| 10-20 mg (some labs will say anywhere from 8-25 though) |
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|
Term
| What is suspected if BOTH the BUN & creatinine are rising? |
|
Definition
| If both BUN & creatinine are increasing, then it could be nothing other then renal disease that does this. |
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Term
|
Definition
| the liver. urea is to eliminate the ammonia from protein metabolism. |
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Term
|
Definition
|
|
Term
| Why is BUN elevated (called Azotemia)? |
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Definition
| BUN is INCREASED by protein catabolism such as: increased protein intake, severe stress (MI, fever, surgery) GI bleeding. Or BUN is increased by impaired renal function. Such as Under Perfusion of the kidney (dehydration, hemorrhage, shock, CHF) Renal damage or disease (necrosis, interstitial nephritis, glomerulonephritis) Obstruction of urine flow (enlarged prostate, kidney stones, tumors and surgery) these ALL CAUSE INCREASED BUN. |
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|
Term
| Decreased BUN is usually d/t |
|
Definition
| lack of protein, severe liver disease or overhydration |
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|
Term
| __________ is a breakdown product of creatine phosphate released from skeletal muscle at a steady rate. |
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Definition
|
|
Term
| INCREASED creatinine is due to... |
|
Definition
| any cause of impaired kidney function, a LOT of meat in the diet, or a very large muscle mass (like bodybuilders, anabolic steroid users, giants and acromegaly patients). Increased creatinine=impaired kidney function. decreased creatinine=not a lot of clinical significance. |
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|
Term
| What does UA & UACS stand for? |
|
Definition
| UA=urinanalysis UACS=urinanalysis for culture & sensitivity |
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|
Term
| What are the different urine specimen that are often collected? |
|
Definition
| VOIDED URINE, CLEAN-CATCH SPECIMEN (urine that is collected from the middle of the urine stream after the first part of the flow has been voided), CATHETERIZED SPECIMENS (a urine sample is taken by inserting a catheter (a thin rubber tube) through the urethra into the bladder). 24-HOUR URINE COLLECTIONS (a person's urine in a special container over a 24-hour period. we look at proteins & creatinine over 24 hrs to test renal function)... doesn't work if any stool, menstruation or some is tossed - really easy for it to get disrupted & have to start over. |
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|
Term
| What's a urine for culture & sensitivity test? |
|
Definition
| this is a laboratory determination of the number and types of pathogens present |
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Term
| What are the NORMAL results of a UA? |
|
Definition
| color is pale yellow, odor is a specific aromatic odor, it is clear, the specific gravity (tells urine concentration) is 1.010-1.025, the pH is an average of 6, but can be 4.6-8, glucose (tells hyperglycemia) is less than 0.5 g/day, there should be no ketones. protein should be 8-18 mg, no bilirubin, RBC field is 0-2 high power, WBC's in males=0-3, females 0-5. There should be NO crystals, should only be a few casts or none (that's protein/bacteria clumped together). |
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Term
| What does the specific gravity tell about the urine? what's normal? |
|
Definition
| tells the urine concentration, normal is 1.010-1.025 |
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|
Term
| Are glucose & ketones usually in urine? |
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Definition
| glucose is indicative of hyperglycemia (there is less then 0.5 g/day normally), there should be no ketones (indicates prolonged fasting or ketoacidosis) |
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|
Term
| If there are more then the normal 8-18 mg of Protein in the urine, what does that mean? |
|
Definition
| increased stress, like an infection |
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|
Term
| If there is bilirubin in the urine, what does that mean? |
|
Definition
| there should be none, if there is some then it means liver problems |
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|
Term
| Increased WBCs in urine indicates... |
|
Definition
| infection or an inflammatory process |
|
|
Term
| if there are more RBCs in the urine then the normal 0-2 high power, it may mean |
|
Definition
| trauma/infection. anytime you put a catheter in though, there is often a little increase of RBCs. |
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|
Term
| If crystals in the urine... |
|
Definition
|
|
Term
| How long do culture & sensitivity urinanalysis' take? |
|
Definition
|
|
Term
| What are the 3 main causes of a UTI? |
|
Definition
|
|
Term
| Normally a UA should have less then _____ bacterial colonies/mL. |
|
Definition
| 1000. If the bacteria is more than this, too numerous to count or packed - you've got an infection! |
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|
Term
| Is there normally parasites or nitrates in urine? |
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Definition
| No! (leukocytes esters + nitrates + bacteria = UTI) |
|
|
Term
| The Creatinine Clearance Test is a good way to test assess for current _______ function. |
|
Definition
| kidney function. good way to assess GFR. It is usually a 24 hour collection test. |
|
|
Term
| What is a normal Creatinine Clearance test for young adults? How does it change each year after 20? |
|
Definition
| 90-120 mL/min for young adults... then it falls about 0.5 mL/year over age 20 |
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|
Term
| Urine Osmolality measures.. |
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Definition
| the concentration of particles in the solution or in this case the concentration of solutes in urine. These solutes include electrolytes and solutes such as glucose, urea and creatinine. The increased concentration of urine=increased risk for infection. |
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Term
| The urine osmolality test is usually compared to a persons blood/plasma osmolality. The blood/plasma osmolality determines whether water will be __________ or ________ by the kidneys. |
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Definition
|
|
Term
| What is blood/plasma osmolality influenced by? |
|
Definition
|
|
Term
| What is a normal blood/plasma osmolality? |
|
Definition
|
|
Term
| Urine Osmolality varies from __ - _____ mOsm/kg of water. What does it depend on? |
|
Definition
| 50-1400. The urine osmolality depends on the hydrated status of the client and the functional status of the kidneys. |
|
|
Term
| What radiographic exams are done to examine the renal system? |
|
Definition
| Kidney, Ureter and Bladder x-ray (KUB), Intravenous Urography, Computed Tomography (CT Scan), Cytography and Cystourethrography |
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Term
|
Definition
| It's plain film x-ray, takes no specific preparation and shows gross anatomic features and may show stones, strictures, calcifications or obstructions in the urinary tract. It doesn't give a lot of info though. KUB is usually the first things done to rule out... |
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Term
| What do you have to ask about before having a Intravenous Urography (formerly called IVP - intravenous pilogram)? |
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Definition
| ask about ALLERGIES to iodine, sea food, eggs, chocolate. |
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Term
| What prep is done before an Intravenous Urography? |
|
Definition
| Bowel Prep. The other prep varies... want them to have a light evening meal or clear liquids with NPO after midnight or some prefer pushing fluids. We want the bowel empty to see the kidneys. Want to increase fluids to decrease damage to the kidneys. This test will tell the size, location, patency of ureters & bladder. After the test is done: push fluids to get the dye out. |
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Term
| What follow-up care is done after a intravenous urography? |
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Definition
| follow-up care includes monitoring the client for altered renal function and other effects from the dye. PUSH FLUIDS. and Monitor CREATININE levels. |
|
|
Term
| What info does a computed tomography (CT scan) provide? |
|
Definition
| gives THREE DIMENSIONAL information. May be with or without contrast (IV dye). |
|
|
Term
| What prep is necessary before a computed tomography (CT scan)? |
|
Definition
| 1. Bowel prep the day before 2. NPO after midnight 3. Assess for allergies to chocolate, shellfish, eggs |
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Term
| What is the prep & procedure for a Cystography and a Cystourethrography? |
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Definition
| Prep is explaining procedure to the client & putting in a catheter. Procedure is dye instilled into the bladder through a catheter. After bladder filling there is a series of x-rays taken. |
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Term
| What follow-up care after a cystography and cytourethrography? |
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Definition
| Monitor for infection, encourage fluid intake, monitor I & O |
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Term
| A cystograpy & cystourethrography looks at ... |
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Definition
| bladder function & bladder anatomy (opposed to kidneys). We're going to see if there is any trauma to the bladder or ureters. |
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Term
| What does the Renal Arteriography (Angiography) look at? |
|
Definition
| The blood supple to the kidneys & what's the problem. When kidneys aren't getting enough blood - they will increase the BP to increase circulation & vasodilate inside the kidneys. Slide said: THIS TEST ASSESSES THE ARTERIAL BLOOD SUPPLY TO THE KIDNEYS-INJECTIONS OF A RADIOPAQUE DYE INTO THE RENAL ARTERIES. It is done under fluoroscopy. |
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|
Term
| What kind of prep does the Renal Arteriography (Angiography) require? |
|
Definition
| Bowel prep the day before. A light meal and NPO after a certain hour. Need to assess the PT/INR. Putting a catheter in a major artery.. ed to worry about PT & INR. |
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|
Term
| The follow up care after a renal arteriography is: (imp this is underlined) |
|
Definition
| Follow up care is to PREVENT the following 2 complications: 1. to prevent bleeding from the insertion site 2. to monitor for signs of kidney failure |
|
|
Term
| What are the 2 types of renal biopsy? |
|
Definition
| 1. CLOSED or percutaneous biopsy is what is usually done 2. OPEN renal biopsy (is reserved b/c it's a full open surgery) |
|
|
Term
| Which liver is usually done in a renal biopsy? |
|
Definition
| The LEFT KIDNEY is generally biopsied in a percutaneous biopsy b/c it is closer to the skin and is not near the liver. |
|
|
Term
| What preparation is done for a Renal Biopsy? |
|
Definition
| Explain procedure to the patient, SIGN CONSENT, assess lab values, they're on an NPO status. For Open Biopsy, prepare the client for general surgery. For Percutaneous, have the patient void prior to procedure. |
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|
Term
| How is a closed renal biopsy done? |
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Definition
| clients in a prone position, place a roll under the client's abdomen, local anesthesia is applied, the exact site of the kidney is determined by radiographic or ultrasound information |
|
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Term
| What are the major risks following a Closed renal biopsy? What needs to be monitored? How long are they on bed rest? |
|
Definition
| Biggest risks are BLEEDING & HEMATURIA (UA's with blood for a while). Monitor for 24 hrs after closed biopsy: the dressing, lab values, vital signs, for flank pain & amt of urinary output. The patient is on bedrest (supine) for at least 6 hours, then limited activity. It's fine for the HOB to elevate to eat. Normal activites are resumed within 24 hours. |
|
|
Term
| It's normal to have some hurting following closed biopsy, but if there is lots of aching back pain this is the tell tale sign of ... |
|
Definition
| excessive bleeding getting into the retroperitoneal space that is bad. they've got a hematoma. |
|
|
Term
| What are the directions after a closed renal biopsy? |
|
Definition
| avoid lifting heavy objects, exercising or performing other strenuous activities for 1-2 weeks after the procedure. Driving may be restricted. want to prevent bleeding. |
|
|
Term
| What test provides general info about RENAL BLOOD FLOW with radioactive material? (it's very small amt - no radioactive precautions are necessary). |
|
Definition
|
|
Term
| Follow-up care after a renal scan is encouraging the patient to void into the commode (to release the radioactive material). for the incontinent patient, what precautions are necessary? |
|
Definition
| STANDARD UNIVERSAL PRECAUTIONS. <-- just for the first day. We want to monitor VS carefully if captopril was used. (it's a vasodilator and inhibits the actions of the renal system). |
|
|
Term
| What's a renal ultrasound? What kind of prep is needed? |
|
Definition
| There is NO prep needed for a renal ultrasound. It assesses the size, cortical thickness, obstruction, tumors, cysts and status of calices. The ultrasound uses sound waves to structures of different densities to produce images of the kidneys, ureters and bladder. |
|
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Term
|
Definition
| has NO prep, nothing is injected, it's non-invasive & can get a lot of information (can see masses, cysts & whether they're large or small) |
|
|
Term
| To do an ultrasound of the kidneys the patient is in the ________ position. Apply the sonographic gel to back and flank. A transducer in contact with moving across the skin delivers sound waves & measures the echoes. Images of the internal structure are produced. The gel is removed after the procedure. |
|
Definition
|
|
Term
| What's a cytoscopy/cytourethroscopy? |
|
Definition
| a cytoscope is inserted via the urethra into the urinary bladder. If visualization of the urethra is also indicated a urethroscope is used. The patient is sedated. |
|
|
Term
| What prep is necessary for a cytoscopy? |
|
Definition
| it is an INVASIVE PROCEDURE, thus operative. Need to complete a preoperative checklist. must have informed consent for ALL procedures. |
|
|
Term
| What is done before a cytoscopy? |
|
Definition
| client education regarding indications: assess the bladder for stones, urinary tract obstructions, enlarged prostate. Make sure the informed consent: permit is signed. NPO status and bowel prep the day before. |
|
|
Term
| Follow up care for a client undergoing cytoscopy is: |
|
Definition
| general anesthesia is used for the client that will go to the recovery room after procedure. Outpatients will also be monitored post procedure prior to being discharged home. On the nursing unit, monitor vital signs, signs of bleeding, and changes in urine output. Encourage fluid intake. |
|
|
Term
| What does the Cytometrography test for? |
|
Definition
| This test determines the effectiveness and sensitivity of the bladder wall (Destrusor muscle). Determinations about bladder capacity, bladder pressure, and voiding reflexes may be made with these measurements of destrusor muscle quality. |
|
|
Term
| What is the PURPOSE of a urethral pressure profile? |
|
Definition
| it can provide info about the nature of urinary continence/incontinence or urinary retention. A urinary catheter may be temporarily placed during the procedure. |
|
|
Term
| The procedure for a urethral pressure profile is: |
|
Definition
| a special catheter with pressure-sensing capabilities is inserted into the bladder. Variation in the pressure of the smooth muscle of the urethra are recorded as the catheter is slowly withdrawn. |
|
|
Term
| What are Retrograde Procedures? What are some examples? |
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Definition
| Retrograde means going against the normal flow of urine. Pyelogram: is an exam of the ureters & pelvis. Cystogram: is an exam of the bladder. Urethrogram: is an exam of the urethra. |
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Term
| What is a Urodynamic Study? |
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Definition
| studies which describe the processes of voiding. they include: 1. tests of bladder capacity, pressure and tone. 2. Studies of urethral pressure and urine flow. 3. Exam of the function of perineal voluntary muscles. |
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Term
| What are some examples of urodynamic studies? |
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Definition
| 1. cystometrography 2. urethral pressure profile 3. Electromyography (EMG) 4. Urine Stream Test |
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Term
| What is an electromyography (EMG)? |
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Definition
| It evaluates the strength of the muscles used in voiding to assist in identifying methods of improving continence. The procedure involves an EMG of the perineal muscles, electrodes are placed in either the rectum or the urethra to measure muscle contraction and relaxation. nurse should provide assurance. |
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Term
| What is the purpose of a urine stream test? |
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Definition
| the urine stream test evaluates pelvic muscle strength and the effectiveness of pelvic muscles in interrupting the flow of urine-useful in evaluating incontinence. |
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Term
| What is the procedure for a urine stream test? |
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Definition
| Three-five seconds after urination begins, the examiner gives the client a signal to stop urine flow. The length of time required to interrupt the flow of urine is recorded. |
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