Simple Nursing

• Urinary Incontinence


  Client can't hold urine in

  U - Urge Incontinence

  • Sudden URGE to urinate
  • Typically known as Neurogenic bladder (loss of bladder control

  S - Stress Incontinence

  • Pressure STRESS causes urine to spill out
  • Coughing, laughing, sneezing, running, jumping

  O - Overflow Incontinence

  • OVERflow leads to dribbling urine
  • Incomplete emptying
• Urinary Incontinence causes


  • Urethra prolapse
  • Prostate enlargement (BPH)
  • Weak bladder muscles - diabetic neuropathy & spinal cord injury
• Urinary Incontinence management


  1. Train Bladder: Void regularly every 2 hours
  2. Weight Loss
  3. Kegel Exercises 4 x daily
  4. AVOID: Caffeine, Alcohol, Smoking
  5. Anticholinergic Meds: Oxybutynin
• Priority teaching for a patient newly diagnosed with stress incontinence


  Voiding every 2 hours
• The client understands self care of urge incontinence with which statement?

  • "I understand that taking oxybutynin may result in dry mouth"
  • "I will do Kegel exercises every day"
• Nursing intervention... overflow urinary incontinence


  • Teach to bear down when voiding
  • Teach to wait 30 seconds after voiding to try & void again
  • Monitor for skin breakdown
  • Record output
• Oxybutynin


  Side effect: Dry Mouth

  (URINARY INCONTINENCE)
• List of clients MOST at risk for Metabolic Acidosis?


  • Renal Failure
  • Pyelonephritis
  • Patient waiting for hemodialysis
  • Child with diarrhea x 2 days
• Client with an infected toe due to diabetes is scheduled for cardiac catheterization with contrast, which lab value should the nurse report to


  Creatinine level of 1.9
• Client with history of diabetes... which does the nurse suspect?


  Dehydration (low fluids intake) & possible UTI
• CELIAC DISEASE


  an immune reaction to eating gluten (a protein found in wheat, grains, & beer)

  Inflammatory damage in the small intestine (absence of intestinal villi) resulting in malabsorption of fats & nutrients as well as slow growth in children
• CELIAC DISEASE


  GLUTEN

  • Whole wheat, Grains, & Beer (Rye & Barley)
  • dinner roll
  • breaded meat
  • spaghetti
• CELIAC DISEASE sign & symptoms


  • Diarrhea
  • Steatorrhea - fatty stools as fast are not absorbed
  • Abdominal pain
  • weight loss, stunted growth, & delayed puberty in children
• CELIAC DISEASE education


  Fat-soluble vitamins - as nutrients are not easily absorbed

  • Vitamin A, D, E, K
• CELIAC DISEASE - Gluten Free Foods


  anything without WHEAT base

  • Plain meats (fish, beef, chicken, turkey)
  • Grains: rice, corn, potatoes, soy, quinoa
  • Nuts, beans, legumes
  • Fruits & veggies
• CONSTIPATION


  inability to go poop or in fancier terms infrequent bowel movements or difficult passage of stools, that persists for several weeks or longer
• CONSTIPATION sign & symptoms


  • Passing fewer than three stools a week
  • Having lumpy or hard stools
  • Straining to have bowel movements
• CONSTIPATION causes


  • Stress
  • Low fluid & fiber

  Basically not enough fruits, veggies, or whole grains in the diet, or even too much fiber without low fluid intake. Fiber can cause constipation if not taken with fluid, since fiber inflates with fluids to scrub the GI tract. So too much fiber without high fluid intake - can cause constipation
• CONSTIPATION complications


  FECAL INCONTINENCE (Encopresis)

  3 Steps to Treatment

  1. Laxatives & stool softners
  2. Fluid & fiber
  3. Change Habits

  • Schedule regular toilet visits after meals
  • Keep a diary for toilet sessions
  • Reward system for effort & NOT rewarding for each bowel movement
• CONSTIPATION treatment


  • High Fluid & Fiber
  • Ambulation (walking)
• DEMENTIA


  DaMage to the brain that is irreversible
• DEMENTIA


  Alzheimer's, Parkinson's, & even Traumatic brain injuries

  In end stage deMentia, there is too much brain daMage making it IMPOSSIBLE for clients to understand reality.

  This causes more anxiety & aggression, so interventions revolve around distraction
• Agitated with Dementia


  1. Acknowledge & Discuss feelings
  2. DO NOT - Present reality or Rationalize
  3. Redirect with new activities
• DELIRIUM


  • Limited, short term confusion that is easily reversible
  • Correct the causes, correct the Delirium
• DELIRIUM causes

  • Infection (sepsis)
  • Temp over 100.3F
  • Urine Culture + Positive
  • Hypoxia (Low SpO2)
  • Agitation
  • Priority Action: "Assess the client"
  • Other Causes:
  • Opioid Pain Meds
  • Low Sodium (norm: 135-145)
  • Low blood glucose (norm: 70-110)
  • Priority action: "Assess the client"
• Nurse understands which factors can cause delirium?

  • Positive Urine culture with 101.F temp
  • Serum sodium level of 123
  • SpO2 82%