N110

• Diarrhea


  Causes laxative and enema misuse, no absorption in the small intestine, inflammatory bowel sound, viral and bacterial infection, short bowel syndrome, hyperactive bowel sound
• Causes of diarrhea


  • Metformin, antibiotic, amoxicillin, antacid, mg
• Diarrhea


  Typically, having three or more loose or watery bowel movements in a day
• Diarrhea


  Fluid and electrolyte imbalance
• C. difficile


  Most commonly occurs in people who have been taking antibiotics, as antibiotics can disrupt the normal balance of bacteria in the gut, allowing C. difficile to multiply and produce toxins that cause inflammation and damage to the lining of the colon
• Constipation


  Causes include low fiber diet, low fluid intake, and pain medication opioids, iron, antidepressant, antacids
• Constipation


  Fewer than 3 bowel movements, 30ml/kg
• Types of laxatives


  • Bulk-forming laxatives
  • Stool softener
  • Help to stimulate peristalsis
  • Cause stool to retain water
  • Increase the weight of stool
• Normal stool


  Soft formed regular intervals without use of a laxative
• Ways to prevent UTI


  • Drinking plenty of water to flush bacteria out of the urinary tract
  • Wipe from front to back after using the bathroom to prevent bacteria from entering the urethra
  • Clean the genital area before and after sexual activity
  • Wear cotton underwear to allow for better airflow and keep the genital area dry
  • Urinate after sexual activity
  • Take a shower, not a bath
• Symptoms of UTI


  • Pain or burning sensation during urination
  • Frequent or urgent need to urinate
  • Passing small amounts of urine frequently
  • Cloudy or strong-smelling urine
  • Blood in the urine
  • Pelvic pain (in women)
  • Rectal pain (in men)
• Other symptoms of UTI


  • Hematuria
  • Tachycardia
  • Onset fall
  • Anorexia
  • Incontinence
  • Hypotension
• Send urine samples for cultural and sensitivity for UTI
• Urinary incontinence


  Involuntary loss of urine, ranging from occasional leakage to a complete loss of bladder control
• Types of urinary incontinence


  • Stress incontinence
  • Urge incontinence (overactive bladder)
  • Overflow incontinence
  • Functional incontinence
• Stress incontinence


  Occurs when pressure on the bladder increases, such as during coughing, sneezing, laughing, or physical activity. Weakness in the pelvic floor muscles or the sphincter muscles that control the bladder can contribute to stress incontinence.
• Urge incontinence


  Involves a sudden, intense urge to urinate followed by an involuntary loss of urine. It can be caused by an overactive bladder muscle or nerve damage.
• Overflow incontinence


  Occurs when the bladder doesn't empty completely, leading to frequent or constant dribbling of urine. It can be caused by conditions that obstruct the flow of urine, such as an enlarged prostate in men or a blockage in the urinary tract.
• Functional incontinence


  Occurs when physical or cognitive impairments make it difficult for a person to reach the bathroom in time, such as in cases of mobility issues, dementia, or severe arthritis.
• Transient urinary incontinence


  Appears suddenly less than 6 months due to medical causes of UTI and alcohol.
• Urinary retention


  Condition characterized by the inability to empty the bladder completely. It can be acute (sudden onset) or chronic (long-term), and it can occur in both men and women, though it's more common in men due to prostate enlargement.
• Types of urinary retention


  • Retention with obstruction
  • Retention without obstruction
• Retention with obstruction


  There is a physical blockage or obstruction that prevents the normal flow of urine out of the bladder. Examples include enlarged prostate, stone, prolapse in women.
• Retention without obstruction


  There is no physical obstruction in the urinary tract, but the bladder muscles are unable to contract effectively to expel urine. Examples include spinal injury, Parkinson's, weakened bladder, psychological factors like stress anxiety.
• Stages of pre-operative care


  • General survey
  • Integumentary
  • Respiratory
  • Cardiovascular
  • Gastrointestinal
  • Neurologic
  • Musculoskeletal
• Goal of pre-operative care


  Establish baseline data
• Preventing atelectasis (lung collapse) and aspiration (inhalation of foreign material into the lungs) is crucial during the perioperative period to minimize respiratory complications.
• Post-operative patient teaching coughing and deep breathing is important.
• Measures to prevent atelectasis


  • Deep breathing exercises
  • Early ambulation
  • Optimal positioning
  • Frequent changes in position
  • Positive end-expiratory pressure (PEEP)
  • Chest physiotherapy
  • Hydration
• Preventing Aspiration: Pre-operative fasting: NPO, Cricoid pressure
• Pre-operative checklist


  • Consent forms
  • Vital signs
  • Nutrition and fluid status
  • NPO status
  • Pre-op teaching
  • Empty bladder
  • Replace clothing with gown
  • Remove cosmetics, jewelry, nail polish, etc.
  • Pre-op medications
  • Special orders
  • Hygiene and skin preparation
  • Safety protocols
  • Anti embolism stockings
  • Sequential compression devices
• Post-operative patient teaching


  • Pain management
  • Activity and mobility
  • Respiratory care
  • Nutrition and hydration
  • Wound care
  • Medication management
  • Follow-up care
  • Signs of complications
  • Bowel movement within 48 hours after eating solid food
• Older adults for surgery


  Have decreased cardiac output, decreased peripheral circulation, decreased oxygenation of blood, decreased thermoregulation ability, and decreased skin moisture and elasticity. Older adults have increased vascular rigidity.
• Types of anesthesia


  • General
  • Moderate sedation/analgesia (conscious sedation/analgesia)
  • Regional
  • Topical and local anesthesia
• Types of surgeries


  • Palliative surgery
  • Curative surgery
  • Reconstructive surgery
  • Exploratory surgery
• Palliative surgery


  Aimed at relieving symptoms, improving quality of life, and providing comfort for patients with advanced or incurable diseases. Cancer, tumor, alleviate pain.
• Curative surgery


  Performed with the goal of completely removing diseased tissue or organs to eliminate the underlying cause of a medical condition.
• Reconstructive surgery


  Aims to restore the form and function of body parts affected by congenital defects, trauma, surgery, or disease.
• Exploratory surgery


  Performed when the cause of symptoms such as abdominal pain, swelling, or unexplained bleeding cannot be determined through non-invasive methods like imaging or blood tests. During the procedure, the surgeon visually inspects the organs and may take tissue samples (biopsies) for further analysis.
• DVT risk and prevention


  • Anti-embolism stockings
  • Sequential compression devices (SCDs)
  • Regular movement and exercise