Elimination Lecture Notes

[Music] hi guys it&#39;s me professor d and welcome back to my youtube channel on this video i&#39;m going to be covering about elimination guys um if you haven&#39;t done so already you know what i&#39;m going to say please do not forget to like and subscribe below i&#39;ve got audio lessons on my website available and soon i will also have study guides at nexusnursinginstitute.com don&#39;t forget to check me out across um my other social media platforms such as tik tok instagram and facebook okay guys so without any further ado let&#39;s get started first question which of the following would the nurse expect as a normal change in bowel elimination as a person ages one absorptive processes are increased in the intestinal mucosa two esophageal emptying time is increased three changes in nerve innervation and sensation cause diarrhea or four mastication processes are less efficient and guys the correct answer is for mastication processes are less efficient so think about it as the patient gets older guys it&#39;s just like wear and tear of the body so you know um something very important if you guys been following me with fundamentals when it comes to the aging adult i tell you this all the time as the person gets older their sense of thirst decreases so number one you have a person that&#39;s drinking less that places that patient at risk for what constipation then number two um mastication that chewing they&#39;re not um the chewing process becomes less okay that puts them at risk for um constipation because now they got all of these bulks of food that the gi tract is supposed to be absorbing um salivation guys becomes less in the older adult all of these places the patient at risk for what constipation why do i keep saying that because i need you to drill that in your head because i promise you this is a test question as the patient gets older they are more at risk for constipation due to these reasons now let&#39;s look at the wrong answer choices one absorptive processes are increased in the intestinal mucosa we wish they&#39;re decreased that&#39;s why that patient&#39;s also at risk for what constipation choice two esophageal emptying time is increased false okay it&#39;s delayed and the reason that it&#39;s delayed is because the patient has decreased motility remember peristalsis that&#39;s what makes that gi tract kind of contract to just move that food along right well it slows down in the older adult which allows the food to sit there much longer right and do what harden which causes what constipation and choice three changes in nerve innervation and sensation cause diarrhea that&#39;s false now the older adult they do have changes in the innervation and the sensation but it doesn&#39;t cause diarrhea it actually causes the opposite what constipation so if you guys learn anything from this one question is that the older adult is at risk for what ladies and gentlemen let&#39;s say together constipation very good moving on next question an eight-month-old infant is hospitalized with severe diarrhea the nurse knows that the major problem associated with severe diarrhea is one pain in the abdominal area two electrolyte fluid loss three presence of excessive flattes or four irritation of the peritoneal and rectal area and guys the correct answer is two electrolyte and fluid loss now again if you&#39;ve been following me for any amount of time you know me i teach you a million times the importance of maslow&#39;s hierarchy of needs that&#39;s how you prioritize patients what is the most important and physiological integrity is always going to take precedence what is physically keeping that patient alive nutrition hydration vital signs airway breathing circulation hemodynamic status glucose rest and sleep fluid and electrolytes right go back to this question this is an eight-month-old infant the smaller the body the faster that that patient will go down on you okay so this is an eight month old infant and it doesn&#39;t only say diarrhea what type of diarrhea severe diarrhea which means that this patient is losing lots and lots of fluid um through the stool so that patient uh places that patient at electrolyte and fluid um uh loss and yes that patient may have uh pain in abdominal area but is that a priority to us absolutely not i talked to you guys about this pain only becomes a priority in certain circumstances such as burns such as myocardial infarction such as stones and i don&#39;t care what kind of stones whether it&#39;s kidney stones uh calcium struvite if they&#39;re stones you know that&#39;s a priority what else sickle cell right in those situations you can put bur uh you excuse me you could put pain in the same category you would put physio everything else that falls under physiological integrity but outside of that it&#39;s not going to kill the patient so pain is not going to be a priority but you better believe that fluent electrolyte will be because that can kill a patient okay next question a client&#39;s to have a stool test for occult blood the nurse is instructing the client excuse me instructing the nursing assistant in the correct procedure for the test the nursing assistant is correctly informed that one sterile technique sterile technique is used for collection two stools should be collected over three day period three the specimen should be kept warm or four a one inch sample of a form stool is needed and guys the correct answer the only correct answer guys number one a one inch uh sample of formed stool is needed we only need a small amount okay to test let&#39;s look at the wrong answer choices one a sterile technique you don&#39;t need sterile technique for this procedure it&#39;s just a clean technique okay two stools should be collected over three over a three day period um that&#39;s actually the stool that we collect over a three-day period that&#39;s when we&#39;re collecting um the fecal um fat okay when we want to actually measure how much fat is in the stool that&#39;s when we&#39;ll collect it for a three-day period choice three the specimen i should have worn my glasses right the specimen should be kept warm that&#39;s actually when we&#39;re testing for like um ova or parasites that&#39;s when you&#39;re gonna keep the stool um warm so for alcohol blood the correct answer is number four we just need a small sample about a one inch sample a client who recently underwent surgery and now has a colostomy is correctly instructed by the nurse for the next few weeks the client&#39;s diet will include foods such as one vegetables two fresh fruit three whole grains or four poached eggs and rice i love this question okay guys the correct answer is for poached eggs and rice before i tell you why i want to go back and tell you why number one two and three are wrong and something i want you guys to notice when you&#39;re testing because you&#39;re not always going to know what the correct answer is but you got to start using clues that are given to you right if you read this question and choices and you didn&#39;t know what the answer was you should have looked at your choice and say okay is there something that all of these choices have in common that one doesn&#39;t if it&#39;s a multiple choice the one that doesn&#39;t choose that answer when we&#39;re looking at this choice is one vegetable choice is two fresh fruits choices three um whole grains all of these are high in what fiber so even if you didn&#39;t know what the answer was you should have seen a pattern in choice one two and three and you should have said to yourself well i don&#39;t know what the answer is but choices one two and three all have something in common so i&#39;m gonna choose the oddball out and guys i&#39;m only talking about if you don&#39;t know what the answer is how to you know try to get the right answer if you know what the answer is don&#39;t use this technique just choose the right answer so anyway let&#39;s go back to number four the um poached eggs and rice so fish chicken eggs and when i say eggs notice it said poached eggs right the reason it said poached eggs is because we don&#39;t want fried eggs that&#39;s why they specifically said poached eggs all of these are good choices for that patient that just had a colostomy we do not want a patient who just had a colostomy to eat foods that are high in fiber because they just had surgery we&#39;re really trying to rest that gut we&#39;re not trying to make them work too hard we&#39;re not trying to stretch the walls of the gi tract are we so that&#39;s why we need the low um vegetables such as the poached eggs the rice the chicken okay let&#39;s look at the wrong answer choices just like i said vegetables fresh food rice all of these are high in fiber and we will we really we really want to rest the bowels after uh that type of gi surgery and so that&#39;s why number four is the correct answer clients been admitted to an acute care unit with diagnosis of biliary disease the nurse suspects that the feces will appear one bloody two plus filled three black and tauri or four white or clay colored and guys the correct answer is for white or clay colored why the bible&#39;s missing bowel is what gives that stool that darkened color right go back to the question it says the client has what kind of disease biliary disease so we know that the gallbladder those uh bile ducts or maybe a combination of both that&#39;s what&#39;s in trouble but the fact that we know bowel is involved and you know it&#39;s most likely not going to be sufficient because this is the disease we&#39;re going to see that stool not having that dark color but being being a clay or white color now let&#39;s look at our other um guys i cannot speak you guys know i can&#39;t speak on my videos be patient with me are other wrong choices one bloody when it&#39;s bloody as in that bright red color that bloody color um you should suspect gi bleeding but specifically lower gi bleeding that&#39;s why still has that red color because it&#39;s fresh coming from that lower gi tract choice two pus field whenever you see something with pus what are you supposed to think of infection choice three black and tarry when is black and tarry you&#39;re thinking of bleeding but you&#39;re thinking more of gi bleeding gr bleeding more upper gi bleeding right so wherever that uh upper gi bleed is originally it would have that reddish bloody color but as it&#39;s going through the gi tract by the time it comes out of that rectum it&#39;s turned what black and tarry so you&#39;re still going to suspect uh gi bleeding but an upper gi bleeding versus that fresh bright red blood which would be what lower gi bleeding so guys number four is the correct answer the client asked the nurse to recommend a bulk forming foods that may be included in the diet which of the following should be recommended by the nurse one whole grains two fruit juice three rare meats or four milk products and guys the correct answer is one whole grains so fruits vegetables guys they absorb fluid okay they absorb fluid and cause what bulk in the gi system okay makes the the stool heavier that&#39;s why it&#39;s called bulk because that&#39;s exactly what it does it bulks up the stool now look at our wrong answer choices two fruit juice three rare meats four milk products these don&#39;t add bulk to the stool but fruits and vegetables do because everything you drink it just soaks up all of that fluid and it adds bulk to the store [Applause] the clients taking medications to promote defecation which of the following instructions should be included by the nurse in the teaching plan for this client one increased laxative use often causes hyperkalemia two cell tablets should be taken to increase the solute concentration of the extracellular fluid three emollient solutions may increase the amount of water secreted in the bottle in the bowel or four bulk forming additives may turn the year in pink and guys the correct answer three emollient solutions may increase the amount of water secreted in the bowl absolutely can cause the patient to have watery stools that is absolutely the truth let&#39;s talk about the wrong answer choices one increased laxatives often causes hyperkalemia no it causes hypokalemia why because you&#39;re losing all that potassium through your stool okay choice two salt tablets should be taken to increase the solute concentration of the extracellular fluid no it should not that is absolutely false and choice four bulk forming additives can turn the urine pink guys that&#39;s crazy that&#39;s absolutely fault they made that up no it doesn&#39;t so the correct answer is three while undergoing a soap suds enema the client complains of abdominal cramping the nurse should one immediately stop the infusion two lower the height of the animal container three advance the enema tubing two to three inches or four clamp the tubing and guys the correct answer is lower the height of the enema container and i know what you&#39;re thinking because you&#39;re saying you know professor d you said whenever patient getting a transfusion whenever a patient&#39;s getting a transfusion if something goes wrong we should stop the transfusion first of all this is not transfusion patient&#39;s getting this is an enema but even more important than that two we&#39;re going to expect some cramping it&#39;s an animal that you&#39;re giving the patient so they can have a bowel movement with that being said if you know that um that uncomfortable feeling is that cramping becomes too much you&#39;re just going to lower you&#39;re not going to stop it you&#39;re just going to lower and the reason you don&#39;t stop is because the patient needs the medication right but the reason you lower it the higher that you have that bag the faster it&#39;s rushing into the patient that&#39;s what may cause those really bad cramping but the more that you lower it the slower the medication goes into the patient so the patient&#39;s still getting the medication they&#39;re just not getting it as fast so the feeling will not be as harsh and that&#39;s why um number two is the correct answer let&#39;s talk about the wrong answer choices one immediately stop the infusion no if you stop the infusion how are they going to get that medication which they need this is not a reaction the patient&#39;s having that&#39;s life-threatening we kind of expect them to cramp up a little okay choice three advances advance the enema tubing two to three inches stop it you don&#39;t do that you just slow it down and you slow down the the um flow by just lowering that bag um choice four clamp the tubing absolutely not necessary okay so the correct answer is number two these answer choices are funny sometimes all right guys the nurse who&#39;s caring for a post-op client on the surgical unit knows that for 24 to 48 hours post-op clients who have undergone general anesthesia may experience one colitis two stomatitis three parallel ileus or four gastrocolic reflex and guys the correct answer is three paralytic ilius so guys parallel ilias is when um the peristalsis of the gi tract stops completely this is transient it&#39;s going to the peristalsis is going to come back as the anesthesia is eliminated from the body so as the patients you know the anesthesia is going down their peristalsis is going to start to go back up and it usually takes about 24 to 48 hours so number three is the correct answer for clients with hypocalcemia the nurse should implement measures to prevent one gastric upset to malabsorption three constipation or four fluid secretion and guys the correct answer is three constipation that is one of the things you&#39;ll see in the patient that&#39;s experiencing hypo calcium along with that patient may have uh muscle cramps excuse me um tetany uh paresthesias you know that tingling sensation all of those are signs and symptoms of hypocalcemia the nurse is to receive k-excellent enema the nurse recom recognizes that this is used to one prevent constipation to remove excess potassium from the system three reduce bacteria in the colon from colon before diagnostic testing or four provide direct anti diarrheal medication to the intestine and the correct answer is to uh remove excess potassium from the system that&#39;s true guys and here&#39;s the trick when you see that medication k excellate that k think of potassium what is your symbol for potassium isn&#39;t the k with the little plus plus sign so when you see k excellent remember potassium so what this medication does it binds the potassium so when the patient has a bowel movement all of that potassium comes out in the stool so that is the absolutely correct answer now let&#39;s look at the wrong answer choices one prevent further constipation that is false that&#39;s not what it does uh three reduce bacteria in the colon before diagnostic testing um neomycin enemas that&#39;s what it does okay not k excellent and choice four provide a direct anti-diarrheal medication to the intestine false the correct answer is choice too like i said it binds the potassium so when the patient has a bowel movement all that potassium will come out in the stool the appropriate amount of fluid to prepare for an enema to be given to an average size school school a child is three 300 to 500 ml that is the correct amount now let&#39;s look at the wrong answer choices choice one 150 to 250 that&#39;s what you give to an infant choice 2 250 to 350 that&#39;s what you give to a toddler and then choice for 500 to 750 that is what you give to an adolescent so the correct answer for school a child would be 300 to 500 ml of the following is an appropriate nursing intervention for a client with an ng tube in place one tape the tube up and around the ear on the side of the insertion two secure the tubing to the bed by the client&#39;s head three mark the tube where it exits the nose or four change the tubing daily and guys the correct answer is three mark the tube where it exits the nose and guys you can either do that with like tape or a red pen but that is the correct answer now remember you&#39;re going to do this only after placement has been confirmed by x-ray so the patient gets it gets a tube um x-ray has confirmed it&#39;s in the stomach and not anywhere else like the lungs right so then you want to mark it either with like a like i said a red pen or tape and the reason you&#39;re doing that is so you can know if displacement happens now let&#39;s look at the other choices choice one tape the tube up and around the ear on the side of insertion no you just tape it to the nose not the ear that&#39;s false uh choice two secure tubing to the bed do we do this guys never secure tubing to the bed no you&#39;re gonna secure it to the patient&#39;s gown not to the patient&#39;s bed choice four change the tubing daily no you don&#39;t change the tubing doesn&#39;t need to be changed daily now what does need to be done daily is irrigation of the tube right so you&#39;re going to irrigate the tube daily the nurse instructs the client that before the fecal occult blood test she may eat one whole wheat bread two a lean t-bone steak three veal or four salmon choices two three and four really making me hungry okay and the correct answer guys is choice one whole wheat bread that&#39;s only the safe choice out of all these choices that have been given this patient&#39;s about to get a fecal occult blood test so we&#39;re looking for blood that&#39;s hidden in the patient&#39;s stool choices two three and four all of them can cause false positive results so we&#39;ll get a result that&#39;s positive but it&#39;s not really positive false positive just because of what they ate so if a patient&#39;s going to get a fecal or cold blood test we&#39;re going to teach them to stay away from food such as a tea steak veal salmon okay the only safe choice here is one the whole wheat bread the nurse is discussing arterial sclerosis and its effects on it has on the body with an older adult client although the most commonly recognized effect is on the cardiovascular system the nurse should include which of the following statements regarding its effect on the gi system to complete the discussion one circulatory problems make getting to the bathroom easily problematic two the benefit you get from your food is also decreased by this condition three the aging process that causes vascular problems also causes elimination process problems or four the problem it creates with blood flow also affects blood flow to the bowels and so affects elimination before i tell you what the answer is i will say this you should have at least you should have at least um narrowed your answer down to choice 2 and choice 4. because choice 2 and choice 4 are both factual statements but the correct answer is choice 4 because choice 4 is more detailed it gives you the exact reason why this is happening if four was it here two would have been the answer so let&#39;s talk about four the problem it creates with blood flow also affects blood flow to the bowels and so it affects elimination and that is absolutely true so guys the what we&#39;re talking about is arteriosclerosis so we have the blood vessels you know especially this is older a older adult as you get older those vessels just start to harden they don&#39;t stretch as much as they used to and on top of that the older that you get the longer you&#39;ve been eating foods that are high in what cholesterol so you&#39;ve got that plaque that&#39;s sticking along the inner lining that&#39;s making the the lumen of the vessel more narrow which means it&#39;s bringing more blood flow remember in blood is the oxygen the vitamins and nutrients that all of your tissues need to absorb right including your gi tract so that&#39;s something else that&#39;s going on and um because of that decreased blood flow it slows down peristalsis it keeps food sitting there in the gi tract longer which allows the patient to be what constipated on top of that guys um decreased blood flow to the gi tract decreases the gi tract&#39;s ability to absorb import to absorb to absorb important nutrients so i just told you what three or four reasons why arterial sclerosis is um harmful or detrimental to the gi tract and that&#39;s why number four is the correct answer and guys i must have been speaking really fast because i can&#39;t believe it but we are already down to our last question if you want to see more questions on this guys please make sure you leave me a note in the comments and i&#39;ll make sure i prepare another video for you last question which of the following statements made by an older adult reflects the best understanding of the role of fiber regarding the bowel patterns one the more fiber i eat the fewer problems i have with my bowels two whole grain cereals and toast for breakfast keeps my bowel moving regularly three my wife makes whole grain muffins they are really good and good for me too or four i you i used to have trouble with constipation until i started taking a fiber supplement and guys the correct answer is two whole grain a cereal and toast for breakfast keep my bowels moving regularly why did you guys notice the um there&#39;s been a common theme with throughout this whole video okay foods that are high in fiber increases bulk in the stool promotes peristalsis which promotes elimination so that way it decreases the chance of the patient being what constipated so number two is the correct answer guys i hope you found this video to be helpful if you&#39;d like to see more content um on this or anything else please be sure to leave me a comment below let me know what you think about this video please do not forget guys i have audio lessons i&#39;ve got my tumblrs available on my website nexusnursinginstitute.com very soon i&#39;m going to 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watching and you&#39;ll see me next time

[Music] hi guys it&amp;#39;s me professor d and welcome back to my youtube channel on this video i&amp;#39;m going to be covering about elimination guys um if you haven&amp;#39;t done so already you know what i&amp;#39;m going to say please do not forget to like and subscribe below i&amp;#39;ve got audio lessons on my website available and soon i will also have study guides at nexusnursinginstitute.com don&amp;#39;t forget to check me out across um my other social media platforms such as tik tok instagram and facebook okay guys so without any further ado let&amp;#39;s get started first question which of the following would the nurse expect as a normal change in bowel elimination as a person ages one absorptive processes are increased in the intestinal mucosa two esophageal emptying time is increased three changes in nerve innervation and sensation cause diarrhea or four mastication processes are less efficient and guys the correct answer is for mastication processes are less efficient so think about it as the patient gets older guys it&amp;#39;s just like wear and tear of the body so you know um something very important if you guys been following me with fundamentals when it comes to the aging adult i tell you this all the time as the person gets older their sense of thirst decreases so number one you have a person that&amp;#39;s drinking less that places that patient at risk for what constipation then number two um mastication that chewing they&amp;#39;re not um the chewing process becomes less okay that puts them at risk for um constipation because now they got all of these bulks of food that the gi tract is supposed to be absorbing um salivation guys becomes less in the older adult all of these places the patient at risk for what constipation why do i keep saying that because i need you to drill that in your head because i promise you this is a test question as the patient gets older they are more at risk for constipation due to these reasons now let&amp;#39;s look at the wrong answer choices one absorptive processes are increased in the intestinal mucosa we wish they&amp;#39;re decreased that&amp;#39;s why that patient&amp;#39;s also at risk for what constipation choice two esophageal emptying time is increased false okay it&amp;#39;s delayed and the reason that it&amp;#39;s delayed is because the patient has decreased motility remember peristalsis that&amp;#39;s what makes that gi tract kind of contract to just move that food along right well it slows down in the older adult which allows the food to sit there much longer right and do what harden which causes what constipation and choice three changes in nerve innervation and sensation cause diarrhea that&amp;#39;s false now the older adult they do have changes in the innervation and the sensation but it doesn&amp;#39;t cause diarrhea it actually causes the opposite what constipation so if you guys learn anything from this one question is that the older adult is at risk for what ladies and gentlemen let&amp;#39;s say together constipation very good moving on next question an eight-month-old infant is hospitalized with severe diarrhea the nurse knows that the major problem associated with severe diarrhea is one pain in the abdominal area two electrolyte fluid loss three presence of excessive flattes or four irritation of the peritoneal and rectal area and guys the correct answer is two electrolyte and fluid loss now again if you&amp;#39;ve been following me for any amount of time you know me i teach you a million times the importance of maslow&amp;#39;s hierarchy of needs that&amp;#39;s how you prioritize patients what is the most important and physiological integrity is always going to take precedence what is physically keeping that patient alive nutrition hydration vital signs airway breathing circulation hemodynamic status glucose rest and sleep fluid and electrolytes right go back to this question this is an eight-month-old infant the smaller the body the faster that that patient will go down on you okay so this is an eight month old infant and it doesn&amp;#39;t only say diarrhea what type of diarrhea severe diarrhea which means that this patient is losing lots and lots of fluid um through the stool so that patient uh places that patient at electrolyte and fluid um uh loss and yes that patient may have uh pain in abdominal area but is that a priority to us absolutely not i talked to you guys about this pain only becomes a priority in certain circumstances such as burns such as myocardial infarction such as stones and i don&amp;#39;t care what kind of stones whether it&amp;#39;s kidney stones uh calcium struvite if they&amp;#39;re stones you know that&amp;#39;s a priority what else sickle cell right in those situations you can put bur uh you excuse me you could put pain in the same category you would put physio everything else that falls under physiological integrity but outside of that it&amp;#39;s not going to kill the patient so pain is not going to be a priority but you better believe that fluent electrolyte will be because that can kill a patient okay next question a client&amp;#39;s to have a stool test for occult blood the nurse is instructing the client excuse me instructing the nursing assistant in the correct procedure for the test the nursing assistant is correctly informed that one sterile technique sterile technique is used for collection two stools should be collected over three day period three the specimen should be kept warm or four a one inch sample of a form stool is needed and guys the correct answer the only correct answer guys number one a one inch uh sample of formed stool is needed we only need a small amount okay to test let&amp;#39;s look at the wrong answer choices one a sterile technique you don&amp;#39;t need sterile technique for this procedure it&amp;#39;s just a clean technique okay two stools should be collected over three over a three day period um that&amp;#39;s actually the stool that we collect over a three-day period that&amp;#39;s when we&amp;#39;re collecting um the fecal um fat okay when we want to actually measure how much fat is in the stool that&amp;#39;s when we&amp;#39;ll collect it for a three-day period choice three the specimen i should have worn my glasses right the specimen should be kept warm that&amp;#39;s actually when we&amp;#39;re testing for like um ova or parasites that&amp;#39;s when you&amp;#39;re gonna keep the stool um warm so for alcohol blood the correct answer is number four we just need a small sample about a one inch sample a client who recently underwent surgery and now has a colostomy is correctly instructed by the nurse for the next few weeks the client&amp;#39;s diet will include foods such as one vegetables two fresh fruit three whole grains or four poached eggs and rice i love this question okay guys the correct answer is for poached eggs and rice before i tell you why i want to go back and tell you why number one two and three are wrong and something i want you guys to notice when you&amp;#39;re testing because you&amp;#39;re not always going to know what the correct answer is but you got to start using clues that are given to you right if you read this question and choices and you didn&amp;#39;t know what the answer was you should have looked at your choice and say okay is there something that all of these choices have in common that one doesn&amp;#39;t if it&amp;#39;s a multiple choice the one that doesn&amp;#39;t choose that answer when we&amp;#39;re looking at this choice is one vegetable choice is two fresh fruits choices three um whole grains all of these are high in what fiber so even if you didn&amp;#39;t know what the answer was you should have seen a pattern in choice one two and three and you should have said to yourself well i don&amp;#39;t know what the answer is but choices one two and three all have something in common so i&amp;#39;m gonna choose the oddball out and guys i&amp;#39;m only talking about if you don&amp;#39;t know what the answer is how to you know try to get the right answer if you know what the answer is don&amp;#39;t use this technique just choose the right answer so anyway let&amp;#39;s go back to number four the um poached eggs and rice so fish chicken eggs and when i say eggs notice it said poached eggs right the reason it said poached eggs is because we don&amp;#39;t want fried eggs that&amp;#39;s why they specifically said poached eggs all of these are good choices for that patient that just had a colostomy we do not want a patient who just had a colostomy to eat foods that are high in fiber because they just had surgery we&amp;#39;re really trying to rest that gut we&amp;#39;re not trying to make them work too hard we&amp;#39;re not trying to stretch the walls of the gi tract are we so that&amp;#39;s why we need the low um vegetables such as the poached eggs the rice the chicken okay let&amp;#39;s look at the wrong answer choices just like i said vegetables fresh food rice all of these are high in fiber and we will we really we really want to rest the bowels after uh that type of gi surgery and so that&amp;#39;s why number four is the correct answer clients been admitted to an acute care unit with diagnosis of biliary disease the nurse suspects that the feces will appear one bloody two plus filled three black and tauri or four white or clay colored and guys the correct answer is for white or clay colored why the bible&amp;#39;s missing bowel is what gives that stool that darkened color right go back to the question it says the client has what kind of disease biliary disease so we know that the gallbladder those uh bile ducts or maybe a combination of both that&amp;#39;s what&amp;#39;s in trouble but the fact that we know bowel is involved and you know it&amp;#39;s most likely not going to be sufficient because this is the disease we&amp;#39;re going to see that stool not having that dark color but being being a clay or white color now let&amp;#39;s look at our other um guys i cannot speak you guys know i can&amp;#39;t speak on my videos be patient with me are other wrong choices one bloody when it&amp;#39;s bloody as in that bright red color that bloody color um you should suspect gi bleeding but specifically lower gi bleeding that&amp;#39;s why still has that red color because it&amp;#39;s fresh coming from that lower gi tract choice two pus field whenever you see something with pus what are you supposed to think of infection choice three black and tarry when is black and tarry you&amp;#39;re thinking of bleeding but you&amp;#39;re thinking more of gi bleeding gr bleeding more upper gi bleeding right so wherever that uh upper gi bleed is originally it would have that reddish bloody color but as it&amp;#39;s going through the gi tract by the time it comes out of that rectum it&amp;#39;s turned what black and tarry so you&amp;#39;re still going to suspect uh gi bleeding but an upper gi bleeding versus that fresh bright red blood which would be what lower gi bleeding so guys number four is the correct answer the client asked the nurse to recommend a bulk forming foods that may be included in the diet which of the following should be recommended by the nurse one whole grains two fruit juice three rare meats or four milk products and guys the correct answer is one whole grains so fruits vegetables guys they absorb fluid okay they absorb fluid and cause what bulk in the gi system okay makes the the stool heavier that&amp;#39;s why it&amp;#39;s called bulk because that&amp;#39;s exactly what it does it bulks up the stool now look at our wrong answer choices two fruit juice three rare meats four milk products these don&amp;#39;t add bulk to the stool but fruits and vegetables do because everything you drink it just soaks up all of that fluid and it adds bulk to the store [Applause] the clients taking medications to promote defecation which of the following instructions should be included by the nurse in the teaching plan for this client one increased laxative use often causes hyperkalemia two cell tablets should be taken to increase the solute concentration of the extracellular fluid three emollient solutions may increase the amount of water secreted in the bottle in the bowel or four bulk forming additives may turn the year in pink and guys the correct answer three emollient solutions may increase the amount of water secreted in the bowl absolutely can cause the patient to have watery stools that is absolutely the truth let&amp;#39;s talk about the wrong answer choices one increased laxatives often causes hyperkalemia no it causes hypokalemia why because you&amp;#39;re losing all that potassium through your stool okay choice two salt tablets should be taken to increase the solute concentration of the extracellular fluid no it should not that is absolutely false and choice four bulk forming additives can turn the urine pink guys that&amp;#39;s crazy that&amp;#39;s absolutely fault they made that up no it doesn&amp;#39;t so the correct answer is three while undergoing a soap suds enema the client complains of abdominal cramping the nurse should one immediately stop the infusion two lower the height of the animal container three advance the enema tubing two to three inches or four clamp the tubing and guys the correct answer is lower the height of the enema container and i know what you&amp;#39;re thinking because you&amp;#39;re saying you know professor d you said whenever patient getting a transfusion whenever a patient&amp;#39;s getting a transfusion if something goes wrong we should stop the transfusion first of all this is not transfusion patient&amp;#39;s getting this is an enema but even more important than that two we&amp;#39;re going to expect some cramping it&amp;#39;s an animal that you&amp;#39;re giving the patient so they can have a bowel movement with that being said if you know that um that uncomfortable feeling is that cramping becomes too much you&amp;#39;re just going to lower you&amp;#39;re not going to stop it you&amp;#39;re just going to lower and the reason you don&amp;#39;t stop is because the patient needs the medication right but the reason you lower it the higher that you have that bag the faster it&amp;#39;s rushing into the patient that&amp;#39;s what may cause those really bad cramping but the more that you lower it the slower the medication goes into the patient so the patient&amp;#39;s still getting the medication they&amp;#39;re just not getting it as fast so the feeling will not be as harsh and that&amp;#39;s why um number two is the correct answer let&amp;#39;s talk about the wrong answer choices one immediately stop the infusion no if you stop the infusion how are they going to get that medication which they need this is not a reaction the patient&amp;#39;s having that&amp;#39;s life-threatening we kind of expect them to cramp up a little okay choice three advances advance the enema tubing two to three inches stop it you don&amp;#39;t do that you just slow it down and you slow down the the um flow by just lowering that bag um choice four clamp the tubing absolutely not necessary okay so the correct answer is number two these answer choices are funny sometimes all right guys the nurse who&amp;#39;s caring for a post-op client on the surgical unit knows that for 24 to 48 hours post-op clients who have undergone general anesthesia may experience one colitis two stomatitis three parallel ileus or four gastrocolic reflex and guys the correct answer is three paralytic ilius so guys parallel ilias is when um the peristalsis of the gi tract stops completely this is transient it&amp;#39;s going to the peristalsis is going to come back as the anesthesia is eliminated from the body so as the patients you know the anesthesia is going down their peristalsis is going to start to go back up and it usually takes about 24 to 48 hours so number three is the correct answer for clients with hypocalcemia the nurse should implement measures to prevent one gastric upset to malabsorption three constipation or four fluid secretion and guys the correct answer is three constipation that is one of the things you&amp;#39;ll see in the patient that&amp;#39;s experiencing hypo calcium along with that patient may have uh muscle cramps excuse me um tetany uh paresthesias you know that tingling sensation all of those are signs and symptoms of hypocalcemia the nurse is to receive k-excellent enema the nurse recom recognizes that this is used to one prevent constipation to remove excess potassium from the system three reduce bacteria in the colon from colon before diagnostic testing or four provide direct anti diarrheal medication to the intestine and the correct answer is to uh remove excess potassium from the system that&amp;#39;s true guys and here&amp;#39;s the trick when you see that medication k excellate that k think of potassium what is your symbol for potassium isn&amp;#39;t the k with the little plus plus sign so when you see k excellent remember potassium so what this medication does it binds the potassium so when the patient has a bowel movement all of that potassium comes out in the stool so that is the absolutely correct answer now let&amp;#39;s look at the wrong answer choices one prevent further constipation that is false that&amp;#39;s not what it does uh three reduce bacteria in the colon before diagnostic testing um neomycin enemas that&amp;#39;s what it does okay not k excellent and choice four provide a direct anti-diarrheal medication to the intestine false the correct answer is choice too like i said it binds the potassium so when the patient has a bowel movement all that potassium will come out in the stool the appropriate amount of fluid to prepare for an enema to be given to an average size school school a child is three 300 to 500 ml that is the correct amount now let&amp;#39;s look at the wrong answer choices choice one 150 to 250 that&amp;#39;s what you give to an infant choice 2 250 to 350 that&amp;#39;s what you give to a toddler and then choice for 500 to 750 that is what you give to an adolescent so the correct answer for school a child would be 300 to 500 ml of the following is an appropriate nursing intervention for a client with an ng tube in place one tape the tube up and around the ear on the side of the insertion two secure the tubing to the bed by the client&amp;#39;s head three mark the tube where it exits the nose or four change the tubing daily and guys the correct answer is three mark the tube where it exits the nose and guys you can either do that with like tape or a red pen but that is the correct answer now remember you&amp;#39;re going to do this only after placement has been confirmed by x-ray so the patient gets it gets a tube um x-ray has confirmed it&amp;#39;s in the stomach and not anywhere else like the lungs right so then you want to mark it either with like a like i said a red pen or tape and the reason you&amp;#39;re doing that is so you can know if displacement happens now let&amp;#39;s look at the other choices choice one tape the tube up and around the ear on the side of insertion no you just tape it to the nose not the ear that&amp;#39;s false uh choice two secure tubing to the bed do we do this guys never secure tubing to the bed no you&amp;#39;re gonna secure it to the patient&amp;#39;s gown not to the patient&amp;#39;s bed choice four change the tubing daily no you don&amp;#39;t change the tubing doesn&amp;#39;t need to be changed daily now what does need to be done daily is irrigation of the tube right so you&amp;#39;re going to irrigate the tube daily the nurse instructs the client that before the fecal occult blood test she may eat one whole wheat bread two a lean t-bone steak three veal or four salmon choices two three and four really making me hungry okay and the correct answer guys is choice one whole wheat bread that&amp;#39;s only the safe choice out of all these choices that have been given this patient&amp;#39;s about to get a fecal occult blood test so we&amp;#39;re looking for blood that&amp;#39;s hidden in the patient&amp;#39;s stool choices two three and four all of them can cause false positive results so we&amp;#39;ll get a result that&amp;#39;s positive but it&amp;#39;s not really positive false positive just because of what they ate so if a patient&amp;#39;s going to get a fecal or cold blood test we&amp;#39;re going to teach them to stay away from food such as a tea steak veal salmon okay the only safe choice here is one the whole wheat bread the nurse is discussing arterial sclerosis and its effects on it has on the body with an older adult client although the most commonly recognized effect is on the cardiovascular system the nurse should include which of the following statements regarding its effect on the gi system to complete the discussion one circulatory problems make getting to the bathroom easily problematic two the benefit you get from your food is also decreased by this condition three the aging process that causes vascular problems also causes elimination process problems or four the problem it creates with blood flow also affects blood flow to the bowels and so affects elimination before i tell you what the answer is i will say this you should have at least you should have at least um narrowed your answer down to choice 2 and choice 4. because choice 2 and choice 4 are both factual statements but the correct answer is choice 4 because choice 4 is more detailed it gives you the exact reason why this is happening if four was it here two would have been the answer so let&amp;#39;s talk about four the problem it creates with blood flow also affects blood flow to the bowels and so it affects elimination and that is absolutely true so guys the what we&amp;#39;re talking about is arteriosclerosis so we have the blood vessels you know especially this is older a older adult as you get older those vessels just start to harden they don&amp;#39;t stretch as much as they used to and on top of that the older that you get the longer you&amp;#39;ve been eating foods that are high in what cholesterol so you&amp;#39;ve got that plaque that&amp;#39;s sticking along the inner lining that&amp;#39;s making the the lumen of the vessel more narrow which means it&amp;#39;s bringing more blood flow remember in blood is the oxygen the vitamins and nutrients that all of your tissues need to absorb right including your gi tract so that&amp;#39;s something else that&amp;#39;s going on and um because of that decreased blood flow it slows down peristalsis it keeps food sitting there in the gi tract longer which allows the patient to be what constipated on top of that guys um decreased blood flow to the gi tract decreases the gi tract&amp;#39;s ability to absorb import to absorb to absorb important nutrients so i just told you what three or four reasons why arterial sclerosis is um harmful or detrimental to the gi tract and that&amp;#39;s why number four is the correct answer and guys i must have been speaking really fast because i can&amp;#39;t believe it but we are already down to our last question if you want to see more questions on this guys please make sure you leave me a note in the comments and i&amp;#39;ll make sure i prepare another video for you last question which of the following statements made by an older adult reflects the best understanding of the role of fiber regarding the bowel patterns one the more fiber i eat the fewer problems i have with my bowels two whole grain cereals and toast for breakfast keeps my bowel moving regularly three my wife makes whole grain muffins they are really good and good for me too or four i you i used to have trouble with constipation until i started taking a fiber supplement and guys the correct answer is two whole grain a cereal and toast for breakfast keep my bowels moving regularly why did you guys notice the um there&amp;#39;s been a common theme with throughout this whole video okay foods that are high in fiber increases bulk in the stool promotes peristalsis which promotes elimination so that way it decreases the chance of the patient being what constipated so number two is the correct answer guys i hope you found this video to be helpful if you&amp;#39;d like to see more content um on this or anything else please be sure to leave me a comment below let me know what you think about this video please do not forget guys i have audio lessons i&amp;#39;ve got my tumblrs available on my website nexusnursinginstitute.com very soon i&amp;#39;m going to have um study guides for you test guides on my website don&amp;#39;t forget to check me out on my other social media platforms my handle is still the same next is nursing i have a podcast for nurse practitioners and registered nurses students same platform um the name of my handle my handle name is the same nexus nursing and guys please if i have helped you in any way and you really want to support this channel do one thing for me share this video share my content i&amp;#39;m really trying to go grow guys i&amp;#39;m trying to um do this for you guys a hundred percent of the time a hundred percent of the time i don&amp;#39;t want my attentions elsewhere but in order for that to happen my channel has to be supported guys so i&amp;#39;m asking you please each and every one of you take just a moment and share just one of my videos on your social media network friends family co-workers whoever you think would benefit from this video and of course guys do not forget to like and subscribe below thank you for watching and you&amp;#39;ll see me next time

Transcript for:Elimination Lecture Notes

Transcript for:
Elimination Lecture Notes