Anti-embolism stockings, Incontinence and elimination Urine testing PN 103

Anti-embolism stockings Type of compression stockings Designed to exert varying degrees of pressure to the ankles and legs Prevents blood clot formation in the legs Blood clots that break free from their site of formation and move into the blood stream are called emboli Embolism -a condition where an embolus travels and becomes lodged in a major vessel of the lungs or brain, causing damage or even death. Anti-embolism stockings

Anti-embolism stockings Deep vein thrombosis (DVT) -blood clots that form in the deep veins of the body, usually the thighs and lower legs -travel to the lungs causing a pulmonary embolism (PE) -travel to the brain causing a cerebral embolism -if a cerebral embolism or PE occurs -blood flow to the affected area is cut off and tissues are starved of oxygen -if this continues for more than few minutes tissue death will occur. Anti-embolism stockings

Anti-embolism stockings Risk Factors -immobile for long periods of time -long flights -prolonged bed rest in or out of hospital -immobilization of the leg, such as in a cast -smoking -heart disease -high blood pressure -high cholesterol -obesity -cancers pressing against deep veins -certain medications and blood disorders that cause blood to thicken -surgery -given birth within the last six months Anti-embolism stockings

Anti-embolism stockings Symptoms -redness -warmth in one leg -leg pain and/or tenderness -swelling or edema Symptoms of embolism -shortness of breath -wheezing -coughing -chest pain -blood in the sputum -dizziness/fainting -can range from mild to severe. Anti-embolism stockings

Anti-embolism stockings Prevention and Treatment -Anticoagulant medications -heparin and warfarin -thins the blood, prevents further clotting and stabilizes present clots and prevents them from traveling . -Anti embolism stockings -increases blood flow between the heart and legs -Oxygen -Analgesics to relieve the pain -Possibly surgery to remove the clot Anti-embolism stockings

Anti-embolism stockings Stocking Design -Designed with a compression gradient -pressure exerted on the leg is greatest at the ankle and gradually reduces toward the top of the stocking -promote better circulation and some pain relief -available in a variety of pressure gradients designed for different uses and wear time -stockings designated anti-embolism will be labeled as having 18 mmHg -designed to worn only short term wear while a patient is not ambulatory Anti-embolism stockings

Anti-embolism stockings http://www.youtube.com/watch?v=AwyIeRYM608 http://www.youtube.com/watch?v=kOQgGNQw7f8 Anti-embolism stockings

Incontinence/Elimination Perineal Care Care of the genitalia Part of the complete bed bath Assess for signs of vaginal or urethral exudate, skin impairment, unpleasant odors, complaints of burning during urination, or localized tenderness or pain of the perineum. Incontinence/Elimination

Female perineal care

Male Perineal care

Bedpans/Urinals

The bedside commode has a toilet seat with a container underneath.

Incontinence/Elimination Assisting the Patient with Elimination Bedpan A device for receiving feces or urine from either male or female patients confined to the bed Urinal A device for collecting urine from male patients; urinals for females also available Bedpans or urinals are used when a patient is unable to get up to go to the bathroom for the purpose of urination or defecation. Incontinence/Elimination

Positioning the bedpan

Incontinence/Elimination Care of the Incontinent Patient -very common problem -older adults. -pressure in the bladder is too great, sphincters are weak -innervation has been compromised due to illness or injury. -small leakage of urine when the person laughs, coughs, or lifts something heavy. Incontinence/Elimination

Incontinence/Elimination Care of the Incontinent Patient -disposable adult undergarments (briefs) or underpads. -clean the skin thoroughly after each episode of incontinence -warm soapy water -dry thoroughly help to prevent skin impairment. -bladder training can be helpful. Incontinence/Elimination

Incontinence/Elimination http://mcom.alexanderstreet.com/View/1665584/ http://mcom.alexanderstreet.com/view/1665500/play/true Incontinence/Elimination

Dipping urine Urine dipsticks -faster way to get a basic urinalysis -laboratory doing a UA will use similar-type sticks -machine that times the reads exactly -a photometer to read the color changes -eliminating the human error element. . Dipping urine

Dipping urine Leukocyte Esterase -indirect indicator that leukocytes are present in the urine -can indicate an infection in the urinary tract -inflammatory disorder of the kidneys/GU tract -Specimens with skin contaminant will frequently come up positive for LEs -adequate cleaning in really important prior to collecting the sample. Nitrites -indirect detection of E. Coli, which produces nitrites -a negative test does not rule out a UTI. Dipping urine

Glucose -a normal person (other than pregnant women) should almost never spill glucose into their urine -uncontrolled diabetes -certain rare disorders where the kidney is incompetent at resorbing glucose. Protein - normal kidney will filter out protein -if it shows up in your urine, something is wrong -underlying systemic illness -contamination of the specimen will cause a positive test -people with blood in their urine come up positive for protein -secondary to lysis of the cells pH -dehydrated person will have more acidic urine (below 7.45) -person with a Proteus-caused UTI will have a very basic urine (above 7.45) Dipping urine

Dipping urine Ketones -not a normal finding in blood or urine -the body switches from aerobic to anaerobic metabolism -low-carbohydrate diets, dehydration, starvation, DKA, or certain metabolic diseases Specific Gravity -measures how concentrated the urine is -high in dehydration -low in hydrated people -Diabetes Insipidus. Urobilinogen -metabolic breadown product of bilirubin -certain liver diseases Blood -measures hemoglobin -kidney diseases, some UTIs, trauma, etc. -easy to get a false positive Dipping urine

Dipping urine http://www.youtube.com/watch?v=jYLIbn7Mb04 http://www.youtube.com/watch?v=EBwmr65AbGM http://www.youtube.com/watch?v=sE7zL5YlGYs http://www.youtube.com/watch?v=nWHac8CENAg Dipping urine