ATI EXAM 1 Concepts
1. Body mechanics: To lower the center of gravity (be more stable) bend the hips and
knees. Also, spread your feet.
When lifting: use major muscle groups to prevent back strain, and tighten abdominal
muscles.
Pushing or pulling: when opportunity allows, pull objects toward the center of gravity rather
than pushing them away. Face the direction of movement. Use your own body as a
counterweight.
Avoid repetitive or jerky muscle movements
Avoid twisting your spine or bending at the waist to minimize risk for injury
2. Nursing Interventions for pressure ulcers:
3. Urinary incontinence is a significant contributing factor to what in older adults:
skin breakdown and falls
4. Risk factors for urinary incontinence: females, history of multiple pregnancies and
vaginal births, renal disease, bladder spasm, chronic bladder infections Obesity,
neurological disorders, medication therapy, decreased estrogen and de- creased pelvic
muscle tone, physiological changes of aging
5. What lab tests can be done for urinary incontinence: Urinalysis and urine culture
and sensitivity - to identify UTI (presence of RBC's, WBCs, microorganisms) Serum
,creatinine and BUN - to assess renal function (elevated with renal dysfunc- tion)
6. Nursing care for urinary incontinence: Establish a toileting schedule; monitor and
increase fluid intake during the daytime and decrease prior to bedtime; remove or control
barriers to toileting; provide incontinence garments; avoid the use of in- dwelling urinary
catheters; teach the client Kegel exercises to tighten pelvic muscles, bladder compression
techniques, to avoid caffeine and alcohol, adverse effects of meds that affect urination
7. Antibiotics for urinary infection: Gentamicin and cephalexin
Administer with food to decrease GI distress
8. Other meds for urinary incontinence: Tricyclic antidepressants (Nortriptyline)-
anticholinergic effects that help relieve incontinence. Monitor for dizziness
Urinary antispasmodics or anticholinergic agents (oxybutynin or dicyclomine) - Decrease
urgency and help eliminate pain. Dry mouth and dizziness common Phenazopyridine -
bladder analgesic treats the symptoms of UTIs. Will not treat infection but will decrease
bladder discomfort. Encourage patient to take with food, and turns urine orange.
9. Therapeutic procedures for urinary incontinence: Bladder retraining - bladder
retrsining increases the bladder's ability to hold urine and patient's ability to suppress
urination. Client should urinate at scheduled intervals, should gradually increase urination
intervals after no incontinent episodes for 3 days, working toward 4 hr
, intervals.
Urinary habit training- helps clients with limited cognitive ability to establish pre- dictable
period of emptying.
Intermittent urinary catheterization- periodic catheterization to empty the bladder. Reduces
the risk of infection from indwelling catheterization, which is a temporary intervention for
client's at risk for skin breakdown or when other options have failed. Nurse should adjust
frequency to keep output at 300 mL or less.
Catheters (suprapubic or urinary) remain until clients have a post void residual of less than
50 mL.
10. Skin breakdown from chronic exposure to urine: Keep the skin clean and dry Assess
for signs of breakdown
Apply protective barrier creams Implement a
bladder retraining program
11. Social isolation due to urinary incontinence: Nursing actions - assist with measures
to conceal urinary leaking (perineal pads, external catheters, adult incon- tinence garments)
Offer emotional support
12. Straight or indwelling catheter insertion and care: Usual size and type of
catheter -
1. Body mechanics: To lower the center of gravity (be more stable) bend the hips and
knees. Also, spread your feet.
When lifting: use major muscle groups to prevent back strain, and tighten abdominal
muscles.
Pushing or pulling: when opportunity allows, pull objects toward the center of gravity rather
than pushing them away. Face the direction of movement. Use your own body as a
counterweight.
Avoid repetitive or jerky muscle movements
Avoid twisting your spine or bending at the waist to minimize risk for injury
2. Nursing Interventions for pressure ulcers:
3. Urinary incontinence is a significant contributing factor to what in older adults:
skin breakdown and falls
4. Risk factors for urinary incontinence: females, history of multiple pregnancies and
vaginal births, renal disease, bladder spasm, chronic bladder infections Obesity,
neurological disorders, medication therapy, decreased estrogen and de- creased pelvic
muscle tone, physiological changes of aging
5. What lab tests can be done for urinary incontinence: Urinalysis and urine culture
and sensitivity - to identify UTI (presence of RBC's, WBCs, microorganisms) Serum
,creatinine and BUN - to assess renal function (elevated with renal dysfunc- tion)
6. Nursing care for urinary incontinence: Establish a toileting schedule; monitor and
increase fluid intake during the daytime and decrease prior to bedtime; remove or control
barriers to toileting; provide incontinence garments; avoid the use of in- dwelling urinary
catheters; teach the client Kegel exercises to tighten pelvic muscles, bladder compression
techniques, to avoid caffeine and alcohol, adverse effects of meds that affect urination
7. Antibiotics for urinary infection: Gentamicin and cephalexin
Administer with food to decrease GI distress
8. Other meds for urinary incontinence: Tricyclic antidepressants (Nortriptyline)-
anticholinergic effects that help relieve incontinence. Monitor for dizziness
Urinary antispasmodics or anticholinergic agents (oxybutynin or dicyclomine) - Decrease
urgency and help eliminate pain. Dry mouth and dizziness common Phenazopyridine -
bladder analgesic treats the symptoms of UTIs. Will not treat infection but will decrease
bladder discomfort. Encourage patient to take with food, and turns urine orange.
9. Therapeutic procedures for urinary incontinence: Bladder retraining - bladder
retrsining increases the bladder's ability to hold urine and patient's ability to suppress
urination. Client should urinate at scheduled intervals, should gradually increase urination
intervals after no incontinent episodes for 3 days, working toward 4 hr
, intervals.
Urinary habit training- helps clients with limited cognitive ability to establish pre- dictable
period of emptying.
Intermittent urinary catheterization- periodic catheterization to empty the bladder. Reduces
the risk of infection from indwelling catheterization, which is a temporary intervention for
client's at risk for skin breakdown or when other options have failed. Nurse should adjust
frequency to keep output at 300 mL or less.
Catheters (suprapubic or urinary) remain until clients have a post void residual of less than
50 mL.
10. Skin breakdown from chronic exposure to urine: Keep the skin clean and dry Assess
for signs of breakdown
Apply protective barrier creams Implement a
bladder retraining program
11. Social isolation due to urinary incontinence: Nursing actions - assist with measures
to conceal urinary leaking (perineal pads, external catheters, adult incon- tinence garments)
Offer emotional support
12. Straight or indwelling catheter insertion and care: Usual size and type of
catheter -
