Question

1. Explain specifically how opioid analgesics affect bowel elimination .
2. Explain what to do if signs and symptoms of vagal response are noted during enema administration.
3. What can you do to help prevent CAUT's when inserting an indwelling catheter.
4. HOw will you perform a 24 hour urine collection when the patient has an indwelling catheter ?
5. Explain how to prevent to prevent recurring UTIs in female patients.

Answer 1

1.Opioid analgesics are used in the management of chronic pain. However other than analgesia effect it has some adverse effects.This will also affect gastrointestinal tract.

Opioid induced bowel dysfunction is a main complication assosiated with long term use of opiods .It may cause constipation, anorexia ,nausea ,Vomiting, abdominal pain,flatulence, bloating and hard stool.

Opiod induced bowel dysfunction,is the result of reduced GI motility,and increases the absorption of fluids from the intestine and decrease epithelial secretion .The stool stored in the the gut lumen for long time and more fluid is reabsorbed from the stool ,hence stool become hard and dry

2.If the patient develop light headedness during the administration of enema ,it is due to vagal nerve stimulation.Which will leads to decrease in heart rate and alterd heart rhythm and patient will fo to syncope and hypotension.If any symptoms occurs of vagal response immediately remove the enema and discard.

3.CAUTI menas catheter assosiated urinary tract infection.

Avoid unnecessary catheter and minimize the use and duration of catheter use.

It can be prevented by some methods.

• Perform hand hygiene before and after insertion and manipulation of catheter.
• Make sure that only trained individuals are doing this procedure.
• Catheterization should done under strict aseptic technique.
• Use sterile gloves and sterile solution for cleaning.
• Use lubricant.
• Avoid touching the key parts of the catheter.

4.24 hour urine is collected in a can ,and preservative is added to this can.

In the morning urine is emptied and start collection. All urine during 24vhour is collected frequently and collected in the can

After the 24 hour the can should be send to lab with adequate labeling.

5.In females chance of urinary infection is high,due to some reasons.In females the urethra is small ,thus the bacteria can travel from the urethane to bladder fastlty. And the urethane is close to r-ectum,so bacteria can easily enter the urinary tract.The occurrence of urinary tract infection in women's can be prevented by

• Drink more fluids to flush out bacteria.
• Wash frequently, especially afetr inter -course.
• Use cotton undergarments.
• Drink cranberry juice .
• Avoid tight pants.
• Avoid diaphragm use.
• Avoid beverages.
• Use lubricant if needed.
• Avoid bubble bath.
• Wipe from front to back.

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