Class 4: Gastrointestinal & Genitourinary Systems Flashcards
Diarrhea
increase in frequency, volume, and fluid content of a stool. A symptom; not a disease. water content of feces is increased, usually due to either malabsorption or water secretion in the bowel.
- may be acute or chronic
- may be a cause of incontinence
oliguria
a urine output of less than 400 mL in 24 hours (adults).
cystitis
an inflammatory condition of the urinary bladder, characterized by pain, urgency and frequency of urination, and hematuria
urgency
sudden urge to urinate
frequency
urinating often
incontinence
the involuntary passage of a stool
urinary incontinence
an uncontrolled loss of urine that is of sufficient magnitude to be a problem
flatus
gas in the intestinal tract or gases passed through the anus
peristalsis
waves of involuntary contraction passing along the walls of the intestines and forcing content onwards
anuria
non-passage of urine, less than 100 mL per day
hematuria
blood in the urine that may or may not be accompanied by pain. But it is always abnormal and should be investigated
micturition
urination
what are two types of movement in the GI tract?
segmentation and peristalsis
What are 5 primary functions of GI system?
ingestion (and propulsion), secretion (of enzymes, mucous and water), digestion, absorption (nutrients, water), elimination
what controls the GI tract?
the autonomic nervous system
venous blood draining from the GI tract empties into the….
portal vein which then goes to the liver
age related changes on the GI system
- increased periodontal disease and tooth loss (inability to chew)
- slowing of peristalsis (bloating, heartburn)
- tongue and taste bud atrophy
- alterations in secretion: saliva, gastric secretions, pancreatic enzymes. problems with digestion
- delayed gastric emptying
- alterations in cardiovascular and neurological systems can affect GI function
- new surgical wound, you need softer bowels
- decreased muscle tone to perineal floor and anal sphincter
common GI diagnostics
- radiological studies
- abdominal ultrasonography
- endoscopy (colonoscopy, capsule endoscopy)
- magnetic resonance imaging (MRI)
- fecal analysis: occult blood, parasites, fat content, mucus, pus
factors that influence elimination
- hydration
- nutrition
- physical activity
what are some causes of diarrhea?
stress, medications, allergies, intolerance of food or fluids, disease of colon
what are some effects of diarrhea?
increased motility
- inflammation and infection of mucosa
- incomplete digestion of food
- reduced absorption of fluids
how can you manage diarrhea?
increase fluids, may need an IV, bland diet, avoid hot and cold fluids, no alcohol or caffeine.
bowel incontinence
loss of voluntary ability to control fecal and gaseous discharges. generally associated with impaired functioning of anal sphincter or nerve supply
possible causes of bowel incontinence
-neurological
spinal cord injury or disease
head injury, stroke or brain tumour
- diarrhea
- tumours
what are goals for bowel incontinence?
maintain or restore normal bowel elimination pattern
- maintain or regain normal stool consistency
- prevent associated risks such as fluid and electrolyte imbalance, skin breakdown, abdominal distention and pain
constipation
decreased frequency of defection
- may be a primary problem or a manifestation of another disease or condition
fecal impaction
mass or collection of hardened feces in folds of rectum.
-recognized by passage of liquid fecal seepage and no normal stool
causes of fecal impaction
usually poor defecation habits and constipation
fecal impaction treatment
soften stool, possible manual disimpaction
what will you include in a focused Gastrointestinal Assessment?
- weight loss/gain
- nausea
- appetite
- heartburn
- blood in stool
- how they are feeling
- problems swallowing
- hemmoroids
- changes in bowels
- past current health history
- medications
- inspection
- auscultation ( listening to internal sounds )
- palpitation (light to deep, feel the person)
- diagnostics
what are the 5 functions of kidneys
removal/excretion, fluid/electrolyte balance, regulate BP, regulation of RBC production
what is erythropoietin
the regulation of RBC production
what are the working units of the kidneys
the nephrons
what are two features that permit the distension capability of the bladder
rugae and elasticity of the bladder
detrusor
smooth muscle in the wall of bladder
age related changes to the Genitourinary system
- bladder muscles weaken, capacity decreases, emptying is more difficult.
diagnostics of the GU system
- take a urinalysis, C&S (colour, smell, pH, is it growing anything?)
- serum creatine: increased levels indicate kidney disfunction
- BUN: above normal levels indicate kidney dysfunction (increases dehydration)
- Utric Acid
- IVP, endoscopy, ultrasound, biopsy
factors the influence urinary elimination
- similar to GI elimination
- diseases
- muscle tone
- medication
- developmental factors
- psychological factors
- fluid and food intake
- pathological conditions
- surgical and diagnostic procedures
urinary incontinence
uncontrolled loss of urine of sufficient amount to be a problem
common causes of urinary incontinence
UTI’s, urethritis, pregnancy, hypercalcemia, fluid overload, delirium
stress urinary incontinence
a sneeze pushing on the bladder
urge urinary incontinence
the feeling that you have to go but only a few seconds or minutes before
overflow urinary incontinence
too much in bladder can’t palpate it
relax urinary incontinence
no warning or stress, frequent and involuntary urinate. common in MS patients
functional urinary incontinence
in ability to get to the toilet in time without assistance
total urinary incontinence
continuous and total loss of urinary control
urinary retention
when they emptying of the bladder is impaired and urine accumulates.
- bladder becomes over-distended and loses contractility
- clients may experience overflow voiding or incontinence
causes of urinary retention
bladder outlet obstruction or deficient detrusor contraction strength
neurogenic bladder
impaired neurological function can interfere with the normal mechanisms of urine elimination.
- client unable to recognize/perceive when bladder is full and is unable to control urinary sphincters
- bladder becomes flaccid and distended or spastic
UTI’s
- 50x more prevalent in women then men
- most common type of health care associated infection found in long term care facilities
- most UTI’s caused by bacteria common to the intestinal environment
causes and risk factors of UTI’s
improper cleaning, long term retention, diet, STI driven
signs and symptoms of a UTI
burning/itching sensation, fever, odour, cloud, behaviour changes, urinary habit changes
assessment/diagnosis of UTI’s
get them to pee, look at urine, ask questions
management of UTI’s
diet, hydration, mobility, exercise.
prevention of UTI’s
practice frequent voiding, avoid harsh soaps, tight clothing, wear cotton underwear rather than nylon, wipe front to back, shower rather than bath
focused GU assessment
risk factors: age, reoccurrence, spinal cord injury pain: where is it? medical history medications CVAT bladder palpation hydration status bladder distension edema urinalysis normal voiding patterns women: cough + valsalva manoeuvre (to assess urine leakage)
