elimination

Question 1

what does urine output of less than 30mL/hour indicate?

Answer 1

renal impairment or hypovolemia (dehydration or blood loss)

Question 2

what does cloudy urine indicate

Answer 2

bacteria or WBCs

Question 3

causes

urinary retention

Answer 3

blockage from an enlarged prostate, renal/urinary stones

Question 4

symptoms

UTI

Answer 4

symptoms:
- dysuria
- urgency
- frequency
- suprapubic tenderness
- incontinence
- cloudy/foul smelling urine
- blood
- in elderly: fatigue, confusion, delirium, incontinence, falls

Question 5

risk factors

UTI

Answer 5

• indwelling catheter
• urinary stasis/retention
• poor perineal hygeine
• incontinence
• constipation
• urinary tract stones
• obesity
• pregnancy
• menopause
• conditions that compromise immune response
• habitual delay in voiding (teacher’s/nurse’s bladder)

Question 6

lower vs upper UTI

Answer 6

lower: urethra + bladder, can cause cystitis
upper: ureters + kidneys, can cause pyelonephritis

Question 7

causes

urge incontinence

aka overactive bladder

Answer 7

damage to brain, spine, nerves that innervate the bladder, diabetes mellitus, neuro disease/trauma, changes to bladder lining + muscle with aging

Question 8

causes

stress incontinence

Answer 8

urethral sphincter/pelvic floor muscles damaged (can’t hold in urine) - coughing + laughing puts pressure on bladder = leakage

Question 9

causes

overflow incontinence

Answer 9

urine blocked from flowing out of bladder by prostate, tumors, stones, scar tissue, prolapsed uterus/bladder (bladder distended - pulls urethra open - urine leaks out)

Question 10

what is it

ureterostomy

Answer 10

ureters attacher to abdomen surface (urine flows directly into pouch)

Question 11

continent internal ileal reservoir

Answer 11

Kock pouch: continent internal ileal reservoir created from segment of ileum + ascending colon

ureters are implanted into the side of the reservoid, special nipple valve attaches reservoir to skin

once healed patient can self-catheter at 4-6 hour intervals

Question 12

sigmoidostomy

Answer 12

urine diverter to large intestine (no stoma)

urine is excreted with bowel movements (can result in incontinenve)

Question 13

conduits

Answer 13

ureters are implanted into a segment of the ileum/colon (abdominal stoma formed)

urine flows in the conduit and out of stoma by peristalsis

Question 14

how does age affect peristalsis

Answer 14

infants have smaller stomach + more rapid peristalsis, older adults have difficulty chewing + swallowing, decreased peristalsis

perineal muscle tone + anal sphincter weaken with aging (can lead to bowel incontinence)

Question 15

diet effects on bowels

Answer 15

fiber = bulk for fecal matter

gas-forming foods (cabbage, beans, broccoli) = bowel distention + increased motility

whole grains + fresh fruit/veggies = promote peristalsis

adequate fluids promote elimination

Question 16

activity effects on bowels

Answer 16

physical activity = promotes peristalsis

early mobilization after procedures + surgeries = prevents constipation

Question 17

psychological factors

Answer 17

emotional distress can accelerate digestion + peristalsis

depression can decreade peristalsis + lead to constipation

Question 18

medication effects on bowels

Answer 18

opioid analgesics slow peristalsis = constipation

antibiotics disrupt instestinal flora = diarrhea

Question 19

ostomies

Answer 19

temporary/permanent pulling of part of the intestine through the abdominal wall

ileostomy = liquid stool (higher in GI tract)