elimination Flashcards
passing of feces
defecation
semisolid, fiber substance, result of digestion
feces
bowel elimination process:
fecal material reaches rectum, stretch receptors initiate contraction of sigmoid colon/rectal muscles, internal anal sphincter relaxes, sensory impulses cause voluntary “bearing down”, and external sphincter relaxes
fecal material reaches rectum, stretch receptors initiate contraction of sigmoid colon/rectal muscles, internal anal sphincter relaxes, sensory impulses cause voluntary “bearing down”, and external sphincter relaxes
bowel elimination process
process of bearing down (pushing down), puts pressure on the vagus nerve, causing decrease in BP and pulse which can lead you to pass out/get light headed
valsalva manuever
bristol chart is used for what?
classifying stools
separate hard lumps
constipation
sausage-shaped but lumpy
mild constipation
sausage-shaped with cracks on its surface
healthy
smooth and soft like a snake
healthy
soft blobs with clear-cut edges
lacking fiber
fluffy and mushy with ragged edges
mild diarrhea
entirely liquid, watery
diarhhea
stool is brown
normal
stool is green
green dye, green vegetables, antibiotics, bacterial infection
stool is yellow
excess fat, small intestinal infection
stool is bright red
red food/dyes, drinks, or food, or hemorrhoids
stool is black or dark brown
iron supplements, bismuth subsalicylate (pepto), bleeding upper digestive tract
stool is white, light, or clay-colored
antidiarrheal medications, lack of bile (fat absorption)
stool is reddish
red foods, drinks, or dyes, bleeding in the lower gut or rectum
components of a complete bowel assessment
nursing history, physical assessment, review of relevant test results, patients medical history, chewing ability, recent stressors or illnesses, and environmental situation
questions to ask during nursing history for a bowel assessment
how long since your last bowel movement, what are they like (color/shape), patient diet
factors that affect bowel elimination:
developmental stage, personal factors, sociocultural factors, nutrition/hydration, activity, medications, surgery & procedures, pregnancy, and pathological considerations
biggest impact affecting bowel movement is ____ and ____
nutrition and hydration
alterations in bowel elimination status:
constipation, impaction, diarrhea, incontinence, flatulence, and hemorrhoids
uncomfortable or infrequent bowel movements, hard stool
constipation
stool you can’t pass, constipation that has gone unchecked
impaction
stool is more watery
diarrhea
inability to control feces or urine
incontinence
gassy
flatulence
ulcers or enlarged blood vessels; straining to poop
hemorrhoids
interventions to promote normal bowel elimination:
high fiber diet, squatty potty - legs 35 degrees on a stool
patient teaching topics:
medications, nutrition, cathartics/laxatives, enema, and promotion of activity level
cathartics do what?
accelerate bowel movements
laxatives do what?
soften stool
device for bowel incontinence
flexi-seal rectal tube
plays a big part in human bowel movements; body secretes this to hold onto body fluid so we aren’t peeing it out
antidiuretic hormone (ADH)
secretion of potassium in the kidneys, released by the adrenal gland
aldosterone
“bearing down” means ____
when the pressure within the abdomen increases and helps empty stool
blood in urine
hematuria
inability to control urine or feces
incontinence
to urinate
void
to urinate
micturate
painful or difficult urination
dysuria
leakage of urine despite voluntary control of urination
dribbling
accumulation of urine in bladder without the ability to completely empty
retention
frequent night urination
nocturia
large amounts of urine
polyuria
the need to void at frequent intervals
urine frequency
the need to void all at once
urine urgency
presence of large protein in urine
proteinuria
difficulty initiating urination
hesitancy
urine remaining post void > 100 ml
residual
components of a complete urinary assessment
nursing history, self-care ability, cultural considerations, review of relevant test results, and patients medical history
kidneys produce approximately __ to ___ ml per hour
50-60 ml
normal voiding is typically how many times per day, this also depends on fluid intake
5-6 times per day
most common urinary incontinence, can happen when a woman sneezes, coughs, etc
stress continence
need to go right now, is what type of urinary incontinence?
urge
build up of urine is what type of incontinence?
overflow
can’t get to the bathroom fast enough because of mobility issues is what type of incontinence?
functional
bladder incontinence devices
condom catheter, pure wicks, foley catheter
for male patients, fits over penis and drains urine out, it is also not invasive
condom catheter
lays over genitalia, has a suction device, collects urine
pure wick
putting a drainage tube into urinary system, balloon inflated that keeps catheter lodged into bladder
foley catheter
promoting normal urination interventions
history health, kegel exercises, bladder training/toileting schedule, privacy, positioning, fluids/nutrition, monitor for skin breakdown
characteristics of urine
color, odor, clarity
indicates intake or lack of fluids
color of urine
urine will appear cloudy if a pathogen is present
clarity
pathogens can change the smell, as well as intake
odor
all fluid intakes that you record
semi-liquid fluids, ice chips, IV fluids, fluids, tube feeding, irrigation instilled and not immediately removed
all fluid outputs that you record
fluid loss via emesis, urine output, diarrhea, and drainage from suction or wounds
emesis is the act of ____
vomiting
what color is urine if there is dehydration?
dark yellow
greenish urine can result from consumption of ____
asparagus
normal urine is what color?
clear to pale yellow
