Elimination Flashcards
Indicates concentrated urine- low fluid intake, vomiting, diarrhea, bilirubin, carotene intake
Dark yellow or amber colored urine (abnormal)
Indicates large fluid intake, alcohol use
Straw colored urine (abnormal)
Can be caused by certain drugs or foods, blood , disease states, or bilirubin levels
Discolored urine (brown, red, smoky)
Golden yellow/ clear, aromatic
Normal findings for urine
Indicates pus, fat, unrated, colloids, standing urine
Cloudy urine
Can be caused by diabetic ketosis
Sweet smelling urine
Can be caused by infection, certain foods
Unpleasant smell to urine
Indicates urine left standing
Ammonia smell in urine
1.0053-1.030 / density compared to water
Normal specific gravity for urine
Renal disfunction
Low specific gravity in urine
Indicates Increased anti diuretic hormone secretion from trauma, stress, DM, excessive water loss
High specific gravity in urine
4.6-8.0
Normal pH for urine
Indicates a diet high in meat protein and noncitrus fruits, certain drugs, and conditions that cause metabolic acidosis
Acidic urine
Metabolic and respiratory alkalosis, certain drugs, immobilization, infection with Proteus, and Pseudomonas
Alkaline urine
Can be caused by diabetes, pregnancy, adrenal disorders
Glucosuria
Glucose in the urine
Glucosuria
Protein in the urine
Proteinuria
Indicates glomerular damage
Persistent proteinuria
Caused by dehydration, fever, exercise, stress, large protein intake
Transient protienuria
Indicates faulty carbohydrate metabolism from a fatty diet, dieting
Ketonuria
Ketones in the urine
Kentonuria
Bacteria in the urine
Baceteriuria
Indicates a UTI
Bacteriuria
600-1000 ml of fluid
What bladder holds
250 ml in the bladder
When we usually have desire to void
1200-1500ml
Minimum intake/output per day
No less than 30 ml per hr
Adequate amount of urine output
Have daytime control, girls learn earlier
2-3 yrs old
Highest risk for UTI
Young females
Growth and development, dietary intake, sociocultural/psychological, personal habits, muscle tone, traumas, diseases, medications
Factors affecting elimination
Decreased blood flow, loosing renal tissue, go more frequently
aging adults/ elimination
Promotes urine retention
High salt diet
Can damage kidney
High protein diet
Can irritate the bladder
Alcohol, caffeine, chocolate, teas, spicy foods
Can cause alkaline/acidic effects on urine
Certain fruits/vegetables - cranberry juices, meat, milk
Lack of privacy can create anxiety /stress
Sociocultural factors affecting urination
Abdominal muscles/ sphincter control can be strengthened
Exercise
Exercise, hygiene, timing
Personal habits that affect urination
Good abd/pelvic muscles promote
Better control of bladder/urination
Severe pain, spinal cord injury, surgery, diagnostic tests, anesthesia
Traumas that can affect urination
Tenses up pelvic muscles
Pain
Numbs your senses to urinate
Anesthesia
Prostatic hyper trophy, UTI, renal diseases, fever/heavy perspiration, DM, MS
Diseases that affect urination
Enlarged prostate causes pressure an urethra
Prostatic hypertrophy
Affect nerve control
DM, MS
Anesthetics/analgesics, diuretics, CV drugs, anticholinergics, antihistamines, antidepressants,antipsychotics
Medications that affect urination
Causes retention, hesitancy, difficulty starting stream
Anesthetics/analgesics
Increase urine output
Diuretics/cardiovascular drugs
causes retention
Anticholinergics, antihistamines, anti depressions, antipsychotics
Most people void
5 or more times per day
Any changes in amounts, frequency or instances of incontinence, changes in characteristics
Subjective data to gather on a pt experiencing urinary problems
Palpate bladder for
Distention
Inspect for swelling, discharge or inflammation,
Urethral meatus
Estimate of fluids intake
Why we measure urine output
Signifies Significant fluid alteration or kidney disease
Large change in urine volume
2000-2500 ml/day
High output is a concern
Color, clarity, odor
Assess these when checking urine
Timed specimen, begins with empty bladder, need every urination in a 24 hr period
24 hr urine
Checks specific gravity
Urinometer
Ability of kidneys to concentrate urine
Measuring urine specific gravity
Decreased fluid intake
Has a higher specific gravity
Increased fluid intake
Has a lower specific gravity
Renal disease causes
Lower specific gravity
BUN/creatinine, IVP, CT scan, Renal US, cysto
Diagnostic tests used for urinary elimination
Measures kidneys ability to excrete wastes
BUN/Creatinine
Xray of urinary tract
IVP
Helps detect masses
Ct scan of kidneys
Noninvasive procedure; uses sound waves
Renal US
Exam of bladder through cystoscope
Cysto
Retention, incontinence
Urinary problems
Voids small amounts 2-3x per hr, can retain up to 2000-3000 ml
Retention
Stress, urge, reflex, functional, mixed
Types of incontinence
Promote urinary elimination, achieve bladder emptying, maintain skin integrity, prevent infection, bladder training
Goals for patients with urinary problems
Suggest disorder in small bowel or proximal colon
Large diarrhea stools
Indicates Disorder of left colon or rectum
Small frequent stools with urgency
Normally neutral or slightly alkaline
pH of stool
Black due to digested blood
Upper GI bleed
Fresh blood in stool
Lower GI bleed
Diet high in milk products
Light brown stool
Narrow pencil shaped stool
Indicates bowel obstruction
Growth and development, aging, diets, physical activity, personal habits, psychological stressors, diagnostic tests, surgical procedures, pathologic conditions, meds
Factors influencing bowel elimination
Children can’t absorb water as well
Growth and development
Muscle tone decreased, decline of peristaltic action, decreased abd muscle tone, decreased absorption
Aging influencing bowel elimination
Decreased amount of bulk/decreased peristalsis
Decreased intake that affects bowel elimination
Distend intestinal walls leading to flatulence
Gas producing foods that affect bowel elimination
What foods affect defecation, what foods they typically eat or avoid, usual time of meals
What to assess when examining a pt
Causes nausea, cramps, bloating, flatulence
Lactose intolerance
Laxative producing foods, constipation producing fluids, diarrhea/flatulence producing foods
Problematic foods
Causes constipation
Fluid deficits
Stimulates peristalsis, increases tone of abd, pelvic and diaphragm muscles
Activity
Causes constipation
Sedentary (sitting a lot) lifestyle
Caused by Lack of exercise, immobility, impaired neurological functioning
Weak Abd muscles
Timing , hospital routine, cultural, lack of toileting facilities, embarrassment, privacy
Personal habits that influence bowel elimination
Cup of coffee, glass of warm/ cold waster, juice, reading, squatting
Habits that trigger peristalsis
Increases peristalsis and can cause diarrhea
Anger/ anxiety
Suppresses urge to go
Pain
Stress, pain, mental depression, anger, anxiety
Psychological stressors affecting bowel elimination
Cause diarrhea
Bowel preps
Cause constipation
Contrast mediums(barium)
Spinal cord injuries, rumors, adhesions, radiation, pain
Pathologic conditions affecting bowel elimination
Causes Decreased sensory stimulation to defecate
Spinal cord injuries
Blocks flow of feces through intestines
Tumors
Scan lead to obstruction; scar tissue
Adhesions
Can cause diarrhea
Radiation to abd area
causes diarrhea, gray-green color
antibiotics
causes constipation
narcotics, sedatives, tranquilizers, diuretics, iron
causes white specks or discoloration
antacids
causes black stools and constipation
iron
assess frequency, time of day, color, texture, shape, odor, and pattern changes
subjective assessment questions
inspect, auscultate, measure girth, check rectal area for redness excoriation, and hemorrhoids
objective assessment questions
age, diet, presence or absence of bile, drugs, bleeding in GI tract
factors that affect color of stool
C&S, parasites, occult blood, hemoccult
diagnostic tests that use stool
decreased frequency (less than 3 per week) of bowel movements/prolonged passage of hard, dry stool
constipation
insufficient fluids, fiber intake, activity, irregular defecation habits, change in daily routine, lack of privacy, chronic use of laxatives or enemas, emotional disturbances
things that can cause constipation
time, positioning, fluids, prune juice, activity,
things that can relieve constipation
prolonged retention and accumulation of fecal matter
impaction
small liquid amounts of stool, rectal pain, frequent nonproductive desire to defecate, feeling of fullness, distention, nausea vomiting,
signs of a fecal impaction
distends intestines, irritates bowels, increases peristalsis
enemas
passage of unformed liquid feces, increased frequency of defecation, cramps nausea and vomiting, causes fluid and electrolyte imbalance
diarrhea
loss of voluntary ability to control fecal discharges through anal sphincter
bowel incontinence
air or gas in GI tract
flatulence
action of bacteria, swallowed air, diffused gas from bloodstream into intestine
causes of flatulence
veins that become distended from pressure and collection of veins . burn and painful
hemorrhoids