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The Older Client > Elimination > Flashcards

Elimination Flashcards

1
Q

What is defecation?

A

Bowel movement

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2
Q

What is micturition?

A

Urination

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3
Q

What is continence?

A

Purposeful control of urinary or fecal elimination

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4
Q

What is elimination?

A

Removal, clearance of matter. Excretion of waste productions

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5
Q

What is bowel elimination?

A

Passage of stool through the intestinal tract and dispelling the stool by mean of intestinal smooth muscle contraction (stool/feces)

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6
Q

What is urinary elimination?

A

Passage of urine through the urinary tract by means of the urinary sphincter and urethra

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7
Q

What is Anuria?

A

Absence of urine

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8
Q

What is dysurisa?

A

Painful urination

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9
Q

What is polyuria?

A

-multiple episodes of urination, w/diabetes

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10
Q

What is urinary frequency?

A

Multiple episodes of urination with little urine produced in a short period of time

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11
Q

What is urine hesitancy?

A

Urge to urinate exists but person has difficult starting urine stream

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12
Q

What is the main functional unit of kidney?

A

Nephron (contain blood vessels/renal tubules)

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13
Q

What are characteristics of internal vs external sphincter?

A

INTERNAL: smooth muscle, involuntary, prevent leaking
EXTERNAL: skeletal muscle, voluntary

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14
Q

What happens with increased peristalsis?

A

Less water absorbed, loose stool

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15
Q

What happens with reduced peristalsis?

A

More absorption and harder stool

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16
Q

What become weak in the elderly?

A

Muscles around the urethra, increase risk of incontinence

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17
Q

What are age related changes in elderly when it comes to elimination?

A
  • decreased bladder capacity (400 -> 200-300)
  • decreased estrogen in post menopausal women
  • loss of smooth muscle in the bladder
  • relaxation of the pelvic floor muscles
  • Hypertrophy of the muscles in the urinary tract
  • less responsive to ADH and less able to concentrate urine
  • decreased time between urge to void and actual need
  • proliferation of the prostate tissue
  • diminished thirst perception
18
Q

What is incontinence and what is a risk factor?

A
  • loss of control of urine or bowel

- risk of skin breakdown, change in daily activities

19
Q

What is urinary incontinence?

A
  • distribution in the storage or emptying of the bladder with involuntary release of urine usually associated with dysfunction of the external or internal urinary sphincters
  • light leakage to full loss
20
Q

What factors can effect urine incontinence?

A

-depression, anxiety, cognitive impairments, acute injury, surgical procedures

21
Q

Define the following terms of urine incontinence:

Stress, overactive bladder, urge, functional, overflow, mixed, transient.

A

Stress: leakage during small amounts of physical movement
overactive bladder: frequent and urgent (pee a lot)
urge:leakage at unexpected times (sleep)
functional: untimely urination b/c of physically disability, obstacles
overflow: leakage from full bladder
mixed: occurrence of stress and urge incontinence together
transient: leakage that occurs temporarily (medication/cold)

22
Q

What is bowel incontinence?

A

Involuntary passage of stool and ranges from occasional leakage of stool while passing gas to complete loss of bowel control

23
Q

What is retention?

A

Unintentional with obstruction, inflammation, ineffective neuromuscular activation within bladder or GI tract

24
Q

What is urinary retention?

A

-incomplete emptying of bladder after urination

25
Q

What can urinary retention be from?

A
  • malfunction of NS interaction
  • change in shape of bladder
  • obstruction (prostate)
  • external sphincter does not relax
  • medication (antidepressants, Anticholinergics, antihistamines)
26
Q

What is retention of stool?

A
  • unable to pass stool

- result in constipation

27
Q

What are types of discomfort from retention?

A
  • UTI (burning while peeing)

- hard stool, inflammation of anus, hemorroids, infection, colitis, IBS

28
Q

What is 1) nephritis, 2) pyelonephritis, 3) cystitis ?

A

Inflammation of

1) kidneys
2) renal pelvis
3) bladder

29
Q

What can happen with tumours in prostate ?

A

-lead to blockage of urinary flow

30
Q

What are consequences for incontinence?

A
  • skin break down
  • decrease social life/ relationships, depression, with drawl
  • urinary retention: pain, infection, distension
  • renal failure: unable to remove waste
  • bowel retention: constipation, pain, loss appetite, nausea, vomiting
31
Q

What are risk factors for urinary elimination?

A
  • children, elderly, pregnant, menopausal
  • hyperplasia of prostate
  • pelvis floor muscles weaken
  • diuretics
32
Q

What are risk factors for bowel elimination?

A
  • medication (laxatives)
  • cognitive impairment
  • radiation
  • excessive caffeine
  • lack fibre
  • lack exercise
33
Q

What to examination with incontinence?

A

Inspection: contour, distension, urinary meatus, pain when voiding, look at stool, urine sample
Auscultation: listen to for bowel sounds
Palpation: soft, non tender
Percussion: identify masses or excessive gas, kidneys should be painless (sharp pain=infection)

34
Q

What are some nursing interventions?

A
  • lifestyle modifications
  • pelvic floor muscle exercises
  • toileting schedules
  • bladder training
  • vaginal weights
  • fibre and fluid monitoring
  • activity
  • regular bowel routine
35
Q

What are some collaborative interventions?

A
  • pharmacotherapy
  • incontinence management
  • invasive procedures and surgery
36
Q

What are incontinence risk factors for older adults?

A
  • age
  • altered mobility
  • neurologic impairment
  • cognitive impairment
  • medication conditions
37
Q

What are types of laboratory tests?

A

-urinalysis, blood urea nitrogen (BUN), creatinine, culture, occult blood

38
Q

What are types of radio graphic tests and scans?

A

-X-rays, computed tomography, CT scan, magnetic resonance imaging, ultrasound

39
Q

What are types of direct observation tests?

A

-colonoscopy, cystoscopy, uroscopy

40
Q

What does CHAMMP stand for?

A

Continence, history, assessment, medications, mobility, plan

41
Q

What is the gold standard for obtaining objective information about voiding patterns, frequency, severity?

A

Voiding diary

  • character of urine
  • difficulty starting/stopping
  • also ADLs (ability to reach toilet, finger dexterity)

The Older Client (5 decks)

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