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FUNdamentals > Elimination Pt.1 > Flashcards

Elimination Pt.1 Flashcards

1
Q

What are the functions of the Urinary Tract?

A
  1. Converts and Removes excess waste & fluids
  2. Regulates electrolytes & RBC production
  3. Produces hormones for regulating BP
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2
Q

What are the 3 important things about the Production of Urine?
(What it’s influenced by, the normal & abnormal color, and normal amnt. per day and hr)

A
  1. Hydration status, oxygenation, activity, and medications influence volume of urine
  2. Normal urine: Light yellow & Clear
    - Dark yellow/amber = increase fluids
    - Dark brown = Dehydration & Kidney/Liver issues
    - Red = blood in urine
  3. 1.5 -1.8 liters/day (0.5 mL/kg/hr)
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3
Q

What are the dietary considerations that affect Urine Production?

A
  1. Longer amount of liquid –> Clear, Longer quantity, & Little odor
  2. Blackberries, Beets, and Rhubarbs –> Reddish color
  3. Food dyes –> Blue or Green urine color
  4. Aloe or Fava beans –> Dark brown
  5. Asparagus –> Increase odor in some ppl
  6. Color changes could be due to medical problems, rule out dietary cause
  7. Alcohol & Caffeine –> Increased urine production and may lead to dehydration
  8. Foods high in SODIUM –> increase urine production
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4
Q

What are the Age-related considerations for Urinary tract??

A
  1. With aging = Decreased kidney function, loss of kidney tissue & nephrons, and decreased blood supply
  2. Loss of bladder tone = Leakage, Incontinence, or Retention
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5
Q

What are the factors influencing urinary elimination?

A
  1. Growth & development (younger vs. older)
  2. Sociocultural factors
  3. Psychosocial
  4. Personal habits
  5. ## Fluid intake
  6. Pathological conditions
  7. Surgical procedures
  8. Meds
  9. DIAGNOSTICS
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6
Q

In the gastrointestinal tract (GI), what important information do we need to know about Production of Feces?

A
  1. Volume depends on QUANTITY of food and liquid consumed
  2. Frequency varies
  3. Continuum from constipation to diarrhea
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7
Q

What are the 5 age-related considerations of GI?

A
  1. Increased risk of PEPTIC ULCER due to changes to stomach lining
  2. Stomach elasticity decreases
  3. Pancreas, Liver, & Gallbladder reduce in SIZE
  4. Increases constipation due to Decreased peristalsis and Decreased muscle tone
  5. Inactivity, Decreased fluid & fiber intake, and medications
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8
Q

What are the factors that influence bowel elimination?

A
  1. Age
  2. Diet
  3. Fluid intake
  4. Physical activity
  5. Psychological factors
  6. Personal habits
  7. Position during defecation
  8. Pain
  9. Pregnancy
  10. Surgery/Anesthesia (Ileus with manipulation with bowel)
  11. Medications (opioids –> constipation; laxatives or cathartics, antidiarrhetics)
  12. Diagnostic tests (bowel prep)
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9
Q

What are the 5 measures to promote normal bowel elimination??

A
  1. Timing
    - Don’t ignore the urge
    - Take advantage of the gastrocolic reflex!
  2. Privacy
    - Known, pull curtain, and Allow to be in bathroom alone if it’s safe for them
  3. Diet
    - Fiber, Fruits, and FLuids
  4. Exercise
  5. Decrease stress & pain
    1) But be careful of narcotics pain meds
    • Slows down, and decreases awareness of urge and appetite
      2) Position naturally
    • Bedside commode is better than bedpan when possible
      3) Bedpan use
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10
Q

What are the defecation reflex?

A
  1. Distention of colon causes internal sphincter relaxation & awareness
  2. Voluntary relaxation of external sphincter
  3. Increased abdominal pressure by:
    - Leaning forward, squatting
    - Valsava maneuver (“Grunting”) CAN CAUSE TROUBLE!!!!!!!!!!!!!
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11
Q

What are the 6 Valsava Maneuver Problems?

A
  1. Drastic BP fluctuations
  2. Decreased pulse
  3. Increased Intra-ocular pressure
  4. Increased Intracranial pressure
  5. Who’s at risk?
  6. May require regular stool softener medications
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12
Q

What are the expected elimination characteristics of urine?

A
  1. Normal urine: Light yellow, Clear, and Odorless
  2. Volume & frequency depends on fluid ingestion, activity level, & meds (Diuretics and meds that cause retention)
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13
Q

atWhat are the expected elimination characteristics of stool?

A
  1. Stool patterns vary
    - Daily vs. less/more frequently
    - Healthy elimination is soft, formed, easily passed without straining
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14
Q

What is a frequently used method of evaluating stool? What are the types?

A

Bristol STOOL chart
1. Type 1 & 2 are Constipation
2. Type 3 - 5 are normal
3. Type 6-7 are Diarrhea

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15
Q

What are the altered urinary elimination – Different types of urinary incontinence?

A
  • Types of Urinary incontinence (watch for skin breakdown):
    1. Stress (coughing, etc. –> pressure –> leaking)
    2. Urge (strong need, leaking occurs prior to toilet)
    3. Reflex (nerve damage) –> urine leaks with no warnings bc the nerve that tells the brain that the bladder’s full is damaged!!!
    4. Overflow (incomplete emptying –> overfilling and leaking out)
    5. Functional (inability to reach toilet in time) - INVOLVES mobility, fine & motility skills like unable to unbutton clothing in time
    6. Nocturnal enuresis (bedwetting – alcohol, caffeine, med-related)
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16
Q

What do you need to know about Urinary Incontinence?
(The epidemiology, pathophysiology, types of incontinence, diagnosis, treatment, complication)

A
  1. Epidemiology : 15-30% of ppl over 60% may experience it
  2. Pathophysiology & clinical manifestations : A process that involves both sympathetic and parasympathetic & involves nerves connecting to brain and spinal cord
  3. Types of incontinence
  4. Diagnosis : Doing a thorough history, past urinary problems, voiding patterns help w/ diagnosis. ONE OF THE EARLY things to do is to RULE OUT INFECTION OR DIABETES as a potential source of incontinence.
  5. Treatment : Plan to stop/prevent leakage, avoid skin breakdown & odor, prevent damage to urinary tract & kidneys. Non-surgical: exercises, pessary, & catheterizations
    - Medical: Anticholinergics, Topical estrogen, and alpha agonist
    - Surgical:
  6. Complications: Skin problems, Kidney disease, & Infections
17
Q

What are the causes of altered urinary elimination IN THE OLDER patient??

A
  1. Certain DRUGS
    - Anything that affects the MENTAL STATUS: opioids, diuretics, anticholinergic
  2. Certain DISEASES
    - Stroke or neurological problems; Arthritis or Parkinson’s
  3. DEPRESSION
  4. Inadequate Resources –> Needing assistance for ambulation
18
Q

What are significant informations for the Urinary retention Of altered Urinary elimination??

A
  1. Health problems = prostate enlargement and prolapsed bladder
  2. Acute vs. Chronic
  3. Untreated can lead to UTI, Bladder or kidney damage, & incontinence.
  4. Symptoms: Pain, abdominal distention, frequency, hesitancy, difficulty urinating, and leaking!!!
  5. Drain urine & find source of problem

FUNdamentals (27 decks)

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