G. I Elimination Flashcards
Elimination
Excretion of waste products from kidneys and intestines.
Defecation
Process of elimination of waste
Feces?
Semisolid mass of fiber undigested food, inorganic matter
Urinary Elimination Defination
Incontinence- inability to control urine or feces
Void - to urinate
Micturate - to urinate
Dysuria - painful or difficult urination
Nocturia - frequent night urination
Polyuria - large amount of urine
Urinary elimination Definition
Urinary frequency
Voiding at frequent intervals
Urinary urgency
The need to void at once
Hesitancy
Difficulty initiating urination
Dribbling
Leakage of urine despite voluntary control of urination
Retention
Accumulation of urine in the bladder without the ability to completely empty.
Residual
Urine remaining post void >100mL
Bowel elimination process
Fecal material reaching rectum
Stretch receptors initiate contraction of sigmoid colon /rectal muscle
Internal anal sphincter relaxes
Sensory impulses cause voluntary
External sphincter relaxes
*valsava maneuver
Factors affecting bowel elimination
*Developmental stage (B.E patterns change thoughout the life span)
*Personal factors (fast faced jobs cause to ignore people the need to defecate)
*Sociocultural factors ( stress, diarrhea or constipation, stress primary risk in development of irritable bowel syndrome)
Factors affecting bowel elimination
*Nutrition/hydration ( regular intake of food promotes peristalsis, high fiber, fluid intake)
*Activity ( can stimulates peristalsis, sedentary have weaker abdominal muscles)
*Medications (oral meds have potential affect to G.I tract)
Factors affecting bowel elimination continuation
*Surgery and procedures
( bowel manipulation can lead to a paralytic ileus) (NG tube on low intermittent suction)
*Pregnancy ( morning sickness, slowing of intestinal motility, risk of hemorrhoids)
Factors affecting bowel elimination continued
*Pathological Conditions ( Neurological disorders that affect innervation of lower GI tract)
(Cognitive condition that limit ability to sense the urge)
(Pain or immobility that leads to sluggish peristalsis)
Planning outcomes /evaluation
The general overall goal is for the patient to have soft, formed, regular BM. And free of nausea, vimiting boating
Promoting Regular Defecation
Privacy
Correct position
Timing
Fluid intake
Proper diet
Exercise
Bowel Incontinence Devices
Flexi seal Rectal tube ( inserted into the rectum, connected to collection bag, use with severe incontinence)
Fluid Balance
●kidney maintain fluid balance in the body
●kidney maintaining the volume and composition of extracellular and to a lesser extent.
● fluid balabce is partially controlled by hormones
Two hormones involved in fluid balance
(1)
■Antidiuretic hormone (ADH) - if ADH high cause more water to be absorbed crusating a high concentration but small volume of urine.
- if ADH is LOW it causes more water to be excreted creating a larger volume of urine.
Two hormones involved in fluid balance
(2)
■Aldosterone - produced by the adrenal gland.
•regulates water reabsorbtion and changes urine concentration by increasing sodium reabsorption.
•helps control secretion of potassium
Normal Urinary Patterns
■the kidney produce approximately 50-60ml per hour or 1500ml per day.
■normal voiding is typically 5 to 6 times per day, depends on fluid intake.
Characteristics of Normal Urine
● if urine solutes increase specific gravity INCREASES
●Normal specifi gravity in urine is 1.002 to 1.003
●fluid intake increase urine becomes diluted and lighter in color.
● fluid intake decrease urine becomes darker. Gravity rise
Characteristics of Normal Urine
Color
■DARK YELLOW - dehydration
■Red/pink - blood
■Brown - liver/rhubarb/gallbladder
■Orange - medication intake or carrots
■milky white - infection in WBC
■ Blue - methyline blue
■Green - drugs meds
■ Purple - colonized bacteria in catheter
Bladder Incontinence Devices
Condom Catheter
Applied to the tip of the pennis and attached to a collection bag ( low infection but potential to skin tear)
Bladder Incontinence Devices
Purewick
Lays between the labia and attached to a suction device
Bladder Incontinence Devices
Foley Catheter
Inserted into the bladder and attached to a collection bag
Promoting Normal Urination
Provide privacy
Assist with positioning
Facilitate toileting routines
Promote adequate fluids and nutrition
Assist with hygiene as needed
Chatateristics of Urine
Color
Clarity
Odor
Urine Testing
Specimen collection
■collection devices
■sterile collection process
■collection from folley collection. bags
Record all fluid Intake
Intake fluids include
Semi liquid foods
Ice chips
Fluids
IV Fluids
Tube feeding
Irritations instilled and not immediately removed.
Record all fluid Output
Output fluid include
Fluid loss via emesis
Urine output
Diarrhea
Drainage from suction or wounds
