GI Elimination Flashcards
elimination
excretion of waste products from kidneys to intestines
defecation
process of elimination of waste
feces
semisolid mass of fiber, undigested food, inorganic matter
urinary elimination definition
- incontinence: inability to control urine or feces
- void: to urinate
- micturate: to urinate
- dysuria: painful or difficult urination
- hematuria: blood in the urine
- nocturia: frequent night urination
- polyuria: large amounts of urine
urinary frequency
voiding at frequent intervals
urinary urgency
the need to void at once
proteinuria
presence of large protein in the urine
dribbling
leakage of urine despite voluntary control of urination
(more common after giving birth)
retention
accumulation of urine in bladder without the ability to completely empty
hesitancy
difficulty initiating urination
(if had catheter before, this is more common,
can pour warm water on their leg or sometimes genital area, play water sounds)
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” (make decision in mind like okay on the toilet, ready to go)
- external sphincter relaxes
- Valsalva maneuver (increasing pressure in order to expel feces by contracting abdominal muscles and maintaining a closed airway (straining and holding breath),
don’t want certain ppl to do this: anyone who’s had abdominal surgery, anything where bowel is manipulated, aneurysm, aneurysm clip, someone who had stroke and got TPA or ____ (why they are on bowel regimen, stool softeners so won’t do valsalva)
factors affecting bowel elimination
- developmental stage: bowel elimination patterns change throughout the life span (very young and very old are more affected)
- personal factors:
– privacy is important to most people, as sufficient time
– fast-paced jobs may cause a person to ignore the need to defecate - sociocultural factors:
– stress has a major influence
– can cause diarrhea or constipation
– stress is primary risk factor in development of irritable bowel syndrome - nutrition/hydration:
– regular intake of food promotes peristalsis
– regular intake schedule
– irregular schedule = irregularity
– high fiber (fiber increases bulk, helps things flow)
– fluid intake - activity:
– can stimulate peristalsis
– sedentary people have weaker abdominal muscles
– patients with limited activity often experience constipation - medications:
– all oral medications have the potential to affect function of the GI tract (most cause nausea, vomiting, constipation and _____) - surgery and procedure:
– bowel manipulation can lead to a paralytic ileus (stunts the nerves there)
– nasogastric tube (NG tube) on low or intermittent suction - pregnancy:
– morning sickness
– slowing of intestinal motility (body working more on baby and not as much room to expand)
– risk of hemorrhoids (constipation and increased blood flow cause this) - pathological conditions:
– neurological disorders that affect innervation of lower GI tract (C-spine injuries, lumbar spine injuries, thoracic spine injuries affect nerves there)
– cognitive conditions that limit the ability to sense “the urge” (can cause constipation)
– pain or immobility that leads to sluggish peristalsis (opiates may be prescribed that also cause constipation)
planning outcomes/evaluation
- the general overall goal is for the patient to have soft, formed, regular bowel movements
- and to be free of nausea, vomiting, bloating
promoting regular defecation
- privacy
- correct position: seated upright
- timing:
– often occurs after meals
– some patients may need assistance - fluid intake: at least 6-8 oz
- proper diet: fresh fruits, vegetables, whole grains, fiber
- exercise:
– 3-5 times a week
– ROM for patients on bed rest
– positioning
– encourage exercise
(if pt on toilet, close the door,
if pt on toilet and fall risk, close door most of way,
if pt on bedside commode and cannot leave room, do something other than stare at them, chart, wash hands, organize closet, something)
bowel incontinence devices
flexi-seal rectal tube
- inserted into the rectum
- connected to connection bag
- for use with severe incontinence
