GI Elimination - Exam 6 Flashcards
Excretion of waste products from kidneys and intestines
Elimination
Process of elimination of waste
Defecation
Semisolid mass of fiber, undigested food, inorganic matter
Feces
Inability to control urine or feces
Incontinence
To urinate
Void
To urinate
Micturate
Painful or difficult urination
Dysuria
Blood in the urine
Hematuria
Frequent night urination
Nocturia
Large amounts of urine
Polyuria
Voiding at frequent intervals
Urinary frequency
The need to void at once
Urinary urgency
Presence of large protein in urine
Proteniuria
Difficulty initiating urine
Hesitancy
Leakage of urine despite voluntary control of urination
Dribbling
Accumulation of urine in bladder without the ability to completely empty
Retention
Urine remaining post void >100ml
Residual
Bowel elimination process
- fecal material reaches rectum
- stretch receptors initiate contraction of sigmoid colon/rectal muscles
- internal anal sphincter relaxes
- sensory impulse cause voluntary “bearing down”
- external sphincter relaxes
~ valsalva maneuver
Developmental stage
Bowel elimination patterns change throughout the life span
Factors affecting bowel elimination- 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 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 scheduled = irregularity
- high fiber
- 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
Surgery and procedures
- bowel manipulation can lead to a paralytic ileus
- NG tube on low or intermittent suction
Pregnancy
- morning sickness
- slowing of intensional motility
- risk of hemorrhoids
Pathological conditions
- neurological disorders that affect innervation of lower GI tract
- cognitive conditions that limit the ability to sense “the urge”
- pain or immobility that leads to sluggish peristalsis
Planning outcomes/ evaluation
- the general overall is for the patient to have soft, formed, regular bowel movements
- and to be free 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 glasses
Proper diet
Fresh fruits, vegetables, whole grains, fiber
Exercise
3-5 times a week
ROM for patients on bed rest
Positioning
Encourage exercise
Flexi- seal rectal tube
- inserted into the rectum
- connected to collection bag
- for use with severe incontinence
Bristol stool chart - 1
Severe constipation - separate head lumps
Bristol stool chart -2
Mild constipation - lumpy and sausage like
Bristol stool chart -3
Ideal - sausage shape with cracks
Bristol stool chart -4
Ideal- smooth, soft sausage
Bristol stool chart - lacking fiber
5 lacking fiber- Soft blobs with clear edges
Bristol stool chart -6
Mild diarrhea - mushy consistency
Bristol stool chart -7
Severe diarrhea- liquid consistency
Fluid balance - what 2 hormones
- Antidiuretic hormone (ADH)
- aldosterone produced by adrenal gland
Antidiuretic hormone (ADH) is produced by
Pituitary gland
Antidiuretic hormone (ADH)- if ADH is high causes more
Water to be absorbed creating a high concentration but small volume of urine
Aldosterone produced by the adrenal gland regulates
Water reabsorption and changes urine concentration
What helps control secretion of potassium
Alsosterone
The kidneys produced approximately x-xmL per hour or 1500mL per day
50-60mL
Normal voiding is typically x to x times per day, this depends on fluid intake
5-6
Characteristics of normal urine - specific gravity
Measure of dissolved solutes in a solution
Sh
