Module 3: Urinary and Bowel Elimination Flashcards
Hypermotility
Adult with greater than 3 stools/day
Hypomotility
Adult with less than 1 stool/week
Hemorrhoids
Abnormally distended rectal veins
Paralytic Ileus
Paralysis of intestinal peristalsis
White or clay-colored stool
Absence of bile or the use of antacids
Light brown stool
Diet high in milk products (light color is from the Ca)
Pale, fatty stool
Malabsorption of fat
Black, tarry stool
Use of iron meds, upper GI bleeds, lg quantities of red meat
Red stool
Bleeding in lower intestinal tract or hemorrhoids
Narrow, pencil shaped stool
Intestinal constriction (inflammation)
Small, marble-shaped stool
Constipation/ slow peristalsis/ dehydration
Hard stool
Dehydration/ slow peristalsis/ constipation
Liquid stool
Diarrhea/ rapid peristalsis
Strong, foul odor
Blood, infection (C. Diff)
Small amounts of watery, “oozy” stool
Can see it in bowel obstruction
Increased bowel sounds (hyperactive)
Diarrhea / rapid peristalsis
Decreased bowel sounds (hypoactive)
Constipation / slowed peristalsis
Absent bowel sounds
only be conclusively documented if each quadrant has been listened to for 5 minutes EACH and occur during obstructions
Discuss patient teaching and how to promote normal bowel functioning
Avoid stimulant laxatives (cause painful peristalsis/diarrhea which could lead to dehydration/electrolyte imbalance)
Adequate fiber intake (increases wt and size of stool and softens it)
AT LEAST 6-8 glasses of water per day
Maintain regular eating schedule
Avoid “holding in” BM (causes more water to be absorbed in colon)
Be active/exercise
Slowed Peristalsis Cause
Some foods: cheese, milk, etc
Narcotic pain meds
Antacids
Iron supplements (can also turn stool black/dark brown)
Stress
Immobility
Nerve damage (from things like abdominal surgery/spinal cord injury)
Food allergies
Dehydration
Rapid Peristalsis Causes
Antibiotics
Laxatives
Magnesium
Vitamin C
Stress
Food allergies/lactose intolerance
Infections
Bowel diseases: IBS, Celiac disease, crohn’s disease/ulcerative colitis
Caffeine
Stool Softener
Helps liquid mix into stool
Osmotic Laxative
Draws water into bowel from surrounding tissue to provide a soft stool mass and improved propulsion
Stimulant Laxative
Causes peristalsis (can be painful and cause diarrhea)
Causes of Diverticulosis/Diverticulitis
CONSTIPATION (low fiber diet, dehydration), high fat/residue diet, age, genetics, obesity
Diverticulosis
Walls of intestines weaken and pouches form (additional diverticula)
Diverticulitis
Inflammation/infection of the diverticulum
Assessment Findings of Diverticulosis/Diverticulitis
Pain
Fever
Nausea
Vomiting
Chills
Cramping
Constipation
Abdominal tenderness
Distension
Change in bowel habits
Indigestion
Possible Complications for Diverticulitis
Risk of infection (peritonitis) -> sepsis
Avoid what for Diverticulitis
kernels and seeds / high residue diet
Stimulant laxatives
Polyps
Mass or finger like projections on the inner lining of the colon
Ileostomy
In ileum of small intestine, avoids all of the colon
Increased caloric diet, supplements (risk of malnutrition)
Watery stool
Ascending Colostomy
Pudding thick stool
Transverse Colostomy
Less watery/ semi-formed stool
Sigmoid Colostomy
Formed stool
Discuss the assessment of stomas
Expected to be beefy red and moist
Assess peri area for breakdown
Autonomic bladder
Bladder no longer controlled by the brain because of injury or disease; void by reflex only
Continent
Having self-control over urination
Enuresis
Involuntary urination
Functional incontinence
State in which a person experiences an involuntary, unpredictable passage of urine
Incontinent
Experiencing involuntary or uncontrolled loss of urine or feces
Micturition
Process of emptying the bladder; urination; voiding
Nephrotoxic
Capable of causing kidney damage (e.g. meds)
Nocturia
Excessive urination during the night
Overflow incontinence
Involuntary loss of urine associated with overdistention and overflow of the bladder
Reflex incontinence
Emptying of the bladder without the sensation of the need to void
Specific gravity
a laboratory test that shows the concentration of all chemical particles in the urine
Stress incontinence
State in which the person experiences a loss of urine of less than 50 mL that occurs with increased abdominal pressure
Total incontinence
Continuous and unpredictable loss of urine, resulting from surgery, trauma, or physical malformation
Transient incontinence
Occurrence that appears suddenly and lasts for 6 months or less and usually is caused by treatable factors, such as confusion secondary to acute illness, infection, and as a result of medical treatment, such as the use of diuretics or IV fluid administration
Urge incontinence
State in which a person experiences involuntary passage of urine that occurs soon after a strong sense of urgency to void
Urinary retention
Inability to void although urine is produced by the kidneys and enters the bladder; excessive storage of urine in the bladder
Kidney Function
Regulate blood volume, BP, electrolyte levels, and acid-base balance
Produces the hormone erythropoietin (stimulates RBC production)
Secretes renin (which promotes the production of angiotensin, causing systemic vasoconstriction)
Activates vitamin D (necessary for body to absorb calcium)
Glomerulus Function
Where wastes, toxins, excess ions, and water are filtered out from blood
Increased Urinary Output Causes
Diabetes, UTIs (sometimes), diuretics, increased intake
Decreased Urinary Output Causes
Dehydration, high fever, antihistamines and drugs with anticholinergic effects, some antidepressants
Be able to identify normal urine output (hourly and daily amounts)
At least 30 mL/hour or 720 mL/24 hours
50-60 mL is ideal
GFR: what it measures, normal range, what increases it, what decreases it
Amount of blood being filtered by kidneys per minute
>90 mL/min
Increase: increased blood volume and increased blood pressure
Decrease: dehydration, decreased CO, kidney failure
BUN: what it measures, normal range, what increases it, what decreases it
A waste product that is produced when proteins are broken down by the liver for metabolism
7-24 mg/dL
Increase: kidney failure, dehydration
Decrease: diet low in protein, malnutrition, severe liver damage overhydration
Creatinine: what it measures, normal range, what increases it, what decreases it
Waste product made of creatine (supplies energy to muscles); produced by normal wear and tear on muscles
0.5-1.5 mg/dL
Increase: kidney failure, kidney infection
Decrease: muscle loss, severe liver disease, low protein diet
Cystitis
bladder infection
Pyelonephritis
UTI, kidney infection
Urinalysis
Test that looks at a small sample of urine; checks appearance, concentration, and contents
C&S
Test that identifies what is causing the UTI and identifies what antibiotic will most likely kill that microbe
Renal Failure Assessment Findings
Edema (anasarca), dry/itchy skin (bc of toxin buildup), pallor (low Hgb), JVD, muscle cramps (high K), dehydration, fatigue, NVD, oliguria/anuria, SOB (bc of metabolic acidosis) (Kussmaul Breathing)
Renal Failure Interventions
Daily weights, fluid restriction, low Na/K/protein/phosphorus diet, control BP and glucose, symptom management
UTIs Assessment Findings
Dysuria, urinary frequency and urgency, cloudy urine with foul odor
UTIs Interventions
Increase fluid intake, antibiotics, pain management, heating pad
Renal/bladder calculi Assessment Findings
Pain, hematuria, fever and chills, vomiting, frequent urination, sweating, cloudy/foul smelling urine
Renal/bladder calculi Interventions
Pain management, increase fluid intake, ambulation, monitor I&O (look for stones)
Discuss nursing interventions to promote normal/healthy urination
Adequate fluid intake, ambulation
Discuss ways to prevent UTI
Urinate after sex, stay well hydrated, take showers instead of baths, wipe front to back
Clean Catch
Collected during midstream (sterile specimen)
Sterile Specimen
May be obtained by catheterizing the pt’s bladder or taking specimen from indwelling catheter
24 hr Collection
All urine is collected for 24 hours
Indwelling Catheter
Catheter that remains in place for continuous urine drainage (Foley)
Straight Catheter
Intermittent urethral catheter; drain bladder for shorter periods of time
CBIs
A procedure that flushes the bladder with sterile liquid; removes urine, blood, etc from the body; may be done to prevent or remove clots after surgery on urinary system or prostate resection (TURP – transurethral resection of the prostate)
