Module 4: Urinary & Bowel Elimination Flashcards
Describe the order of organs urinary system
Kidneys (filter waste products from metabolism), ureter (transport urine from kidneys to bladder), bladder (holds urine until the volume triggers a sensation of urge), urethra (bladder contracts, urinary sphincter relaxes, urine leaves body through urethra)
Describe the order of organs digestive system
mouth, esophagus, stomach, small intestine, large intestine, anus
Define peristalsis
Series of unvoluntary wave length motion that moves food along the intestinal tract
What are the factors that impact the production and elimination of urine
- Growth & development
- Sociocultural factors
- Psychological factors
- Personal habits
- Fluid intake
- Pathological condition
- Surgical procedures
What are the three most common urinary elimination problems?
Urinary retention, urinary tract infection, urinary incontinence
Name six symptoms associated with urinary alterations
enlarged prostate, or benign prostatic hyperplasia
bladder outlet obstruction, such as urethral stricture or scar tissue in the bladder neck
pelvic organ prolapse, including cystocele and rectocele
urinary tract stones, also called calculi
constipation
pelvic masses, such as noncancerous or cancerous tumors, fibroids, polyps, or clots
tight pelvic floor muscles
Most common bowel elimination problems
constipation/bladder MOST COMMON but also impaction, incontinence, hemorrhoids, flatulence
Name the four major parts of nursing assessment
Self-care ability, cultural consideration, health history, nursing history (pattern of elimination, symptoms experienced/OLDCARTS)
define urinary urgency
feeling the urge to urinate
define dysuria
pain/discomfort associated w/ voiding.
define frequency
voiding more than 8 times during waking hours
define hesitancy
can’t void because of nervousness
define polyuria
voiding excessive amont of urine. difference is volume is larger than simply more frequently
define oliguria
diminished amount of volume
define nocturia
urinating at night
define hematuria
blood in urine
name some factors of elimination.
elimination pattern, surgery/illness, medications, urine/stool characteristics, routines, emotional state, bowel/urinary diversions, exercise, appetite changes, pain/discomfort, diet history, social history, daily fluid intake, mobility and dexterity.
type 1 bowel movement
hard small lump
type 2 bowel movement
lumpy sausage
type 3 bowel movement
sausage with cracks
type 4 bowel movement
smooth and soft, long
type 5 bowel movement
soft blobs
type 6 bowel movement
fluffy pieces
type 7 bowel movement
watery
Name four common urinary diagnostic tests
UA, culture
– Computed
tomography (CT)
– Intravenous
pyelogram (IVP)
– Ultrasound
– Cystoscopy (invasive)
Name four common bowel diagnostic tests
- Occult blood testing
- Endoscopy
- X-rays
- Ultrasound
- CT
- MRI
Responsibilities after
testing include
pt outcome, fluid intake, pt education
Common nursing Dx/problems for urinary
- Urinary incontinence
– Functional
– Stress
– Urge - Risk for infection
- Toileting self-care deficit
- Impaired skin integrity
- Impaired urinary
elimination - Urinary retention
Common nursing Dx/problems for bowel
- Bowel incontinence
- Disturbed body image
- Constipation
– Perceived
– Risk for… - Diarrhea
- Nausea
- Deficit knowledge
(nutrition)
Three types of catheters
straight, indwelling, triple lumen (three holes, one for inserting water for irrigation, one for urine drainage, one for balloon inflation)
Coude vs straight tip
coude is bent and narrow at the tip for men with prostate issues
Define micturition
when the brain triggers the bladder to empty
Where are the kidneys located?
on either side of vertebral column behind the peritoneum and against the deep muscles of the back. Left kidney is usually higher than right due to liver placement.
What are nephrons?
the functional unit of the kidneys that remove waste from the blood an play a major part in fluid and electrolyte regulation
What is the function of the glomerulus?
A cluster of capillaries in each nephron. It filters water glucose, amino acids, uric acid, urea, creatine, and major electrolytes. Large proteins and blood cells generally don’t filter through so when you see protein or blood, suspect a glomerulus injury. Most of the fluid it filters go back into the body (99%) and is absorbed by the proximal convolutes tubule of the nephron, the loop of Henle, and the distal tubule and enters the plasma.
What is the normal range of urine production?
1-2L/day
What are other functions of the kidneys besides urine production and fluid/electrolyte balance?
Produces erythropoietin which stimulates red blood cells and maturation of bone marrow. Also play an important role in blood pressure control via the renin-angiotensin (release of aldosterone (causes water retention) and prostacyclin (helps maintain renal blood pressure through vasodilation)). Lastly, kidneys produce hormone that converts vitamin d into its actives\ form which affects calcium and phosphate regulation.
What is the function of the ureters?
Ureter is attached to each kidney pelvis and carries urinary waste to the bladder. Urine is sterile. Peristaltic waves allow urine to enter bladder in waves rather than a stream. The bladder contracts the bottom of the ureters to ensure urine doesn’t back flow.
Define Peristaltic waves
allow urine to enter bladder in waves rather than a stream.
What are the potential long-term effects of a kidney stone?
Stone occludes ureter which causes immense urine backflow to the kidney and potential long-term kidney damage
What is the bladder?
A hollow, distensible, muscular organ that hold urine. Male male rests against rectum. Females it rests against anterior part of uterus and vagina. There are two parts of the bladder, the trigone (fixed base) and the detrusor (distensible body). Pressure in bladder stays low to reduce backflow but if a pregnant woman’s fetus pushes against the bladder it can cause backflow/urgency.
What is the urethra?
Urine from bladder travels through urethra and passes through the urethra meatus to leave body. The urethra passes through a thick layer of skeletal muscles called the pelvic floor. The external urethral spincter (made up of striated muscles) contributes to voluntary control of urine. The female’s urethra is 3-4cm long and males are 18-20cm long. The short length for females’ increase UTI likelihood.
What are other words for urination?
Micturition and voiding
What parts of the brain are involved in urination?
cerebral cortex, thalamus, hypothalamus, and brainstem.
Describe the neurological process of urination
2 urination centers in the spinal cord. urinations inhibited by bladder contraction caused by sympathetic stimulation from the thoracic allow urine to enter caused by thoracic urination center. The central nervous system allows urination by stopping sympathetic stimulation and starting parasympathetic stimulation from sacral center.
Name some common urination elimination problems
infection, irritable or overactive bladder, obstruction of urine flow, impaired bladder contractibility, or issues that impaired innervation to bladder
What is the most common bacteria that causes UTIs
Escheria coli from colon Bacteriuria does not always mean the presence of a uti
What is PVR?
Post-void residual is the amount of urine left in the bladder after voiding measured with ultrasound or straight cath
Name of serious upper UTI
pyelonephritis
Name for an inflamed bladder
cysitis
What is CAUTI
catheter-associated urinary tract infection
What is a stoma?
people that can’t use their bladder have an operation to divert urine to a hole through the abdominal wall. Ureterostomy is a permanent stoma (patient doesn’t know when they pass urine). Nephrostomy is for when a ureter is obstructed and a temporary pathway through abdominal wall is made
what are the two types of urinary diversions?
continent and orthotopic neobladder.
When do children generally begin to urinate on their own?
18-24 months old. Infants excrete large volumes of urine for their size. They also don’t concentrate their urine which is why they urinate so much.
What do diuretics do?
Make you pee more. Antidiuretics make you pee less
What pathological conditions can affect bladder contractility?
Diabetes mellitus, multiple sclerosis, stroke, spinal cord injury, prostatic enlargement
What does the GI tract consist of?
The alimentary canal and it’s accessory organs.
What is the alimentary canal
a signle tube that extends from the mouth to the anus and includes the mouth, esophagus, stomach, and intestines.
What are the accessory organs of the GI tract?
teeth, tongue, salivary glands, liver, pancreas, and gallbladder. These organs prepare food for absorption and use by body cells and provide for temp storage of feces
Other than food, what else goes into the GI tract?
secretions from the gallbladder and pancreas
Where is the cardiac sphincter?
End of esophagus, door to stomach
What does the stomach produce?
Chyme (mixed food and digestive juices), hydrochloric acid, mucus, pepsin, and intrinsic factor. Pepsin and HCl help digest protein, Mucus protects stomach mucosa and enzyme activity. Intrinsic factor helps absorb B12.
Describe what happens in the small intestine
Chyme moves down via peristalsis and turns into a thick liquid with semisolid particles. It is divided into three sections, the duodenum, jejunum, and ileum. Duodenum continues process from stomach. Jejunum absorbs carbs and protein. Ileum absorbs water, fats, bile salts, vitamins, and iron. The duodenum and jejunum absorb the most nutrients and electrolytes.
What do the pancreas and liver do to the small intestine?
Digestive enzymes and bile are excreted into small intestine
What are the parts of the large intestine?
cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum.
What causes watery vs. hard stools?
rate of peristalisis. fast is watery slow is hard
Where are the nerve ending that tell you whether you need to expell, liquid, solid, or a gas?
The anus
Name some defecation facts about infants
smaller stomach capacity, less secretion of digestive enzymes, more rapid peristalis, abilit5y to control defecation at 2-3 years old,
Name some defecation facts about older adults
decreased chewing ability less digested food, peristalis declines, esophageal empyting slows, impaired absoprition by intestinal mucosa, muscle tone of perineal floor and anal sphinter weakens which makes contolling defecation difficult.
What should daily fluid intake be generally?
3.7L for men 2.7 L for women
What dies fiber in your food do in your gut
absrobrs water so that your stools are easily passed (larger, softer stools)
What should a patient do immediately after surgery to prevent gi issues
ambulate
