Topic 6: Bowel & Urinary Elimination Flashcards
what are the three functions of the large colon
absorption, secretion, and elimination
The body expels feces and flatus from the rectum through the
anus
how does AGE affect bowel elimination
Peristalsis declines and esophageal emptying slows. This impairs absorption by the intestinal mucosa. Muscle tone in the perineal floor and anal sphincter weakens, and may cause difficulty in controlling defecation.
how does DIET affect bowel elimination
Regular daily food intake helps maintain a regular pattern of peristalsis in the colon. Fiber in the diet provides the bulk in the fecal material.
how does FLUID affect bowel elimination
Fluid liquefies intestinal contents by absorbing into the fiber from the diet and creating a larger, softer stool mass. This increases peristalsis and promotes movement of stool through the colon.
how does physical activity affect bowel elimination
promotes peristalsis
how does psychological factors affect bowel elimination
During emotional stress, the digestive process is accelerated and peristalsis is increased.
how does personal habits affect bowel elimination
A busy work schedule sometimes prevents the individual from responding appropriately to the urge to defecate, disrupting regular habits and causing possible alterations such as constipation.
what is the normal defecation position
squatting
what affect does anesthesia have on bowel elimination
cause temporary cessation of peristalsis. The temporary stop of peristalsis is called ileus.
how do diagnostic tests effect bowel elimination
Diagnostic examinations involving visualization of GI structures often require a prescribed bowel preparation (e.g., laxatives, and/or enemas) to ensure that the bowel is empty.
Constipation
A symptom, not a disease; infrequent stool and/or hard, dry, small stools that are difficult to eliminate
Impaction
Results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel
Diarrhea
An increase in the number of stools and the passage of liquid, unformed feces
Incontinence
inability to control passage of feces and gas to the anus
Flatulence
Accumulation of gas in the intestines causing the walls to stretch
Hemorrhoids
Dilated, engorged veins in the lining of the rectum
causes of hemorrhoids
o Diarrhea
o Constipation
o Pregnancy
o Prolong sitting and standing
o Cirrhosis of the Liver
repeat
repeat
stoma
Temporary or permanent artificial opening in the abdominal wall
what color is a normal stoma
bright pink or brick red
Ileostomy or colostomy
These surgical openings are called an ileostomy or colostomy depending on which part of the intestinal tract is used to create the stoma.
sigmoid colostomy has what kind of stool consistency
A more formed stool
Transverse colostomy has what kind of stool consistency
Be thick liquid to soft consistency
ileostomy has what kind of stool consistency
The fecal effluent leaves the body before it enters the colon, creating frequent, liquid stools. Loop colostomy
pouching ostomies
An effective pouching system protects the skin, contains fecal material, remains odor free, and is comfortable and inconspicuous.
what are nutritional considerations for ostomies
o Consume low fiber for the first weeks.
o Eat slowly and chew food completely.
o Drink 10 to 12 glasses of water daily.
o Patient may choose to avoid gassy foods.
Ileoanal pouch anastomosis
o A surgical procedure that is used in patients who need to have a colectomy for treatment of ulcerative colitis or familial adenopolyposis (FAP). In this procedure the surgeon removes the colon, creates a pouch from the end of the small intestine, and attaches the pouch to the patient’s anus.
Continent ileostomy
o Involves creating a pouch from the small intestine. The pouch has a continent stoma on the abdomen created with a valve that can be drained only when the patient places a large catheter into the stoma. The patient empties the pouch several times a day.
Antegrade continence enema
o A.C.E. procedure is usually done in children with fecal soiling associated with neuropathic or structural abnormalities of the anal sphincter. A continence valve with an opening on to the abdomen is surgically created in the intestine so that the patient or caregiver can insert a tube and give themselves an enema which comes out through the anus. Colonic evacuation begins about 10 to 20 minutes after the patient receives the enema fluid.
Enemas
the instillation of a solution into the rectum and sigmoid colon. The primary reason for an enema is to promote defecation by stimulating peristalsis
Cleansing enemas
promote the complete evacuation of feces from the colon. They act by stimulating peristalsis through the infusion of a large volume of solution or through local irritation of the mucosa of the colon.
· Tap water
· Normal saline
· Hypertonic solutions
· Soapsuds
Oil retention
lubricate the feces in the rectum and colon. The feces absorb the oil and become softer and easier to pass. To enhance action of the oil, the patient retains the enema for several hours if possible.
Carminative and Kayexalate
provide relief from gaseous distention. They improve the ability to pass flatus
kidney function
filter waste products of metabolism that collect in the blood.
ureter function
Ureters are tubular structures that enter the urinary bladder
bladder function
The urinary bladder is a hollow, distensible, muscular organ (detrusor muscle) that stores and excretes urine
urethra function
Urine exits the bladder through the urethra and passes out of the body through the urethral meatus. (urine flow washes urethra free of bacteria)
what are the terms to describe the bladder emptying
Urination, micturition, and voiding
Urinary retention
An accumulation of urine due to the inability of the bladder to empty
Urinary tract infections (UTIs)
Usually caused by Escherichia coli. Urinary tract infections are characterized by location; upper urinary tract (kidney) or lower urinary tract (bladder, urethra) and have signs and symptoms of infection.
-Results from catheterization or procedure
Urgency UI
involuntary leakage associated with urgency
Stress UI
involuntary loss of urine associated with effort or exertion on sneezing or coughing
Mixed UI
when stress and urgency type symptoms are both present
Functional UI
caused by factors that prohibit or interfere with a patient’s access to the toilet or other acceptable receptacle for urine
Overflow UI
involuntary loss of urine associated with over distention(overfull) of the bladder
Overactive Bladder
defined as urinary urgency, often accompanied by increased urinary frequency and nocturia that may or may not be associated with urgency incontinence and is present without obvious bladder pathology or infection
* condition in which bladder squeezes urine out at the wrong time
the urinary tract is
sterile
what helps prevent the spread of UTI
Perineal care, hand hygiene, sterile technique with catheter
infants, children and their ability to control urination
need to learn to recognize the need to urinate
the elderly and their ability to control urination
need to deal with decreased functioning that accompanies aging.
Pregnancy
causes many changes in the body, including the urinary tract. In early and late pregnancy, urinary frequency is common.
urine is very ____ which makes skin at more risk for skin break down
acidic
Intake and output
A way to evaluate bladder emptying, renal function, and fluid and electrolyte balance.
characteristics of urine
color, clarity, odor
normal urine
ranges from a pale straw color to amber
dark red urine
bleeding from the kidneys or ureters
bright red urine
bleeding from the bladder or urethra
dark amber urine
is the result of high concentrations of bilirubin (urobilinogen) in patients with liver disease.
cloudy urine indicates
· Urine that stands several minutes
· protein concentration.
· result of bacteria and white blood cells (WBCs).
foul smelling odor may indicate
UTI
specific gravity
weight or degree of concentration of a substance compared with an equal volume of water.
Maintaining elimination habits
· Integrating the patient’s habits into the care plan fosters a more normal voiding pattern (privacy: closing the door/curtain; asking visitors to leave a room; masking the sounds of voiding with running water)
· Respond to requests for assistance with toileting as quickly as possible.
Women void better when
sitting on the toilet or bedside commode with the feet on the floor.
Men void easier in the
standing position.
To improve bladder emptying, encourage patients to
wait until the urine flow completely stops when voiding and encourage them to attempt a second void (double voiding)
