UN Elimination Flashcards
Ideal bristol stool type
3&4
Factors affecting normal bowel elimination
- Diet
- Fluid intake
- Physical activity
- Personal bowel elimination habits
- Privacy
Factors related to altered patterns of bowel mvmt
- Age related
- Medication
- Acute illness, surgery, anaesthesia
- Pain
Common bowel elimination problems
- Constipation
- Hemorrhoids
- Fecal impaction
- Flatulence
- Fecal incontinence
- Diarrhea
Constipation
-Defined in relation to person’s baseline
-hard dry lumpy stools
-abdominal pain, cramps, distension
Hemorrhoids
-dilated engorged veins in lining of rectum due to increased venous pressure
-symptoms: bleeding, pruritis, pain, edema
Fecal impaction
-result from unrelieved constipation
-collection of hardened feces
-loss if appetite, cramps, rectal pain
-fluid seeps around
-may require digital disimpaction
Fecal incontinence
-inability to control passage of feces and gas
-associated w impaired function of anal sphincter
-effects on social and psychological well-being
Flatulence
-100ml-200ml of gas in GI tract
-accumulation of gas in lumen of intestine cause bowel walls to stretch and leads to abdominal fullness, pain, intestinal bloating
Diarrhea
-increase in nb of stool a day and liquid unformed feces
-major causes: meds, allergies, intestinal disease, infectious organisms
Promote healthy diet
- 1,5-2L/day
- High fiber diet
- Reduce caffeine and alcohol
Activity promotion
- Daily physical activity
- Chair/bed exercise
Position for good bowel mvmt
Upright on toilet
Fowler’s
Bowel training
- Regular toileting
- Use laxatives
- Unhurried enviro
- Respond to urge of to BM ASAP
Defecation using bedpan
-if pt condition permits, the hob raised to 30-60 degrees
-impossible to contract muscles used during defecation in supine position
Urination synonyms
Voiding, micturition
First urge to vois starts when
Bladder is half full
Strong urge to void when bladder is at what
500ml
Voluntary control of urination is possible only if
Nervous system is intact
Function of kidneys
Remove waste and excess fluid from blood to form urine
Function of ureters
Transport urine from kidney to bladder
Bladder function
Reservoir for urine
Holds ~500ml comfortably
24h output: 1500-1600ml
Urethra function
Urine exits through urethral meatus
Way larger in male than female
Urine concentration
96% water, 4% solutes -> urea, creatinine, uric acid
What is MIN amount if urine per hour
30 cc (30ml)
Color of urine
Can go from pale straw color to amber (depends on [])
Clarity of urine
Should be transparent
Odour of urine
The more [] the stronger the odor
Factors affecting urination
- Age
- Food intake
- Fluid intake
- Muscle tone
- Psychosocial factors (privacy, normal position, sufficient time)
- Medications (diuretics increase excretion, spinal anesthesia ->retention)
- Chronic disease (stroke, spinal cord injury
Common alterations in urinary elimination
- Urinary tract infection
- Urinary incontinence
- Urinary retention
Symptoms of uti
- Fever, chills, nausea, vomiting
- Dysuria, frequency, urgency
- Foul-smelling cloudy urine
- Hematuria
- Flank pain, lower back pain (if spreads to upper urinary tract)
Causes of uti
- Urinary stasis
- Incomplete bladder emptying (immobility, dehydration)
- Poor perineal hygiene
- Urinary catheterization
*women more susceptible to uti)
Uti diagnosis
Urinalysis
Urine culture and sensitivity (C&S)
Uti treatments and interventions
Antibiotics, adequate fluid intake
Teach abt risk factors, early recognition of symptoms, respond to urge to void, wipe front to back (women), showers rather than baths
Urinary incontinence is
Involuntary loss of urine
Occurs along with other lower urinary tract syndrome
Urinary incontinence causes
Utis, pregnancy, volume overload, delirium, fecal impaction, CVA, spinal cord injury, cognitive impairment
Urinary retention is
Emptying of bladder is impaired, residual urine accumulates, bladder becomes overdistended
Caused of urinary retention
-Prostatic hypertrophy, urethral obstruction, post surgery (general, spinal and regional anesthetics)
-meds
-others
Urinary retention clinical manifestations
Distention, suprapubic pain/bloating, overflow of voiding/incontinence
Urinary retention iterventions
Positioning
Relaxation techniques
Sound of running water
Catheterization
Bladder scan/PVR
Common symptoms of urinary alterations
Oliguria
Anuria
Polyuria
Dribbling
Hematuria
Nocturia
Incontinence
Urgency
Dysuria
Frequency (more than 8x/hr)
Hesitancy
Elevated postvoid residual urine
Oliguria
Low urine output, < 400ml/day or < 30ml/hr
Anuria
Absence of urine production
Polyuria
Abnormally large amount of urine produced
Dribbling
Leakage of urine despite voluntary control
Hematuria
passage of visible blood mixed with urine
Nocturia
Number of times urine is passed during main sleep period
Dysuria
Difficult or painful voiding
Hesitancy
Delay and difficulty in initiating voiding, associated with dysuria
Promote fluid
1500ml-2000ml a day, reduce caffeine and alcohol
Position for maximal emptying
Standing for males, squatting for females
If in bed, sitting position on bedpan
Relaxation to promote urinary elimination
-No rushing
-warm towels
-warm water poured over female perineum
-sound of running water
-stroking inner thigh
-analgesia
Timing to promote urination
Respond to urge as soon as possible
Maintain regular pattern of elimination (q3h-q4h)
