Week 9 Elimination Needs Flashcards
The process of emptying the bladder
Micturition
The inability to control the discharge or urine or faeces
Incontinence
Involuntary passing of urine in children after bladder control is achieved.
Enuresis
The feeling that one must urinate.
Urgency
Painful or difficult voiding
Dysuria
The unusual presence of blood in the urine, as a result of injury or disease of the kidney or bladder.
Haematuria
The production of large amounts of urine.
Polyuria
Production of abnormally small amounts of urine.
Oliguria
Voiding two or more times at night.
Nocturia
An increase in the production of urine.
Diuresis
The failure of the kidneys to produce urine, resulting in a total lack of urination or output of less than 100mL per day in an adult.
Anuria
Faecal incontinence not associated with a physical condition or disease.
Encopresis
Body wastes and undigested food eliminated from the bowel.
Faeces
Expulsion of faeces from the rectum and anus.
Defaecation
An inability to control the bowel movements.
Faecal Incontinence
Passage of small, dry, hard stool or passage of no stool for an abnormally long time.
Constipation
Defecation of liquid faeces and increased frequency of defecation.
Diarrhoea
Black faeces where the colour is caused by bleeding in the intestine
Melaena
Hidden blood
Occult blood
Gas or air normally present in the stomach or intestines.
Flatus
A high level of sugar in the urine, a symptom of diabetes mellitus.
Glycosuria
A state in which ketone bodies are excreted in the urine.
Ketonuria
A condition in which there are proteins present in the urine.
Proteinuria
Joan tells the nurse that she often does not defecate when she has the urge because of time. The nurse realises that failure to heed the urge to defecate can result in:
Constipation
What physiological changes of ageing predispose older adults to constipation?
Loss of smooth muscle tone of colon
The nurse is planning outcomes for Jessie, a 75-year-old woman with urinary incontinence. An appropriate outcome for Jessie would be:
She empties her bladder completely
RN Jones asks you which of the following actions describes non touch technique (NTT) when assisting Mr Green to use of a urinal?
Donning gloves when emptying and cleaning Mr Green’s urinal
RN Jones asks you which of the following is the primary reason for performing perineal care on a person who is incontinent?
It reduces the risk of skin breakdown on the person’s genitals and perineum.
The initial results indicates the sample was positive for protein, and negative for glucose and blood with a pH of 8. Which of the following nursing actions is appropriate in response to these results?
Notify RN Jones of the results of the test.
Which of the following actions best ensures an accurate chemical reaction when testing urine with a Multistix test strip?
Holding the test strip horizontally while timing the process.
You are assisting RN Jones to position Mr Stevens who is dependent and confused on a bedpan. RN Jones asks you which of the following best ensures Mr Stevens’ safety:
Lower the bed position (relative to the floor) after placing the bedpan.
The normal SG of urine is
Between 1.010-1.025.
Upper urinary tract
- Kidneys
- Ureters
Lower urinary tract
- Bladder
- Urethra
- Pelvic floor
Nephrons consist of
Glomerulus
- Tuft of capillaries surrounded by Bowmans capsule
Ureters
Deliver formed urine to the bladder
Bladder
- Hollow muscular organ located in the pelvis
- Mainly consisting of smooth muscle
- Under indirect voluntary control
Urethra
- Extends from bladder to urinary meatus
- Passageway for the elimination of urine
- Gender differences (women more prone to UTI)
Pelvic floor
- Consists of sheets of muscles and ligaments providing support to viscera of the pelvis
- Extend from symphysis pubis to coccyx forming a sling
- Specific sphincter muscles contribute to the continence mechanism
Micturition
- Pressure stimulates special stretch receptors in bladder wall
- Receptors transmit impulses to spinal cord voiding reflex centre
- Internal sphincter relaxes stimulating urge to void
Factors affecting voiding
- Developmental
- Psychosocial
- Fluid/food
- Medication
- Muscle tone
- Pathological conditions
- Surgical procedures
Goals for urine elimination
- Maintain or restore normal voiding pattern
- Regain acceptable urine output
- Prevent associated risks (infection, skin breakdown, electrolytes)
- Perform toilet activities independently w/wo assistive devices
- Contain urine with appropriate device (catheter, stoma, appliance, product)
Average fluid intake
1500-2000 mL
Impact of incontinence
- Emotional
- Social (isolation, exclusion)
- Environmental (landfill)
Behaviour oriented continence training program
- Bladder training
- Prompted voiding
- Pelvic floor muscle exercises
Person with IDC
- Acidify urine
- Bag lower than bladder
Suprapubic catheter
- Inserted through abdominal wall into urinary bladder
- Temp/perm
- Skincare
- Aseptic technique
