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Urine/Bowel Eliminat
urine and bowel elimination for exam 3
| Question | Answer |
|---|---|
| urinary system | eliminated fluid and toxic substances through urine production |
| the urinary system involves the | kidneys, ureters, bladder and urethra |
| kidneys | remove waste from blood and urine |
| ureters | transport urine from kidney to the bladder |
| bladder | holds urine until urge to urinate develops |
| urethra | the urine leaves body from bladder |
| meatus | opening on outside of body where urine comes through |
| process of emptying bladder includes | urination, voiding and micturition |
| normal urine production Is | 1500-3000 ml a day |
| factors of voiding | age, newborns, pregnancy, males, elderly, time, position, diet, medications, diseases |
| males have problems with prostate and it causes problems with voiding for examples | dribbling or hesitancy |
| polyuria or diuresis | excessive amount of urine |
| anuria | less than 100ml, absent or very little |
| oliguria | still low, less than 400ml in 24hrs |
| nocturia | increase voiding at night |
| dysuria | difficult or painful urination |
| hesitancy | delay or difficult in starting output |
| stress incontinence | loss of small amount of urine when intra-abdominal pressure rises coughs, sneezes, laughs, lifting, position changing |
| urge incontinence | need to void more frequently with a short lived ability to sustain control of flow have urge but then too late |
| reflex incontinence | spontaneous loss or urine when bladder is stretched, leak urine but do not realize |
| functional incontincence | control over urination is lost because of inaccessibility |
| total incontinence | loss or urine without power or warning no certain factors |
| overflow incontinence | urine leaks because ladder is not completely empty |
| retention | accumulation of urine in the bladder leads to urinary stasis (stops) |
| diuretics | blood pressure meds can cause incontinence |
| faint aroma (odor) is normal | true |
| urinalysis | tested at the lab ph normal is 4.5-5.8 |
| specific gravity | 1.010-1.030 |
| glucose in urine | negative |
| ketones in urine | negative |
| white blood cells in urine | negative |
| hematuria | blood in urine |
| pyuria | urine with pus present |
| proteinuria | urine with protein |
| ketonuria | urine with ketones |
| glycosuria | urine with glucose |
| nursing diagnosis | all incontinence types, impaired urinary elimination, and risk for ineffective Renal perfusion |
| what can nurses do for urinary elimination | position comfortable, water faucet on, hands in water, water over perineal area, privacy, assistance, hygiene, fluid intake, easy access, readily available, pelvic floor exercise, catheters |
| condom or texas catheter | males |
| pure wick catheters ( can be connected to suction on wall) | females |
| retention catheter | in and out catheter, can be used for sample urine |
| indwelling catheter | drainage bag, leg bag or bed frame, invasive, risk of infection |
| coude catheter | tapered tip and used as enlargement when prostate is inspected, inclined a bit, mainly for men with prostate problems |
| Foley catheter | balloon near its tip that is inflated after insertion to hold catheter in place for continuous drainage |
| straight in and out catheter | To collect a specimen or drain bladder then it is removed |
| mushroom catheter | drain renal pelvis of kidney |
| suprapubic | Inserted through the abdomen above the synthesis pubis (pubic bone) creates urinary diversion, obstruction, injury and not through perineal area it is inserted surgically into the bladder |
| three way catheter | Third lumn is used for irrigation of the bladder, it is connected to a bag of irrigation constantly flushing out the bladder and it will be used mostly anything wrong with prostate or after surgery or if they tend to clot |
| what can nurses do for urinary draining systems | Follow aseptic technique when inserting catheter, record fluid intake and output, proper placement and functioning of the draining system, fluid intake, only open where the tape connects the tubes, check for leaks, and secure catheter to prevent pulling a |
| collect specimen from catheter from drainage port by using | sterile needle and 10mm syringe |
| female catheter should be tapped | inner thigh |
| male catheter should be taped | top of thigh or abdomen |
| bowel elimination | elimination of intestinal waste |
| peristalsis | involuntary constriction and relaxation of muscles of intestine, creating wave like movements |
| feces or stool | What is left after digestive system absorbs nutrients and fluids from what you eat and drink, diarrhea can happen when store passes through the large intestine to quickly |
| defecation | discharge of feces from body |
| meconium | Dark green substance forming the first species of a newborn infant they usually pass within the first few hours |
| Infants have faster peristalsis | More frequent stools, around age 2 or three children develop awareness and then be potty trained |
| Elderly have a slower peristalsis | Become constipated easily, everything slows down, less muscle control, less fiber intake and less fluid intake |
| Diet for bowel elimination | Fiber intake, food with laxative effect, constipation foods, brat diet, gas forming foods |
| fiber foods | grains vegetables fruits and greens |
| foods with laxative affect | Prunes, prune juice, spicy food, and hot drinks |
| constipation foods | Cheese, dairy, saturated fats, brat diet BRAT diet Bananas, rice, applesauce, and toast |
| gas forming foods | Beans, cabbages, broccoli, and cauliflower |
| Increase fluids and exercise can increase peristalsis | true |
| Nervous or anxious causes diarrhea because it speeds up the system depression could cause both depending on situation | true |
| what medications affect bowel elimination | Narcotics and anesthesia, they decrease for sale sister stop it, laxatives, anti-diarrheal's |
| Assessment of bowel elimination | History- pattern, consistency, color, volume, odor, problems with illumination, diet, activity, stress level, if the abdomen is distended, asymmetrical, swelling, damage, it's bell sounds are active and pain tenderness of abdomen, color of store, addition |
| Hypoactive | Soft and in frequent, occur one per minute or less, decrease peristalsis or motility |
| Present or active | 4 to 32 per min |
| Hyperactive | Occur more frequently, loud rushing sounds |
| Absent sounds | No peristalsis or motility present, listen 5 minutes, if absent must contact doctor |
| Brown stool | Infants may be lighter in color because of breast milk and soft foods |
| Black stool | Blood in stool, iron |
| clay or tan stool | Pepto-Bismol, certain medication or drinks, G.I. related, example liver problems, and jaundice |
| Green or yellow stool | |
| Odor can be caused from | C-dip or infection |
| Consistency of stool | Soft, warm, abnormal would be hard, dry, watery or paste like |
| Shape of stool | Round, full, in form of intestine, abnormal would be flat, pencil shaped, or stone lot |
| Components of stool | Undigested fiber, abnormal would be blood, mucus or pus |
| Condition of skin around the anus | Irritation, hemorrhoids, breakdown |
| Causes of constipation | Disease, inactivity, decreased food or fiber intake, decreased fluid intake, certain medication's, laxative abuse, decrease of nominal space, ignoring urge, stress |
| Ways to relieve constipation | Increase fluid intake, increase fiber, increase activity, stool softeners, laxatives |
| Intestinal distention | Gas or flatulence, we can determine by inspection and palpation, patient may also be complaining |
| Causes of distinction | Swallowing too much air, gas forming foods, inactivity, post surgery |
| Relief of distinction | Simethicone, increase activity, amputation, change diet, rectal tube |
| Diarrhea | Set of unformed watery stools more frequently with cramping and increased mouth sounds |
| Causes of diarrhea | Bacteria or virus, allergic reaction, food poisoning, stress, disease of intestines like colitis or Crohn's disease, medication's |
| Relief of diarrhea | Identify cars and remove cars, change of diet, NPO, answer call lights ASAP, prevent accidents, keep patient clean and dry, encourage more fluids, if unable connect to IV fluids |
| Fecal incontinence | Inability to control elimination of stools |
| Fecal impaction | Collection of hardened feces in rectum that cannot be passed |
| Fecal impaction causes | Constipation, retained barium, dehydration, muscle weakness, can past stool but are hard and stress causing hemorrhoids, digital rectal exam |
| Other than a digital rectal exam how can you tell if someone has a fecal impaction | Put gloves on and lubricant on to see if you can fill the infection inside and if you can you may have to manually remove the feces, enemas and laxatives are common |
| Hemorrhoids | Distended veins in the anal area, they can be external or internal, itchy painful and can bleed |
| Hemorrhoid causes | Straining, pressure in abdomen, obesity, lifting, standing, and setting |
| Hemorrhoid interventions | Relief of pressure, illuminating problem with constipation, diets, medication, and limiting straining |
| Ways nurses can promote normal bowel elimination | Privacy, positioning, timing, fluids, diet, exercise, stool softeners, laxatives, and administering enemas |
| Safest laxatives to use | Bulk forming laxatives |
| Enemas | Introducing a solution into the rectum the reason is to promote defecation, people can come dependent on enemas |
| Purposes of enemas | To cleanse the bell, colonoscopy, soft in the feces, expel platies, soothe irritated mucous membranes, outline colon for x-rays, treatment for certain disorders |
| Cleansing enemas | Stimulates peristalsis by irritating the colon or by descending the intestine with volume of fluid to moist in the store |
| Examples of cleansing enemas | Tap water enema, soapsuds enema, saline enma, and fleets enema |
| Retention enema | This is all in rectum to lubricate insult in the store, mineral oil enema |
| Medicated enema | Liver medication's, examples are steroid enema and Kayexalate (elevated potassium level) |
| How to give enema | Prepare enema, bag with tubing or bucket attach to tubing, primer tubing and clamp tubing, lubricate before insertion, have in lateral position or Sims position |
| Further steps on giving enema | , have a waterproof pad disposable pads, tissue, clean up supplies, gloves, wipes, bedpan, insert, hanging bag or bucket 12 to 8 inches above the rectum, release clamp and allow solution to flow |
| Further steps on giving enema | slowly, slow deep breath and relax, remove tubing and make sure it is retained as long as they can for at least five minutes, this to bedpan, visually expect to see what was expelled, may have to come back and give more or can just be one enema, document |
| Ostomies | Artificial opening, artificial opening in the abdomen, side of opening is called a stoma, could be due to trauma to intestine, severe inflammation, diseases, cancer, can be temporary or permanent stoma should look like a mucous membrane, will have a colle |
| Who is different depending on the type of ostomy | true |
| Ileostomy | Opening in ileum and small intestine, liquid and watery, not had time to sit in Farm |
| Colostomy | Opening in large intestine more formed depending on how far down and how far up |
| Urostomy | Opening to divert urine away from the bladder, drain urine |
Created by:
20moramb
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