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Measuring Urine Output Pour urine into appropriate measuring device. Then place calibrated container on flat surface and read at eye level. Note amount of urine voided and record on appropriate form. Discard unless needed.
Urine Specimens Routine urinalysis can be Clean-catch or midstream specimens. Sterile specimens from indwelling catheter. Sometimes needed 24-hour urine specimen. Specimens from infants and children
Urinary functioning as the problem Incontinence,Pattern alteration,Urinary retention
Urinary functioning as the etiology Anxiety,Caregiver role strain,Risk for infection
Planned Patient Goals Produce sufficient quantity of urine to maintain fluid, electrolyte, and acid–base balance. Empty bladder completely at regular intervals without discomfort. Provide care for urinary diversion and know when to notify physician
Urethral Catheterization Indwelling/Foley: continuous drainage. Straight: intermittent drainage. Strict sterile procedure and drainage bag below bladder
Reasons for Catheterization Relieving urinary retention,obtaining a sterile urine specimen and obtaining a urine specimen when usual methods can’t be used. Emptying bladder before, during, or after surgery and monitoring critically ill patients
Stress Uninary Incontinence —increase in intra-abdominal pressure
Urge Uninary Incontinence urine lost during abrupt and strong desire to void
Mixed Uninary Incontinence symptoms of urge and stress incontinence present
Overflow Uninary Incontinence over distention and overflow of bladder
Uninary Incontinence caused by factors outside the urinary tract
Reflex Uninary Incontinence emptying of the bladder without sensation of need to void
Total Uninary Incontinence continuous, unpredictable loss of urine
Factors to Consider With Use of Absorbent Products Functional disability of the patient Type and severity of incontinence Gender and patients prference
Process of Peristalsis under control of the nervous system and contractions occur every 3 to 12 minutes
Mass peristalsis sweeps occur one to four times each 24-hour period.
bowel movement One third to one half of food waste is excreted in stool within 24 hours.
Variables Influencing Bowel Elimination Daily patterns,Food and fluid, and Activity and muscle tone, lifestyle choices
Other factors influencing bowel elimination (Medical Base) Pathologic conditions,Medications,Diagnostic studies and Surgery and anesthesia
Infants —characteristics of stool and frequency depend on formula or breast feedings
Toddler —physiologic maturity is first priority for bowel training
Child, adolescent, adult —defecation patterns vary in quantity, frequency, and rhythmicity
Older adult —constipation is often a chronic problem; diarrhea and fecal incontinence may result from physiologic or lifestyle changes
Effects of meds on stool Aspirin, anticoagulants—pink to red to black stool
Effect of iron on stool black stool
Effects of antiacids on stool white discoloration or speckling in stool
Effects of antibodotics —green-gray color
Stool Collection Medical aseptic technique is imperative. Make sureWear disposable gloves and Wash hands before and after glove use. Do not contaminate outside of container with stool. Obtain package for stool and handle properly
Patient Guidelines for Stool Collection Void first, no urine in stool. Poop in container not toilet. No toilet paper in container.
Patient Outcomes soft formed bowel movement every 1 to 3 days without discomfort. Understand relationship between bowels movement and diet and exercise.
Individuals at High Risk for Constipation Patients on bed rest taking constipating medicines and with reduced fluids or bulk in their diet. Patients who are depressed & with central nervous system disease or local lesions that cause pain
Nursing Measures for the Patient With Diarrhea Answer call bells immediately and Remove the cause of diarrhea whenever possible (e.g., medication). If there is impaction, obtain physician order for rectal examination.
Methods of Emptying the Colon of Feces Enemas(cleansing & Retention),Rectal suppositories, and Digital removal of stool
Retention Enemas: Oil-retention —lubricate the stool and intestinal mucosa easing defecation
Retention Enemas: Carminative help expel flatus from rectum
Retention Enemas:Medicated— provide medications absorbed through rectal mucosa
Retention Enemas:Anthelmintic —destroy intestinal parasites
Created by: cjnnovak