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MB16 136-149

136 A) Describe the 3 step process of urine formation: •Glomerular filtration •tubular reabsorption •tubular secretion.
136 B) Describe the processes of urine elimination: •kidneys remove wastes •filter into the Bowmen’s capsule. •Some fluid excreted as urine, most reabsorbed back to plasma. •Urine output must be at least 30ml/hour
137) Discuss factors that affect urinary elimination: •Surgical Procedures •Medications- Diuretics (Lasix) •some change the color of the urine •Diseases •Calculi (stones) •BPH •Neurogenic bladder from impaired neurological function
138) Describe the contents of a nursing assessment and physical examination focused on urinary elimination: •History: usual pattern/ alterations •Bladder distension •I & O (Intake & Output) • UA (urinalysis) • Culture and sensitivity
139) Accurately measure urine output: • strict, use Pilgrim’s Hat to measure cc. • • not strict, note that the patient urinated (x3) or however much they went.
140) Describe nursing interventions that promote normal urination; •Position •Privacy •Fluid intake •Stimulation of reflexes
141) Identify the basic structures and functions of the G.I. system: 23-26 feet long. •Mouth, esophagus, stomach, S.I and L.I., rectum, anus. •Primary functions are food breakdown to the molecular form for digestion. •The absorption into bloodstream of small nutrient molecules via digestion •elimination of undigested unabsorbed foodstuf
142) Discuss factors that affect bowel elimination; •Age- cardiovascular effects •Diet •Fluid intake •Physical activity •Psychological factors- anxiety can cause increase in activity
142 cont'd) Discuss factors that affect bowel elimination; •Personal habits, Position •Pain, Pregnancy •Surgery/anesthesia- stops peristaltic waves •Manipulation during surgery •Medications- narcotics slow the GI tract (slowed peristalsis), laxatives
143) Describe normal bowel elimination: •75% fluid, 25% solid. Stool is light to dark brown. •Average frequency is once daily but this varies. (And they all stink no matter what anyone says...)
144) Discuss common bowel elimination problems: •Constipation- Valsalva maneuver can be a danger •Impaction- confused and debilitated patients are at risk. Loose stool can be a sign (with no recent formed stool) distension. Loss of appetite, N/V
144 cont'd) Discuss common bowel elimination problems: •Diarrhea- electrolyte imbalance •Incontinence •Flatulence, Hemorrhoids
145 ?s to assess bowel elimination problems -have you been experienceing pain?fear?nausea?vomiting? -what is your normal amount of BM? activity?daily rest? stress?
146. Physical exam to focus on bowel elimination See Lynn book for exam tips and lovely pics
147. Nursing diagnosis associated with altered bowel elimination 1.Bowel incontinence 2.Colonic constipation 3.Impaired skin integrity 4.Excess fluid loss
148. Nursing interventions that promote normal bowel elimination 1.Education on good nutrition 2.Promote physical activity 3.Encourage hydration
149. Care for patients experiencing BM problems 1.Provide privacy 2.Maintain nutritional regimen 3.Educate on valsalva maneuver 4.Provide stool softeners
Created by: Marshall3