MB16 136-149
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| 136 A) Describe the 3 step process of urine formation: | •Glomerular filtration
•tubular reabsorption
•tubular secretion.
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| 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
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| 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
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| 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
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| 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.
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| 140) Describe nursing interventions that promote normal urination; | •Position
•Privacy
•Fluid intake
•Stimulation of reflexes
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| 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
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| 142) Discuss factors that affect bowel elimination; | •Age- cardiovascular effects
•Diet
•Fluid intake
•Physical activity
•Psychological factors- anxiety can cause increase in activity
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| 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
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| 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...)
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| 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
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| 144 cont'd) Discuss common bowel elimination problems: | •Diarrhea- electrolyte imbalance
•Incontinence
•Flatulence, Hemorrhoids
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| 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?
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| 146. Physical exam to focus on bowel elimination | See Lynn book for exam tips and lovely pics
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| 147. Nursing diagnosis associated with altered bowel elimination | 1.Bowel incontinence 2.Colonic constipation 3.Impaired skin integrity 4.Excess fluid loss
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| 148. Nursing interventions that promote normal bowel elimination | 1.Education on good nutrition 2.Promote physical activity 3.Encourage hydration
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| 149. Care for patients experiencing BM problems | 1.Provide privacy 2.Maintain nutritional regimen 3.Educate on valsalva maneuver 4.Provide stool softeners
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