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Factors that influence elimination
- Personal habits
- Fluid/dietary factors
Diarrhea - the rapid movement of fecal mass through the intestine
The ability to voluntary control the passage of stool
a collection of putty like/hard stool that has accumulated in the rectum or sigmoid colon; prevents passage of a normal stool
Blockage occurs because of a mass or adhesions in the colon preventing the elimination of stool
Abnormal amount of gas in the GI tract causing abdominal distention and discomfort. Flatulence is expelled throught the lower tract.
- a mass of dilated, tortuous, swollen veins in the anorectal region: Two types
- internal - dilated veins in the lower rectum
- External - dilated veins extending outside of the anal mucosa with the anal skin
What symptoms might tell us that the client may have a bowel problem?
- Decrease/Increase fx of defecation
- Ha8rd, dry, stool vs. loose stool
- Straining, painful defecation
- Rectal fullness/pressure/incomplete bowel evacuation
- Abdominal cramps, pain, distention
- Use of laxatives
- Decrease apetite/food allergies
- Headache/malabsorption syndrome/stress
What are some Radiological and Diagnostic test we can give to determine if the client is have a bowel complication?
- upper GI/ Barium Swallow
- Upper Endoscopy
- Barium Enema
- Flexible Sigmoidoscopy
- CT Scan, MRI
What is an Ostomy?
An opening on the abdominal wall for the elimination of feces or urine
What are the different types of Ostomies?
Know the parts of the intestines!!
What are the skills that the nurse should do for pouching an ostomy?
- Emotional support
- Gather supplies
- Peri-Stomal skin care
- Assess Stoma (size, color, shape, drainage, type of feces.)
- Dietary habits
What are the different types of Enemas?
- Bulk forming
- Emollient or wetting
- Stimulant cathartics
In what order should the nurse administer an enema?
- Prepare equpiment
- Encourage client to retain solution/assist with toileting
- Document/record output/client response
- other skills - sitz bath
In what order should the nurse do a digital removal of stool?
- Verify fecal impaction
- Explain procedure, V/S, Positioning
- Provide privacy
- Don Clean gloves and lubricated finger
- Periodically assess vital signs; stop if clients heart rate goes up
- Assist the client to toilet/bedpan
What is Micturition?
The act of making urine;the desire to urinate; aka voiding
What are some factors that might affect voiding?
- Personal Habits
- Fluid & food intake
- Muscle tone and Activity
- Pathological conditions
- Surgical and Diagnostic procedures
What is Anuria?
the absence of urine formation
What is Oliguria?
Diminished urinary output relative to intake ( ussually 400mL/24hr)
What is Polyuria?
Excessive passage of urine, as in diabetes
What is enuresis?
The uncontrolled or involuntary discharge of urine
What is Retention?
Involuntary withholding by the body of wastes or secretions that are normally eliminated.
What is a UTI?
an infection of one or more structures in the urinary system. The condition is more common in women than in men. UTI may be asymptomatic but is usually characterized by urinary frequency, burning pain with voiding, and, if the infection is severe, visible blood and pus in the urine. Diagnosis of the cause and location of the infection is made by microscopic examination and bacteriologic culture of a urine specimen. Teaching the patient about increased fluid intake, frequent voiding, and good perineal hygiene is also helpful.
What is Dribbling?
To flow or fall in drops or an unsteady stream; trickle
What is Residual urine?
The quantity left over at the end of a process; a remainder.
What is Nocturia?
excessive urination at night; especially common in older men
What is Dysuria?
Painful or difficult urination.
What is Hematuria?
The presence of blood in the urine.
What is Hesitancy?
Urinary hesitancy describes a difficulty in passing urine that may involve starting or maintaining the flow of liquid wasteRead more
What is Urinary Incontinence? (various types)
ity to control the flow of urine and involuntary urination
Physical assessment of a clients
- Olfaction - smells indicating incontinence
- Abdominall Girth
What procedures should be done on an assessment of urine?
- Intake and Output
- Characteristics of urine
- Urine testing
- Las - Specific Gravity/BUN/Creatinine/U/A
- other procedures - IVP, CT, Cystoscopy
What steps should the nurse take to measure urine output?
What are some common urine test?
- Urine Cultural
- Clean Voided
- Timed Urine
- Indwelling Catheter
- Intermittent Catheterization
Feels the urge to go suddenly and cant get to the toilet
Coughing, Sneezing, Laughing, r/t increased abd. pressure
Unaware the bladder is full and the client voids in response to spinal reflex
Part of the ileum is removed; the intestinal ends are re-attached; one end is closed to create a pouch and the other is brought out through the abd. wall to create a stoma
Continent Urinary Diversion
Part of ileum is used as a pouch to collect urine- client must self catheterize
A nephrostomy tube is a small rubber tube that is placed through a hole in the skin and that extends into the kidney. The tube allows direct drainage from the kidney.The device attaches to a collection bag that collects and measures urine output. The tube allows urine to bypass blocked or damaged ureters in order to avoid the risk of infection or irreversible damage that the backflow of urine causes for a patient with a blockage or leak.
Skills in inserting a straight or indwelling catheter
- Assess for clients last void
- Assess clients knowledge re:purpose for catheterization
- Hand hygiene, privacy, place waterproof pad, position client
- Cleanse the genital area
- Insert catheter
- Collect a specimen
- Promote client comfort
- Document the procedure and client response