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ELIMINATION

ELIMINATION. URINARY ELIMINATION. ANATOMY AND PHYSIOLOGY. ANATOMY. FEMALE STRUCTURES MALE STRUCTURES. URINE . 96% WATER 4% SOLUTES ORGANIC SOLUTES UREA* AMMONIA CREATININE URIC ACID INORGANIC SOLUTES SODIUM (Na) CHLORIDE (Cl) MAGNESIUM (Mg) PHOSPHORUS (Phos)

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ELIMINATION

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  1. ELIMINATION

  2. URINARY ELIMINATION • ANATOMY AND PHYSIOLOGY

  3. ANATOMY • FEMALE STRUCTURES • MALE STRUCTURES

  4. URINE • 96% WATER • 4% SOLUTES • ORGANIC SOLUTES • UREA* • AMMONIA • CREATININE • URIC ACID • INORGANIC SOLUTES • SODIUM (Na) • CHLORIDE (Cl) • MAGNESIUM (Mg) • PHOSPHORUS (Phos) • SODIUM CHLORIDE (NaCl)*

  5. FACTORS AFFECTING URINARY ELIMINATION • Fluid • Diet • Response to urge • Stress • Psychosocial factors • Activity • Pathological conditions • Medications • Developmental level • Medical Diagnosis or Surgery

  6. ALTERATIONS IN URINARY ELIMINATION • Urinary Retention • Urinary Incontinence • functional • reflex • stress • total • urge • Enuresis • nocturnal enuresis • diurnal enuresis

  7. ALTERATIONS CONT. • Nocturia • Frequency • Urgency • Dysuria • Hesitancy • Polyuria • Suppression • anuria • oliguria

  8. DIAGNOSTIC TEST • Culture and sensitivity • KUB • IVP • Cystoscopy • Blood test • BUN (7-18 mg/dl) • Creatinine (.6-1.2 mg/dl) • Urinalysis (type of specimens)

  9. ASSESSMENT OF URINATION • frequency • amount • color • odor • character • specific gravity • ph • abnormal constituents • discomfort

  10. NURSING INTERVENTIONS TO PROMOTE U. E. • intake & output • position • hygiene • privacy • sitz • catheterize • medications • kegel’s exercise

  11. CATHETERIZATION • STRAIGHT • RETENTION OR FOLEY • QUICK CATH • LUMENS • SINGLE-STRAIGHT • DOUBLE-RETENTION • TRIPLE-IRRIGATION

  12. SIZE OF CATHETERS • RANGE FROM # 8-24 • CHILD # 8-10 • FEMALE # 14-16 • MALE # 16-18 • TURP # 22-24 • BALLOONS 5-30 cc

  13. Nursing Interventions • Insertion of catheters • Maintenance of caths • Specimens from caths • Removing catheters • Irrigation procedure • Residual urine • Suprapubic catheters

  14. URINARY DIVERSION • Cutaneous Ureterostomy • Ileal Conduit • Ureterosigmoidostomy • Ureteroileosigmoidostomy • Kock Pouch (Continent Vesicostomy)

  15. NURSING DIAGNOSES • ALTERED URINARY ELIMINATION • INCONTINENCE • URINARY RETENTION • PAIN • BODY IMAGE DISTURBANCE

  16. BOWEL ELIMINATION

  17. ANATOMY • Small intestine (ileum) • Ileocecal valve • Cecum • Ascending • Transverse • Descending • Sigmoid • Rectum • Anus

  18. PHYSIOLOGY • Peristalsis • Water absorption • Storage • Secretion of mucus

  19. DEFECATION • Parasympathetic reflex • Defecation reflex • Assessment of stool • pattern • color • consistency/shape • blood • Odor • Bowel Diversions • Stoma, drainage, skin condition

  20. Age Diet / Fluids Exercise Stress Schedule Medications Environment Anesthesia/Surgery Diagnostic Test Pathology Irritants Pain FACTORS AFFECTING BE

  21. ALTERED BE • Constipation • Fecal Impaction • Diarrhea • Incontinence • Flatulence • Hemorrhoids

  22. DIAGNOSTIC TEST • Guaiac test • Hematest • Hemoccult • Proctoscopy • Proctosignoidoscopy • Colonoscopy

  23. PHYSICAL ASSESSMENT • Inspection • Four quadrants • Nine regions • Auscultation • Percussion • Palpation

  24. Cathartics (laxative) Bulk forming Lubricant Wetting agent Stimulant/irritant Saline Suppository Enema Cleansing Hypertonic Oil Carminative Return Flow Cooling Medication MEDICATIONS

  25. ENEMA ADMINISTRATION • PROCEDURE • HIGH VS. LOW • AGE • POSITION • SOLUTIONS • HYPOTONIC • HYPERTONIC • ISOTONIC • VOLUME CONSIDERATION

  26. BOWEL DIVERSIONS • Ileostomy • Ascending Colostomy • Transverse Colostomy • Descending Colostomy

  27. TYPES OF CONSTRUCTION • Loop • Double Barrel • End • Temporary • Permanent

  28. NURSING INTERVENTIONS • Psychological needs • Nutritional needs • Hygiene needs • Maintenance • Teaching

  29. SPECIMEN COLLECTION • Urine • Midstream • Sterile/Culture • 24 hour • Drug • Stool • Blood/Parasite • Technique • Documentation

  30. NURSING DIAGNOSES • CONSTIPATION • DIARRHEA • INCONTINENCE • ALTERED ELIMINATION • BODY IMAGE DISTURBANCE

  31. THE END!!!

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