alterations in elimination gi elimination urinary elimination
TRANSCRIPT
Alterations in Elimination
•GI Elimination
•Urinary Elimination
Alterations in Elimination
Normal Position
Thigh Flexion
Factors affecting GI Elimination
Age
Young
Elderly
smooth muscle tone of colon
Abdominal muscle tone
Anal sphincter control
Factors affecting GI Elimination
Diet
Bulk/fiber intake
Digestion
Spicy foods
Eating schedules/routines
Factors affecting GI Elimination
Fluid Intake2000 – 3000 ml/day
Mobility/ImmobilityPsychological ConsiderationLife-style Considerations
Early bowel trainingAvailability of toilet facilitiesEmbarrassmentPrivacy issuesTime management
Factors affecting GI Elimination
Medications
side effects
GI medications
Diagnostic ProceduresPreparing the pt
Barium studies
Factors affecting GI Elimination
Anesthesia and SurgeryAbdominal surgeryParalytic ileus
Pathologic conditionsaltered sensory stimulation/sensation
Impaired mobility/decreased physical strength/stamina
Factors affecting GI Elimination
Irritants
Pain
Common GI Elimination Problems
Constipation
**Always identify the client’s normal bowel elimination pattern**
Constipation: contributing factors
Irregular defecation habits
Laxative abuse/enema abuse
Psychological stress
Diet
Fluid intake
Age
Disease processes
Constipation: complications of
Bowel obstruction
Vagal Response
Fecal impaction
Hemorrhoids
Constipation: Treatment
Medications
Fluid intake
Diet
Activity
Prevention
Common GI Elimination Problems
Diarrhea
Treatment
Complications
Common GI Elimination Problems
Bowel incontinence
Flatulence
Treatment:
Position » side lying for rectal tube » Prone with knees flexed under
abdomen
Flatulence: Treatment
Decreased amt of swallowed air:
Carbonated beverages
Straws
Gum
Hard candies
NGT for decompression of abdomen
Common GI Elimination Problems
Hemmorrhoids (piles)
Nursing Process
Factors Affecting Urinary Elimination
Growth and DevelopmentYoungElderly
Psychosocial factorsprivacy“normal position”sufficient timerunning water
Factors Affecting Urinary Elimination
Fluid/food intake
Medications
Muscle tone/immobility
Pathologic conditions
Surgical/diagnostic procedures
Common Urinary Elimination Problems
Definition of normal: 30 ml/hour
45 ml in 5 hours
200 ml in 2 hours
How much is “normal” for each voiding?
What would be abnormal?
Common Urinary Elimination Problems
Voiding Patterns
Polyuria diuresisLarge fluid intake, ingestion of diuretic
Other s/s:
polydipsia
dehydration
wt loss
BP changes
Common Urinary Elimination Problems
Oliguria and anuriaetiology:
low fluid intake***Renal, Cardiac Pathology
Frequency and nocturiaetiology:
fluid intakeUTIPregnancyRenal pathologyDiuretic therapy
Common Urinary Elimination Problems
Urgency
Etiology:UTI
Decreased perineal muscle tone
Dysuria
Etiology:
UTI, urinary catherization
Urinary Incontinence
Total
Stress
Urge, Functional
Reflex***
Urinary retention with overflow**
Common Urinary Elimination Problems
Neurogenic Bladder
Urinary retention
tx: »normal position, running water,
etc.»catherize