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Alterations in Elimination

GI Elimination

Urinary Elimination

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Alterations in Elimination

Normal Position

Thigh Flexion

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Factors affecting GI Elimination

Age

Young

Elderly

smooth muscle tone of colon

Abdominal muscle toneAnal sphincter control

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Factors affecting GI Elimination

Diet

Bulk/fiber intake

DigestionSpicy foods

Eating schedules/routines

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Factors affecting GI Elimination

Fluid Intake

2000 3000 ml/day

Mobility/Immobility

Psychological Consideration

Life-style Considerations

Early bowel training

Availability of toilet facilities

Embarrassment

Privacy issues

Time management

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Factors affecting GI Elimination

Medications

side effects

GI medications

Diagnostic Procedures

Preparing the ptBarium studies

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Factors affecting GI Elimination

Anesthesia and Surgery

Abdominal surgery

Paralytic ileus

Pathologic conditions

altered sensory stimulation/sensation

Impaired mobility/decreased physicalstrength/stamina

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Factors affecting GI Elimination

Irritants

Pain

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Common GI Elimination Problems

Constipation

**Always identify the clients normal

bowel elimination pattern**

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Constipation: contributing factors

Irregular defecation habits

Laxative abuse/enema abuse

Psychological stressDiet

Fluid intake

AgeDisease processes

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Constipation: complications of

Bowel obstruction

Vagal Response

Fecal impactionHemorrhoids

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Constipation: Treatment

Medications

Fluid intake

DietActivity

Prevention

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Common GI Elimination Problems

Diarrhea

Treatment

Complications

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Common GI Elimination Problems

Bowel incontinence

Flatulence

Treatment:Position side lying for rectal tube

Prone with knees flexed under

abdomen

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Flatulence: Treatment

Decreased amt of swallowed air:

Carbonated beverages

StrawsGum

Hard candies

NGT for decompression of abdomen

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Common GI Elimination Problems

Hemmorrhoids(piles)

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Nursing Process

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Factors Affecting Urinary Elimination

Growth and Development

Young

Elderly

Psychosocial factors

privacy

normal position

sufficient time

running water

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Factors Affecting Urinary Elimination

Fluid/food intake

Medications

Muscle tone/immobilityPathologic conditions

Surgical/diagnostic procedures

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Common Urinary Elimination Problems

Definition of normal: 30 ml/hour

45 ml in 5 hours200 ml in 2 hours

How much is normal for each voiding?What would be abnormal?

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Common Urinary Elimination Problems

Voiding Patterns

Polyuria diuresisLarge fluid intake, ingestion of diureticOther s/s:

polydipsia

dehydrationwt loss

BP changes

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Common Urinary Elimination Problems

Oliguria and anuria

etiology:

low fluid intake***

Renal, Cardiac Pathology

Frequency and nocturia

etiology:

fluid intake

UTI

Pregnancy

Renal pathology

Diuretic therapy

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Common Urinary Elimination Problems

Urgency

Etiology:

UTIDecreased perineal muscle tone

Dysuria

Etiology:

UTI, urinary catherization

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Urinary Incontinence

Total

Stress

Urge, FunctionalReflex***

Urinary retention with overflow**

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Common Urinary Elimination Problems

Neurogenic Bladder

Urinary retention

tx:normal position, running water,etc.

catherize