Renal System: Urinary Diversions Quiz

Study Notes

Renal System: Urinary Diversions

Urinary diversions can be temporary or permanent and involve the creation of a stoma using a section of intestine
Continent diversions include:
- Continent urinary reservoir: patient must self-catheterize for the rest of their life and has control
- Orthotopic neobladder: ileal pouch replaces the bladder and the patient voids through the urethra
Incontinent diversions include:
- Ureterostomy: requires a collection pouch and the patient has no control
- Nephrostomy tubes: tubes come out of the back from the kidneys and are used when the ureters are obstructed

Basic GI Anatomy and Function

Factors that affect bowel elimination in patients include:
- Age
- Fluid intake
- Position during defecation
- Pregnancy
- Medications
- Diet
- Physical activity
- Pain
- Mobility

Bowel Elimination Vocabulary

Constipation: a symptom characterized by infrequent stools or hard, dry, and small stools
Impaction: unrelieved constipation resulting in a collection of hardened feces wedged in the rectum
Diarrhea: an increase in the number of stools or unformed feces
Incontinence: inability to control feces
Flatulence: accumulation of gas in the intestines causing the walls to stretch
Hemorrhoids: dilated veins in the lining of the rectum

Bowel Diversions

Ileostomy/colostomy: surgical opening of the ileum or colon
Types of colostomy include:
- Sigmoid colostomy: more formed stool
- Transverse colostomy: thick liquid to soft consistency stool
- End colostomy: usually on the left side, colon is severed and brought to the skin
- Loop colostomy: reversible stoma, 2 openings
Antegrade continence enema: enema through a catheter in the abdominal wall (some pediatrics)
WOCN: Wound Ostomy Continence Nurse

Diagnostic Exams

Colonoscopy: surgery of the lower GI tract (large intestine, colon, and rectum)
Endoscopy: surgery of the upper GI tract (esophagus, stomach, and small intestine)
Barium swallow: examination of the motility of the GI tract
CT and MRI scans: diagnostic imaging tests
Fecal specimens: tests for bowel function and disorders

Cathartics, Laxatives, and Antidiarrheals

Cathartics: stronger and more rapid effect on the intestines than laxatives and suppositories
Laxatives: empty the bowel (not long-term use)
Overtaking cathartics and laxatives may cause impaired bowel motility and decreased response to sensory stimulus
Cathartics and laxatives are used for GI tests, surgery, and constipation
Antidiarrheals: treat the cause (specific) or symptoms (nonspecific) of diarrhea

Enemas

Cleansing enemas: promote complete evacuation of feces from the colon
Types of enemas include:
- Tap water enema: hypotonic, lower osmotic pressure than fluids
- Normal saline enema: isotonic, same osmotic pressure as fluids
- Hypertonic solutions enema: pulls fluid out, beneficial for patients unable to tolerate large volumes of fluid
- Soap suds enema: causes intestinal irritation to stimulate peristalsis
- Oil retention enema: lubricates the feces to make it easier to pass
- Carminative and kayexalate enema: relieves gaseous distension and causes diarrhea to bring potassium down
- Digital removal of stool: last resort

Description

Test your knowledge on urinary diversions in the renal system. Learn about various types of diversions created from sections of the intestine, including continent and incontinent diversions, and the different techniques involved such as continent urinary reservoir and orthotopic neobladder.