Elimination Needs PDF

Elimination needs Dr/ Assma Lasheen Medical Surgical Department Elimination Process Elimination of urine Elimination of stool Elimination of Urine Physiology of Urinary Elimination Urinary elimination depends on effective functioning of the upper urinary tract: kidneys and uret...

Elimination needs Dr/ Assma Lasheen Medical Surgical Department Elimination Process Elimination of urine Elimination of stool Elimination of Urine Physiology of Urinary Elimination Urinary elimination depends on effective functioning of the upper urinary tract: kidneys and ureters; and the lower urinary tract: urinary bladder, urethra, and pelvic floor Eliminatio n Definition Urination, micturition and voiding all refer to the process of emptying the urinary bladder Urination process: 1-The body usually eliminates urine every two-three hours if 2-The body needs 2,000-3,000 mL of fluid each day. Provide adequate fluids, especially water and fruit juices. 3-Urine collection in the bladder until pressure stimulate special sensory nerve ending in the bladder called stretcher receptor 4-When the adult bladder containing between 250 and 450 ml of urine. In children 50 to 200 ml stimulate Urinary elimination depends on effective functioning of four urinary tract organ: kidneys Ureters bladder Urethra.  Normal Urine Characteristics Color: a straw yellow color and is clear and free of sediment or mucous. Amount: The usual amount voided is 200-300 mL five to six times a day; or 1,000 to 1, 500 mL every 24 hours; however, this amount varies by individual. Frequency of urination depends on fluid intake. Most people void at least every three hours while awake. Medication: some medications can Factor affecting voiding process: Age: Aging affects all of the body systems including the urinary system. With age the bladder opening weakens which may result in urinary incontinence and dribbling. A decrease in bladder muscle tone occurs that leads to urinary retention and infections. The aging kidneys’ ability to filter  Psychological factor (Anxiety, Fear, Depression , Panic attack Fluid and food intake (Coffee , tea, cola intake and citrus fruit ) Medication: (Diuretics , Antipsychotic and lithium) Muscle tone Pathologic condition: Altered urinary production and process 1. Polyuria: The production of abnormal large amount of urinary by the kidneys. 2. -Oliguria and anuria: are used to describe as decreased urinary output. -Oliguria: is a low urine output. usually less than 500 ml a day or 30 ml an hour. -Anuria: very low or no urine It is usually expressed in a term of the number of time the person's get out of bed to void. - 5-Urgency: is the feeling that the person must void. There may be or may not a great deal of urine in the bladder 6-Dysuria: means voiding that is either painful or difficult. 7-Urinary hesitancy: a delay in initiating voiding. 8-Enuresis: is involuntary urination in 8-Nocturnal enuresis: or bed wetting involuntary passing of urine during sleep. 9-Urinary incontinence: is the inability to stop or control the passage of urine , involuntary urination is symptom not a disease, physiologic or psychological. 10-Urinary retention: when emptying the bladder is impaired, urine accumulate and the bladder become Urinary alteration: 1) Urinary retention: is the inability to empty the bladder caused by poor muscle tone of bladder, obstruction of urethra, or damage to certain areas of nervous system. The client with urinary retention usually complains of difficulty passing urine and urinates in small  Urinary incontinence. Types of incontinence. Stress incontinence is the inability to control the passage of urine when pressure is placed on the bladder when coughing, sneezing, laughing, exercising, or pressure on the lower  Urge incontinence occurs when the client is unable to control the passage of urine long enough to reach a bathroom after experiencing the urge to urinate. This may be seen in a client with a urinary tract infection or an elderly  Neurogenic incontinence occurs as the result of an injury or disease of the nervous system that affects the client’s ability to feel the urge to urinate. Functional incontinence caused by disease conditions or disabilities that create strong urges to void or bladder contractions that Elimination Of stool Factors That Maintain Normal Bowel Elimination 1-privacy and embarrass the client by comments or actions. 2-Adequate fluid intake makes the stool softer and increases the bulkiness of the stool. -Most clients should have 2000- - 2-A diet containing fiber helps to maintain normal bowel elimination. - Fiber holds water in the colon and makes the stool softer. - Fibrous foods are slightly irritating to the bowel and move wastes along more rapidly. - Fresh fruits, fresh vegetables, prunes, and bran are allgood sources of fiber. 4- Physical activity, such as ambulation, produces a “massaging” action of abdominal muscles to the intestines, promoting peristalsis. 5-Ambulation if possible. If the client is on bed rest or confined to a wheelchair, encourage active ROM, and change the client's position every two hours, or according to the service 6-Usual bowel habit :Most people defecate at a certain time of day, sometimes more easily after eating or drinking certain foods or fluids. - Find out from the client or a family member past bowel habits – how often, time of day, and any routine assistance from suppositories/enemas/medications. Characteristics of Normal and Normal stool Abnormal stool Abnormal Color Stool light to dark Abnormal color brown in color such as green, white, yellow or black. Black stool may be caused from bleeding in the gastrointestinal tract. Consistency soft or formed liquid or very hard OR contains undigested food, blood, or mucus Frequency Some people Diarrhea or defecate three constipation times a day while Conditions That Cause Abnormal Bowel Function: 1-Constipation and Impaction Definition of constipation Is the passage of unusually dry, hard stools. Etiology: When stool is in rectum for along 3-damage to nervous system that prevents messages from getting to client's brain. 4-Limited mobility and lack of assistance in getting to the bathroom Management: 1-Provide privacy 2-Increase fluid intake and fiber diet 3-Maintain regular bowel habit 4-Regular physical exercise 4-Stoole softener  Fecal impaction occurs when a hard mass of stool that cannot be passed normally forms in the bowel. Liquid stool passes around the blockage. - A client with constipation or an impaction may also have stool  2-Diarrhea Definition: is the frequent passage of liquid stools. Mangement : 1-Note the color, consistency, amount, and frequency of stool. 2-Encourage clear fluids. If not, 3-It is especially important to keep perineal area clean and dry when the client has diarrhea.  4-Hemorrhoids Definition: Are varicose veins in the rectum. Lay term for hemorrhoids is “piles.” They may protrude from the anus, be very tender, and bleed from irritation. Causes: Hemorrhoids can be aggravated by straining due to constipation. Family history Pregnancy Management: Therapeutic bath with warm water and betadin Analgesic and anti inflammatory ointment Hemorridectomy  4-A bowel obstruction Definition : Is a blockage in the intestine that does not allow stool to pass through. Causes :It can be caused by a twisting of the bowel, a tumor, or a large impaction of stool. Management :surgical  5-Bowel incontinence Definition : Is the inability to stop or control the passage of stool. Causes: 1-Confusion 2-sphincter muscle weakness  h a n k T Yo u