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ELIMINATION

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urinary elimination anatomy and physiology anatomy female structures male structures urine 96% water 4% solutes organic solutes urea* ammonia creatinine uric acid ... – PowerPoint PPT presentation

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Title: ELIMINATION


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

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

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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