Elimination

Question 0

Factors Affecting Fecal Elimination

Answer 0

• age
• infection
• diet (high starch)
• fluid intake
• physical activity
• habits
• bedridden=constipation
• position (lying difficult)
• pregnancy (constipation)
• pain (constipation)
• surgery and anesthesia
• meds
• diagnostic tests
• pathological conditions
• G&D (kids scared)

Question 1

Fecal Elimination Assessment

Answer 1

• colour–>tarry (blood), clay (bile)
• odour
• consistency
• frequency
• amount
• shape
• constituents–>other things in it

Question 2

Constipation Interventions

Answer 2

• timing–>what is happening later
• positioning
• privacy
• nutrition
• fluids
• exercise helps peristalsis
• health teaching
• use of bedpan/commode

Question 3

Risks

Answer 3

Constipation

• hemmorhoids–>hurts and therefore become more constipated
• fecal impaction

Diarrhea

• fluid and electrolyte imbalance
• skin breakdown–>irritating and painful
• fatigue, malaise, weakness–>fluid loss

Question 4

Abdominal Assessment

Answer 4

Prep
-empty bladder, privacy, good light, supine, warm

Inspection

• at eye level, describe using quadrants
• skin, umbilicus, contour, symmetry, movement, size
• ascites–>fluid collection, shiny appearance

Auscultation

• bowel sounds indicate peristalsis
• all 4 quadrants (start at LRQ, 1 min. each)
• note frequency and character, normal is 5-30/min.
• hyperactive, hypoactive, borborygmi (rapid, like storm)

Palpation
-lumps, bumps, hardness, temp.

Question 5

Urinary Elimination

Answer 5

• aka micturition, voiding, urination
• enuresis–>involuntary passing of urine
• nocturnal enuresis–>bed wetting
• retention–>unable
• urinary incontinence
• polyuria–>excessive amount
• oliguria/anuria–>absence of
• dysuria–>painful/difficult

Question 6

Characteristics of Urine

Answer 6

• colour–>straw-coloured, amber
• clarity–>clear, cloudy
• odour–>not normal
• specific gravity–>1.010-1.025
• constituents
  
  • no blood (know if menstruating)
  • MO, glucose, ketones, pus

Output

• 1200-1500mL
• I/O should be relatively equal over 24hrs
• min. 30ml/h

Question 7

Factors Affecting Urinary Elimination

Answer 7

-disease
-G&D
-culture
-psychological factors
-muscle tone
-diet
-fluid balance (caffeine, alcohol)
-surgical procedures
-meds (diuretics)
diagnostic tests

Question 8

Interventions/Health Teaching-Urinary

Answer 8

• promote fluid intake
• maintain normal habits
• positioning
• strengthen muscle tone (Kegal increases tone in bladder)
• provide hygiene
• explain not to hold, but respond to urge
• encourage voiding by
  
  • running water
  • warming bedpan
  • fingers in water
  • Credes Maneuver (push on bladder)
  • warm water over perineum