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Alterations in Elimination

Alterations in Elimination. GI Elimination Urinary Elimination. Alterations in Elimination. Normal Position Thigh Flexion. Factors affecting GI Elimination . Age Young Elderly smooth muscle tone of colon Abdominal muscle tone Anal sphincter control.

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Alterations in Elimination

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  1. Alterations in Elimination GI Elimination Urinary Elimination

  2. Alterations in Elimination Normal Position Thigh Flexion

  3. Factors affecting GI Elimination • Age Young Elderly smooth muscle tone of colon Abdominal muscle tone Anal sphincter control

  4. Factors affecting GI Elimination • Diet Bulk/fiber intake Digestion Spicy foods Eating schedules/routines

  5. 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

  6. Factors affecting GI Elimination • Medications side effects GI medications • Diagnostic Procedures • Preparing the pt • Barium studies

  7. Factors affecting GI Elimination • Anesthesia and Surgery Abdominal surgery Paralytic ileus • Pathologic conditions altered sensory stimulation/sensation Impaired mobility/decreased physical strength/stamina

  8. Factors affecting GI Elimination • Irritants • Pain

  9. Common GI Elimination Problems • Constipation **Always identify the client’s normal bowel elimination pattern**

  10. Constipation: contributing factors • Irregular defecation habits • Laxative abuse/enema abuse • Psychological stress • Diet • Fluid intake • Age • Disease processes

  11. Constipation: complications of • Bowel obstruction • Vagal Response • Fecal impaction • Hemorrhoids

  12. Constipation: Treatment • Medications • Fluid intake • Diet • Activity • Prevention

  13. Common GI Elimination Problems • Diarrhea Treatment Complications

  14. Common GI Elimination Problems • Bowel incontinence • Flatulence Treatment: Position • side lying for rectal tube • Prone with knees flexed under abdomen

  15. Flatulence: Treatment Decreased amt of swallowed air: • Carbonated beverages • Straws • Gum • Hard candies NGT for decompression of abdomen

  16. Common GI Elimination Problems • Hemmorrhoids (piles)

  17. Nursing Process

  18. Factors Affecting Urinary Elimination • Growth and Development Young Elderly • Psychosocial factors privacy “normal position” sufficient time running water

  19. Factors Affecting Urinary Elimination • Fluid/food intake • Medications • Muscle tone/immobility • Pathologic conditions • Surgical/diagnostic procedures

  20. Common Urinary Elimination Problems Definition of normal: 30 ml/hour 45 ml in 5 hours 200 ml in 2 hours How much is “normal” for each voiding? What would be abnormal?

  21. Common Urinary Elimination Problems • Voiding Patterns • Polyuria diuresis • Large fluid intake, ingestion of diuretic • Other s/s: polydipsia dehydration wt loss BP changes

  22. 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

  23. Common Urinary Elimination Problems • Urgency Etiology: UTI Decreased perineal muscle tone • Dysuria Etiology: UTI, urinary catherization

  24. Urinary Incontinence • Total • Stress • Urge, Functional • Reflex*** • Urinary retention with overflow**

  25. Common Urinary Elimination Problems • Neurogenic Bladder • Urinary retention tx: • normal position, running water, etc. • catherize

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