Urinary, Bowel, Elimination, Ostomy

Assisting with Elimination

urinalysis

the examination of urine under a microscope and by chemical means

urinalysis

helps doctors dx kidney disease, metabolic diseases, and infections

midstream or clean catch

prevents contamination of the urine by the bacteria around the urethra; ordered when UTI is suspected

urine culture

tests for the growth and identification of micro-organisms; requires clean catch specimen or specimen from catheter

sensitivity test

follows a culture to determine which antibiotics effectively kill the specific pathogen

reagent strip method

involves dipping chemically treated paper strips into a urine sample, causing the chemical blocks on the paper to change color if certain substances are present in the urine

4.6 - 8.0

normal pH range

about 6.0

normal pH for a urine specimen

specific gravity

measures urine concentration

document the date and time of collection

what to ALWAYS do when collecting specimens

first urine of the morning

used for testing fasting specimens; is the most accurate

kidneys, bladder, ureters, and urethra

the urinary system consists of…

kidney

filters blood, forming urine

to remove waste products from the blood and eliminate excess fluid from the body

the primary function of the urinary system

urination, voiding, micturition

the process of passing urine from the body (3)

beet, coffee, asparagus

foods that can affect urine

onset of confusion or change in mental status

a sign of UTI or cystitis in the elderly

dysuria

difficulty voiding that may be associated with pain

occult

hidden or invisible

hematuria

blood in the urine; may be occult requiring urinalysis

frequency

used to describe voiding that occurs more often than usual; often accompanied by a feeling of urgency

decreased muscle tone in the bladder, dementia, illness/injury affecting the spinal cord, brain or nerves

causes of permanent urinary incontinence

stress incontinence

occurs when pt coughs, sneezes, or exerts themself

urge incontinence

occurs right after feeling a strong urge to void

overflow incontinence

occurs when the bladder is too full of urine

reflex incontinence

occurs when there is damage to the nerves that disables the person from controlling urination

twice daily or as needed

condom catheters are changed…

urinary catheterization

done when a pt is unable to urinate using a toilet, bedpan, urinal, or bedside commode

urinary catheter

a tube that is inserted into the bladder through the urethra to allow the urine in the bladder to drain out

straight catheter

used when the catheter is to be inserted and removed immediately

indwelling catheter

left inside the bladder to provide continuous urine drainage; retention or Foley

suprapubic catheter

a type of indwelling catheter inserted into the bladder through a surgical incision made in the abdominal wall right above the pubic bone

condom catheter

noninvasive, used by men to manage urinary incontinence

urine drainage bags

routinely emptied and measured at the end of each shift or when they are full

allow the urine to fill the bladder, then unclamp, drain and repeat; to train the bladder

when preparing to remove a catheter clamp the tubing of the catheter to…

oliguria

state of voiding a very small amount of urine over a given time

polyuria

state of excessive urine output

anuria

state of voiding <100mL of urine over the course of 24 hours

750 - 2000mL

normal UOP for 24hrs

chyme

mass of digested food formed in the stomach

peristalsis

wave-like muscular movements that move the chyme through the intestines

rect-um

the last part of the large intestine

flatus

a natural by-product of digest (gas)

diarrhea

the passage of liquid, uniformed stool

flatulence

the presence of excessive amounts of flatus in the intestines causing abdominal distention(swelling) and comfort

stool specimens

test for bacterial infections, parasites, and occult blood

fecal occult blood test

FOBT

specimen testing for parasites

should not be refrigerated; transfer immediately

upper GI bleeds

can have emesis that looks like coffee grounds or dark tarry stools

lower GI bleeds

may have bright red bleeding noted in stools; if present needs a FOBT

enemas

the introduction of fluid into the large intestine by the way of the anus for the purpose of removing stool from the rectum

enemas

used to relieve constipation, fecal impactions, and empty the intestine of fecal material before surgery or certain diagnostic tests; ordered by doctor

cleansing, oil retention, commercial

types of enemas used in health care

the enema solution, amount, and temperature are correct

PCTs should ensure this for enemas

105 degress

correct enema temperature

<18 inches above anus, 3 to 4 inches deep

enema bag should be placed

rectal suppository

a small, wax-like cone or oval that is inserted into the anus

rectal suppository

dissolves at body temperature, stimulating peristalsis or lubricating and softening the stool.

glycerin rectal suppositories

often used to help with bowel elimination before resorting to an enema

inserted by a nurse

rectal suppositories that contain medication should be…

ostomy

done when a segment of the intestine needs to be removed due to disease or injury

stoma

an artificial opening made in the abdominal wall with the remaining portion of the intestine connected to it

ileostomy

the ENTIRE large intestine is removed, and the end of the small intestine is attached to abdominal wall; feces are liquidy, pt is prone to dehydration

colostomy

after the diseased part of the large intestine is removed, the healthy end is attached to the abdominal wall; PART is still present

cancer, bowel trauma/disease, diverticulitis

causes for an ostomy