PHARM: Elimination

What does Type 4 stool on the Bristol Stool Chart indicate?

1. Type 4 normal (sausage like), smooth

Glomerular filtration rate

Creatinine clearance (24 hr urine)

1. how much creatinine gets peed out during 24 hrs

What does Type 7 stool on the Bristol Stool Chart indicate, and what dietary intervention is recommended?

1. Type 7 - severe diarrhea (moving faster through colon ( add fiber to diet)

What does Type 1 stool on the Bristol Stool Chart indicate?

1. Type 1: severe constipation, hard, sepeerate

what is the role of fiber?

1. traps water and helps stool become more softer so that it can pass easier.

What are two key interventions to promote healthy bowel movements and prevent constipation?

1. increase fiber

2. increase fluid intake

Is incontinence a normal finding

1. NO!

2. can be through possible issue of infection, risk of dementia, pelvic floor muscle weakness

What are common changes of elimination in infants, toddlers, children

1. lack control over elimination

2. begin to identity urgency to elimination

What are common changes of elimination in pregnancy?

1. growing fetus increases pressure on the bladder

2. frequent urination

3. risk of constipation

What are common changes of elimination in older adult

1. Decreased renal function

2. less urine production

3. bladder capacity decreases

what medication can cause constipation

1. iron supplements

Which population are at greater risk for problems with digestion and or bowel/urinary elimination

1. Children

2. pregnant people

3. older adults

4. those with short urethra

5. prostate

What sort of drugs can cause urinary retention?

1. opiods

Incontinence can lead to…

1. skin breakdown

2. change in daily activity

3. change in social relationships

Retention can lead to…

1. discomfort/pain

2. if urine stays in too long, urine can backflow to kidney and can cause infection.

3. feces can contribute to constipation

Why might elimination issues such as incontinence or constipation be underreported by patients?

1. patients can often feel reluctant to reveal

Chronic constipation can lead to what severe problem

1. impaction - large, hard mass of stool becomes stuck in the rectum

Describe the fecal occult blood test

1. screening that helps detect GI bleeding and colon cancer.

What lab values indicate a urinary tract infection (UTI)?

1. increase in WBC count.

What dietary factors can lead to a false positive result on a fecal occult blood test (FOBT)?

1. red meat

2. iron supplements

What should not be present in a normal urinalysis?

1. glucose

2. protein

3. High WBC count

4. nitrites

5. leukocytes

6. blood

7. bacteria

One example of a non-invasive test to assess patient urine

1. Bladder scan

What is the difference between a straight catheter and a regular (indwelling) catheter?

1. straight catheter: used for one-time bladder drainage and is removed immediately after use.

2. (Indwelling/Foley) catheter stays in the bladder for continuous drainage, balloon helps hold it in place.

what to complete before inserting catheter

1. complete a bladder scan

bladder scan should be completed if….

1. There is suspicion of urinary retention.

2. after the patient pees in the morning.

3. before catheterization.

primary prevention of elimination

1. adequate hydration -increase fluid intake

2. increase fiber intake

3. regular toileting.

4. increase ambulation - increases peristalsis

secondary prevention of elimination

1. verbal screening of elimination issue

Collaborative interventions to help with elimination

1. nutrition support - dietician

2. incontinence management

3. pharmacotherapy

What should be done only if indicated when assessing or managing urinary retention?

catheterization (only if indicated)

What is the average range of blood urea nitrogen?

1. 8-20 mg/dl

elevated BUN levels indicate which problem of which organ?

1. suggests a problem with the kidneys

what is serum creatinine?

1. waste product from the normal breakdown of muscle tissue

what is the average range of serum creatinine?

1. 0.6-1.3 mg/dl

Define Azotemia

1. elevated BUN level and serum creatinine

Define uremia

1. when the kidney fails and waste products like urea build up in blood.

high ammonia level indicates a problem with which organ

1. problem with the liver