Hydration and Elimination

Urinary system

Removes waste products from the blood and maintains the body's water balance.

Urination/Voiding/micturition

Means the process of emptying urine from the bladder.

Normal urine production

The healthy adult produces about 1500 mL (milliliters) or 3 pints of urine a day.

Factors affecting urine production

Age and disease (especially heart and kidney).

Frequency of urination

Affected by the amount of fluid intake, habits, available toilet facilities, activity, work, illness or disease.

Urine observations - Normal

Pale yellow, yellow, or amber color; clear; faint odor; intake should closely match output; without difficulty or pain.

Urine observations - Abnormal

Red, brown, blue, green, orange color; turbid/cloudy; strong odor; small/scant amount; pain or difficulty.

Dysuria

Painful or difficult urination.

Hematuria

Blood in the urine.

Nocturia

Frequent urination at night.

Oliguria

Scant amount of urine.

Polyuria

Abnormally large amounts of urine.

Urinary frequency

Voiding at frequent intervals.

Urinary incontinence

The involuntary loss or leakage of urine.

Urinary urgency

The need to void at once.

Urinals

Men use urinals to void; some need support when standing and may have to place and hold the urinal.

Toilets

Encourage the use of grab bars; raised toilet seats can help prevent falls in the bathroom.

Emergency bathroom call light

Use the emergency bathroom call light in the bathroom.

Assisting with hygiene needs

Don't leave a high risk person alone in the bathroom.

Bladder training methods

Describe methods to help individuals regain control over urination.

Common bowel elimination problems

Describe issues such as constipation, diarrhea, and bowel obstruction.

Enemas

Given to promote bowel elimination; common solutions include saline and soap suds.

Ostomy care

Describe how to care for a person with an ostomy.

Stress incontinence

Urine leaks during exercise & certain movements that cause pressure on the bladder (often called dribbling) can occur with sneezing, laughing, coughing, lifting.

Urge incontinence

(Overactive bladder) Urine is lost in response to sudden, urgent need to void. The person cannot get to the toilet in time. Frequency, urgency, night-time voiding are common.

Overflow incontinence

Small amounts of urine leak from a full bladder. The person feels like the bladder is not empty. May dribble and have weak urine stream.

Functional incontinence

The person has bladder control but cannot use the toilet in time. Immobility, restraints, unanswered call lights, difficulty removing clothing, are causes. Confusion, disorientation, not able to find restroom can also be causes.

Reflex incontinence

Urine is lost at predictable intervals when a specific amount of urine is in the bladder. Nervous system disorders/injuries are common causes.

Transient incontinence

Temporary or occasional incontinence. (physical illness or drugs can cause)

Skin breakdown

Problems with urinary incontinence.

Infections

Problems with urinary incontinence.

Bladder training

What can be done to manage incontinence.

Embarrassment

Problems with urinary incontinence.

Catheters

Devices used to assist with urine drainage.

Low self esteem

Problems with urinary incontinence.

Incontinence products

Such as briefs, help keep the person dry. They usually have 2 layers and a waterproof back.

Isolation

Problems with urinary incontinence.

Depression

Problems with urinary incontinence.

Loss of independence

Problems with urinary incontinence.

Contributes to falls

Problems with urinary incontinence.

Complete incontinence brief

An incontinence product.

Pull-on underwear

An incontinence product.

Belted undergarment

An incontinence product.

Pad and undergarment

An incontinence product.

Kegel exercises

A method included in bladder training.

Weight loss

A method included in bladder training.

Diet change

A method included in bladder training.

Schedule training

A method included in bladder training.

Delayed urination

A method included in bladder training.

Catheter clamping

A method related to urinary catheters.

Urinary Catheters

A catheter is a tube used to drain or inject fluid through a body opening.

Indwelling catheter

(retention or Foley catheter) is left in the bladder.

Catheterization

The process of inserting a catheter.

Straight catheter

Used to empty bladder or collect sample and then removed.

Condom catheter

An external catheter used for incontinent men. It is a soft sheath that slides over the penis and is used to drain urine. Changed daily.

Purewick

An external catheter for women and men. It is connected to suction.

Suprapubic catheter

Inserted into the bladder above the pubis through a surgical opening.

CAUTI

Catheter-associated urinary tract infection.

Closed drainage system

Used for indwelling catheters to prevent contamination.

Defecation

The process of excreting feces from the rectum through the anus.

Feces

The semi-solid mass of waste products in the colon that is expelled through the anus.

Stool

Excreted feces.

Normal elimination

The goal of the care plan to meet the person's elimination needs.

Bleeding in the stomach and small intestine

Causes black or tarry stools.

Bleeding in the lower colon and rectum

Causes red-colored stools.

Stool characteristics

Stools normally are brown, soft, formed, moist, shaped like the rectum, and have an odor.

Privacy

A consideration when observing bowel movements.

High-fiber foods

A dietary consideration for bowel health.

Standard bedpans

Used by persons who cannot be out of bed for voiding and bowel movements.

Fracture pans

Used by persons with casts, in traction, or with limited back motion.

Using a bedpan

The person raises the buttocks off the bed with help, and the bedpan is slid under them.

Commode

A chair or wheelchair with an opening for a container, used by persons unable to walk to the bathroom.

Constipation

The passage of a hard, dry stool.

Fecal impaction

The prolonged retention and buildup of feces in the rectum.

Obstipation

A severe form of constipation where stool or gas cannot be passed.

Constipation relief methods

Includes suppositories, enemas, digital extraction, increasing water and/or fiber, medications, and ambulation.

Diarrhea

The frequent passage of liquid stools.

Fecal incontinence

The inability to control the passage of feces and gas through the anus.

Symptoms of diarrhea

Abdominal cramping, nausea, and vomiting may occur.

Intestinal diseases

Causes of bowel issues.

Nervous system diseases and injuries

Causes of bowel issues.

Aging

A factor that can contribute to bowel issues.

Unanswered call lights

A potential cause of bowel issues.

Irritating foods

A cause of diarrhea.

Microbes in food and water

A cause of diarrhea.

Diet

A factor that can cause diarrhea.

Bowel training

A method to gain control of bowel movements and develop a regular pattern of elimination.

Good skin care

Important for individuals with bowel issues.

Medications aimed at reducing peristalsis

Used to manage bowel activity.

Flatus

Gas or air passed through the anus.

Flatulence

The excessive formation of gas or air in the stomach and intestines.

Exercise

Helps produce flatus.

Walking

Helps produce flatus.

Moving in bed

Helps produce flatus.

Left side-lying position

Helps produce flatus.

Soap suds enema

A type of enema.

Oil enema

A type of enema.

Fleet enema

A type of enema.

Ostomy

A surgically created opening.

Stoma

The opening created by an ostomy.