nursing 160 W8

Urinary Elimination Structures

• Kidneys: Primary organs for filtering blood and removing metabolic waste.

• Ureters: Tubes connecting kidneys to bladder for urine transport.

• Bladder: Holds approximately 300-500 milliliters of urine in adults.

• Urethra: Final passage for urine elimination.

Urinary Function

• Proper function of organs and muscles is essential for normal elimination.

• Kidneys filter blood, removing water, electrolytes, and waste products.

• Reabsorption Process: Kidneys retain necessary elements like potassium and maintain metabolic balance.

Gastrointestinal Tract Involvement

• GI Tract: Comprises esophagus, stomach, and intestines for digestion and absorption of nutrients.

• Organs aiding digestion: liver, gallbladder, and pancreas, although not part of the main GI tract.

• Large Intestine (Colon): Absorbs water/electrolytes, and processes waste into stool.

Large Intestine Components

• Cecum: First part of the large intestine.

• Colon: Main area for water absorption and stool formation.

• Rectum & Anus: Final sections leading to fecal elimination.

Peristalsis and Stool Consistency

• Peristalsis: Refers to the rhythmic contractions of the gut.

• Increased Peristalsis: May lead to diarrhea due to insufficient water absorption.

• Decreased Peristalsis: Risks constipation from prolonged stool retention and increased water absorption.

Common Elimination Disorders

Conditions related to urinary and GI elimination can include:

• Incontinence: Loss of control over urination or defecation.

• Retention: Inability to empty the bladder or bowels completely.

• Inflammation: Caused by various infections or diseases.

• Neoplasms: Tumors affecting organ function.

• Organ Failure: Severe dysfunction affecting elimination processes.

Factors Affecting Elimination Control

• Neurological Issues: Cognitive impairments can lead to incontinence.

• Physical Limitations: Difficulty accessing bathrooms can exacerbate elimination problems.

• Skin Breakdown Risk: Prolonged exposure to urine or feces increases risk of skin deterioration.

Urinary Retention

• Urinary Retention: Involuntary inability to fully empty the bladder.

• Causes: Obstruction, inflammation, or neurovascular issues (e.g., in paralyzed individuals).

• Consequences: May lead to bladder distension, infections, and kidney damage (e.g., pyelonephritis).

• Medications Contributing to Retention: Antidepressants, anticholinergics, and antihistamines.

Bowel Issues and Retention

• Bowel Retention: Inability to pass stool effectively.

• Can occur due to ignoring defecation urges or medication side effects (e.g., narcotics).

• Ongoing retention can result in loss of appetite, abdominal discomfort, and fecal impaction.

Assessment and Diagnosis

• Patient History: Regularly assess urinary and bowel patterns, appearance, frequency, and any symptoms.

• Physical Assessment: Involves inspection, palpation, and auscultation of the abdomen for distension or tenderness.

• Lab Tests: Urinalysis, blood tests for renal function (e.g., BUN, creatinine) to evaluate body functions related to elimination.

Urinary Elimination Conditions

• Benign Prostatic Hyperplasia (BPH): Enlargement of the prostate leading to urinary obstruction.

  • Symptoms: Increased urination frequency, nocturia, and difficulty initiating urination.

  • Complications: Risk of urinary tract infections due to urinary retention.

• Acute Kidney Injury (AKI): Sudden decline in renal function, potentially due to causes like dehydration or obstruction.

  • Symptoms: Fluid overload, electrolyte imbalances, nausea, decreased urine output.

• Neurogenic Bladder: Loss of voluntary control over urination stemming from nervous system lesions.

  • Spastic Bladder: Involuntary contractions without control.

  • Flaccid Bladder: Retention without sensation or urge to void.

Treatment and Management Strategies

• Use of medications for BPH: Alpha blockers (e.g., Cardura, Flomax) to improve urine flow.

• Surgical Options: TURP for severe BPH cases.

• Continuous Bladder Irrigation (CBI): Utilized post-TURP to prevent clot formation and ensure urine flow.

• Ostomy Care: Importance of proper care for patients with ostomies to prevent skin irritation and maintain hygiene.

Surgical Procedures Overview

• TURP: A common procedure to alleviate symptoms of BPH.

• Post-Operative Care: Monitoring for bleeding and performing bladder irrigation as necessary.

Concluding Remarks

Overall understanding of urinary and gastrointestinal elimination is crucial for identifying and managing related disorders. Ongoing assessment and patient education are key components of successful elimination management