Elimination complete

• Urinary Elimination


  Essential to health and voiding can be postponed for only so long before the urge normally becomes too great to control
• Physiology of Urinary Elimination


  • Depends on effective functioning of: Upper urinary tract, Lower urinary tract, Cardiovascular system, Nervous system

  
• Anatomic Structures of the Human Urinary System


  • Kidneys, Ureters, Bladder, Urethra
• Physiology of Urine


  Kidneys filter waste out of the blood, Ureters carry urine to bladder, Bladder stores urine, Urethra removes urine from body

  
• Everyday our kidneys process around 200 liters of blood and around 1-2 liters of waste is removed as urine

  
• Parts of a Nephron

  • Glomerulus, Bowman's capsule, Proximal convoluted tubule, Loop of Henle, Distal convoluted tubule, Collecting duct
• Ureters


  • 25-30 cm long, 1.25 cm in diameter, Upper end funnel shaped enters the kidney, Lower end enters bladder at posterior corners
• Bladder


  • Hollow organ serving as reservoir for urine
• Urethra


  • Extends from bladder to meatus
• Pelvic floor


  • Contains vagina, urethra, rectum
• Urination Process


  Urge to void happens when bladder contains 250-450 ml of urine in adults, 50-200 ml in children, Emptying the bladder
• Factors Affecting Voiding


  • Developmental, Psychosocial, Fluid & food intake, Medications, Muscle tone, Pathologic conditions, Surgical & diagnostic procedures

  
• Polyuria (Diuresis)


  Production of abnormally large amounts of urine by the kidneys

  
• Oliguria


  Low urine output less than 500 ml / day
• Anuria


  Lack of urine production

  
• Altered Urinary Elimination


  • Frequency, Nocturia, Urgency, Dysuria, Enuresis, Urinary Retention

  
• Types of Urinary Incontinence

  • Stress Urinary Incontinence, Urge Urinary Incontinence, Mixed Urinary Incontinence, Overflow Incontinence

  
• Nursing Diagnoses


  • Impaired urinary elimination, Readiness for enhanced elimination, Functional urinary incontinence, Overflow urinary incontinence, Reflex urinary incontinence, Disturbed body image, Deficient knowledge, Risk for caregiver role strain, Risk for social isolation
• Nursing Interventions for Urinary Elimination


  Maintaining normal urine elimination, Preventing urinary tract infections
• Fecal Elimination


  Elimination of waste products of digestion from the body is essential to health
• Physiology of Defecation


  Large Intestines, Rectum, Anal canal, Nervous system

  
• Products of digestion are flatus and feces
• Rectum


  • Contains folds that extend vertically containing a vein and artery, Folds help retain feces within the rectum
• Anal canal


  • Bounded by internal (involuntary) & external (voluntary) muscle
• Factors affecting hemorrhoids


  • Genetics, Pregnancy, Seating in the toilet for too long
• Process of Defecation


  Expulsion of feces from the anus to the rectum, Feces are 75% water & 25% solid
• Normally feces are brown in color (urobilin) and contain Escherichia coli or staphylococci

  
• Bristol Stool Chart


  Medical aide designed to classify the types of feces

  
• Meconium is the first fecal material passed by the newborn in 24 hrs, it is black, tarry, odorless and sticky
• Fecal Elimination in Infants, Toddlers, School age/Adolescents, Older Adults


  • Infants pass frequent soft stools, Toddlers start bowel control, School age/Adolescents similar to adults, Older adults may suffer from constipation

  
• Nursing Diagnoses related to Fecal Elimination


  • Bowel Incontinence, Constipation, Risk for Constipation, Perceived Constipation, Diarrhea, Dysfunctional Gastrointestinal Motility, Risk for deficient fluid volume, Risk for impaired skin integrity, Situational low self esteem, Disturbed body image, Deficient knowledge, Anxiety
• Elimination

  Promoting regular defecation, Decreasing flatulence, Increase oral fluid intake- Nursing Interventions for Fecal Elimination