Promoting Urine Elimination

Concepts of Nursing NUR 123

Factor affecting voiding

Developmental factor: Infant may urinate 20 times a day. The output decreased at older people according to the decrease of renal function.

Fluid and food intake: the healthy body maintains a balance between the amount of fluid ingested and the amount of fluid eliminated. Some foods and fluid change in urine color.

Medications: diuretics increase urine formation.

Pathologic conditions: such as kidney or heart disorders.

Psychosocial factors: such as not suitable time or place.

Altered urine production and elimination

1- Hematuria: red blood cell in the urine.

2- Dysuria: painful or difficult urination.

3- Anuria: total urine out put less than 50 ml in 24 hr.

4- Oliguria: total urine out put less than 500 ml in 24 hr.

5- Urinary frequency; is voiding at frequent intervals, that is more than usual.

6- Urgency: is sudden strong desire to void.

Assessment

A complete assessment of the patient's urinary function include:

Nursing history: normal voiding pattern and frequency, appearance of urine and any recent changes, habits of diet and fluid intake.

Physical examination of the genitourinary system, hydration status, and examination of the urine:

Assessment

Measuring urinary output normally, the kidney produce urine at a rate of approximately 60 mL per hr or about 1500 ml per day, urine out put below 30 ml/hr indicate kidney malfunction.

Diagnostic tests: blood urea nitrogen, creatinine and urine analysis.

Diagnosis

Impaired urinary elimination.Functional urinary incontinence.

Planning: Maintain or restore normal voiding pattern

Promoting Bowel Elimination

Concepts of Nursing NUR 123

Process of Peristalsis

Peristalsis is a wavelike movement produced by the muscle fibers of the intestinal wall.

Peristalsis is under control of the nervous system.

Contractions occur every 3 to 12 minutes.

One-third to one-half of food waste is excreted in stool within 24 hours.

Variables Influencing Bowel Elimination

Developmental considerations.

Daily patterns.

Food and fluid intake.

Activity and muscle tone.

Lifestyle, psychological variables.

Pathologic conditions.

Medications.

Surgery and anesthesia.

Nursing Interventions to Promote Normal Bowel Elimination

The nurse can help the patient to achieve a regular defecation by attending to:

Privacy

Timing- Patients should be encouraged to defecate when the urge to defecate is recognized.

Nutrition and fluids

Exercise- Ambulation helps to stimulate normal motility, and therefore should be encouraged in post-surgical patients.

Positioning

Nursing Interventions for constipated patients

Increase fluid intake. Instruct the patient to drink fruit juices.

Include fiber in the diet with foods.

Administration of laxatives.

Administration of Enema

Nursing Interventions for patients with diarrhea

Encourage intake of fluids and food.

Eating small amounts of bland foods.

Encourage the ingestion of food or fluids containing potassium, since diarrhea can lead to great potassium losses.

Avoid excessively hot or cold fluids and highly spiced foods and high fiber foods that can aggravate diarrhea.

Promoting Proper Nutrition

Concepts of Nursing NUR 123

Functions of Nutrition

1. Providing energy for body processes and movement.

2. Providing structural material for body tissues.

3. Regulating body processes.

Factors Affecting Food Habits

1. Age.

2. Religion.

3. Culture.

4. Education.

5. Socio-economic status.

6. Lifestyle.

7. Health status.

8. Medications.

9. Psychological factors.

Nursing Interventions

1. Screening patients for nutritional risk.

2. Observing intake and appetite.

3. Evaluating the patients tolerance.

4. Assisting the patient with eating.

5. Administering enteral and parenteral feedings.

6. Consulting with the dietitian and physician.

7. Addressing potential for drug-nutrient reactions.

8. Participating in nutrition education efforts.