POO and PEE med surg

post enema nursing interventions

monitor fluid and electrolyte imbalances tissue trauma vagal nerve stimulation dependence

Enteral locations

nasogastric esophagostomy gastrostom nasoduodenal jejunosotmy

antidiarrheals

opiods, immodium, perogoric, kaopectate, antibiotics

indicators for INTERMITTENT catherization

over distended bladder, sterile urine specimen, assessing reidual volume (50 ml) epmtying for incompetent bladder

Best indicator of fluid status

patient weight

stool

poop outside the body

Indicators for SHORT TERM Catherization

post surgery, urinary retention preven blood clot obstruction, sacral wounds, post-delivery less than 2 weeks

catheter care

prevent kinks remove as soon as possible keep system closed replace every 4-6 weeks

defecation

process of going poop

Tube feeding administration

pt should be sitting HOB elevated for 30 to 60 min water irrigation before and after residual checks 200 to 500 ml per feeding

peristalsis

smooth muscle contraction

Urinary Obstructions

stones strictures (pinching) enlarged prostate **must be corrected or may lead to renal failure

Feces

stool INSIDE the colon

valsalva maneuver

straining with a closed airway

types of incontinence

stress - small amount urge - sudden desire mixed - combo of both *women more than men^ overflow reflex - neuro functional - problems with mobility, cognition, etc.

24 hour urine collection

void first one this tells us about kidney fx

Factors affecting defecation

age, pattern, food, fluid, lifestyle, diversions, motor and sensory disturbances, pathological, medications, surgery, pregnancy

Renal lithiasis

aka kidney stones

Diagnostic tests and assessments

auscultation and palpation visualization xray

Catheter specifics

balloon size usually 10ml lumens per catheter 1-3 keep foley b ag lower than bladder sizes 14-16 cm for men and 12-16 cm for women

incontinence tx

bladder training electodes estrogen catheters absorbent products medications - ditropan and detrol sacral nerve stimulation surgical

Factors affecting urinary elimination

bladder/kidney infections kidney stones hypertrophy of the prostate mobility problems decrease blood flow through glomeruli neurological conditions communication problems alteration in cognition

autonomic bladder

brain or spinal cord injury reflex incontinence controlled with intermittent catherization

types of laxatives

bulk-forming lubricating saline stimulants

child vs adult bladder volume

child: 50-200ml adult: 200-500ml

Enteral nutrition delivery methods

continuous infusion by pump intermittent by gravity intermittent bolus by syringe cyclic feedings by infusion pump

diagnostic urine tests

cystoscopy urodynamic tests - how well able to store and how well able to eliminate imaging - ct or ultrasound

hypertonic enema

distends colon and irritates mucosa

isotonic enema

distends colon stimulates peristalsis and softens feces

hypotonic enema

distends colon, stimulates peristalsis, and softens feces

pros of enteral nutrition

easily administered, safter, efficient, less expensive

Peeing process

filling of bladder activiation of stretch receptors signaling to voiding reflex center contraction of detrusor muscle conscious relaxation of external urethral sphincter

Urinary retention interventions

fluid management monitor BUN and creatinine

types of urine collections

freshly voided clean catch sterile specimen 24-hour urine

Urinary assessment

habits, changes, aids, difficulties, alterations, kidneys bladder urethra skin, hydration, medications

knowing when you have to go because of..

higher nerve centers

UTI assessment and care

hygiene & cotton underwear pee after sex pee every 2-4 hours cranberry juice or vitamin c adequate fluid intake report signs of infection ASAP (pain when peeing, cloudy pee, increase in urgency and frequency, odor) take all antibiotics

types of enemas

hypertonic hypotonic isotonic soap oil

Urinary Retention

inablity to empty bladder caused by anesthesia, spinals, meds, obstruction 50 ml retained

risk for stone development

increased calcium obesity dehydration genetics warm climate

indicators for LONG TERM catherization

irreversible incontinence, terminally ill, inrreversible urinary retention and stage 3-4 sacral wound more than 4 weeks

soap enema

irritates and distends

Lifespan considerations for bladder

kidney function decreases loss of bladder elasticity

Lab studies of poop

looking for occult blood, fecal fat, ova and parasites

oil enema

lubricates

process of bowel elimination

1. fecal material reaches rectum 2. stretch receptors initiate contraction of sigmoid colon/rectal muscles 3. internal anal sphincter relaxes 4. sensory impulses cause voluntary "bearing down" 5. external sphincter relaxes

post enema retain time

15 min

Amount collected in urine sample

15-30ml

kidney stones collaborative care

1st treat the pain, infection, obstruction opioids stent 2nd evaluate cause history

ml of urine in bladder

200-500

post suppository retain time

30-40 min

Kidney stones clincical manifestations

UPJ UVJ abdominal/flank pain hematuria renal colic

Relationship between cardiac and urine

Urine output depends on cardiac output and vessels -- so if blood flow decreases due to low blood pressure or congestive heart failure then urine output will decrease

Bowel Training

-plan with pt. -increase fiber gradually -increase fluid -establish a time -privacy -need for stool softener -assess and modify

Alterations in urinary elimination

MED dx - UTI NURSE dx - urinary retention, urinary incontinence ALT urinary diversion/urostomy