Across the Lifespan
Fluid overload and limited concentration and dilution of urine.
Newborns are at risk for what urinary alteration?
Polyuria (polydipsia), Oliguria, Anuria
What are common alterations in urine production?
What subjective and objective information is important during the patient interview?
Presence of urine odor, Voiding pattern, elimination problems.
What are alterations in bowel elimination?
Diarrhea, constipation, incontinence, obstruction
What are some nursing interventions in managing elimination problems?
I&O, catheter care, specimen collection, patient teaching, skin care.
Control is established between 2 and 5, easier during the day.
When is urinary and bowel control established for toddlers and preschoolers?
Urinary incontinence, retention, frequency, and urgency.
What are common alterations in urinary elimination?
What are we looking for during a physical examination?
Bladder distension or pain, flank pain, abdominal pain, skin turgor, mucous membranes
What are risk factors for bowel elimination alterations?
Age, medication, immobility, chronic disease
What are treatments for alterations in urinary elimination?
Diuretics, Anticholinergic, Cholingergic, Antibiotics, and Dialysis
Prescription diuretics, weakened pelvic floor muscles, kidneys excrete more fluid and electrolytes at night
Reasons why the older adult might have urinary alterations
age, women, smoking, obesity, inactivity, medications.
What are risk factors for urinary incontinence?
What are diagnostic labs for elimination problems?
Urinalysis (UA), BUN/Creatinine, Fecal occult tests
What can lead to a paralytic ileus?
Surgery or medications (anything that inhibits the muscles of the intestines pushing food through)
What are pharmacologic treatments for bowel elimination?
Laxatives, antidiarrheals, stool softeners
Chronic constipation related to long term laxative use.
Older adults are at risk for what bowel alteration and why?
After surgery, a patient is having difficulty voiding. Which nursing action would most likely lead to an increased difficulty with voiding?
a. Pouring warm water over the patients fingers
b. Having the patient ignore the urge to void until her bladder is full
c. Stroking the patient's leg or thigh
d. Using a warm bedpan when the patient feels the urge to void
b. Having the patient ignore the urge to void until her bladder is full
What are some diagnostic tests for elimination problems?
bladder scans, radiology exams (CT, Ultrasound),Colonoscopy
A nurse is caring for a patient who has been experiencing diarrhea for the past 48 hours. The patient reports feeling weak, has abdominal cramping, and has had multiple loose stools. Which of the following interventions should the nurse prioritize to address the patient’s condition?
A) Encourage the patient to drink clear fluids and administer oral rehydration solutions as prescribed.
B) Restrict all fluids to prevent further bowel irritation.
C) Administer an antidiarrheal medication to stop the diarrhea immediately.
D) Recommend the patient increase fiber intake to bulk up the stool consistency.
Encourage the patient to drink clear fluids and administer oral rehydration solutions as prescribed.
A patient is diagnosed with urinary retention following abdominal surgery. The healthcare provider orders an intermittent catheterization schedule for the patient. What is the most important nursing action before performing intermittent catheterization?
A) Assess the patient's level of pain and provide analgesia as needed.
B) Ensure the patient has voided spontaneously within the last 6 hours.
C) Obtain a urine sample for culture before catheter insertion.
D) Educate the patient on the purpose of the procedure and obtain informed consent.
Educate the patient on the purpose of the procedure and obtain informed consent.
Urinary frequency, glycosuria, UTI
Pregnant women are prone to what elimination alteration?
The nurse is instructed to assess the patient’s postvoid urine residual volume. Which is the best method by the nurse to perform this task?
Utilize a bladder scanner
Perform an intermittent catheterization
Instruct the patient to attempt to void again immediately
Apply pressure to the patient’s suprapubic area while the patient is on a bedpan
Utilize a bladder scanner
A patient who is recovering from abdominal surgery reports feeling constipated and has not had a bowel movement for 4 days. The nurse notes the patient is receiving opioid pain medication. What is the most appropriate initial nursing action?
A) Administer a laxative as prescribed to promote bowel movement.
B) Encourage the patient to increase fluid intake and ambulate as tolerated.
C) Ask the patient to consume a high-fiber diet to stimulate bowel movement.
D) Perform a digital rectal exam to assess for impaction.
Encourage the patient to increase fluid intake and ambulate as tolerated.
A nurse is caring for a patient who has been prescribed a stool softener following abdominal surgery. The patient asks why the medication is necessary. Which of the following responses by the nurse is the most appropriate?
A) "The stool softener will help prevent you from straining during bowel movements, which could cause injury."
B) "The medication will stimulate your bowels to move more frequently and relieve constipation."
C) "It will make your stool more solid so you can have more formed bowel movements."
D) "Stool softeners help to reduce the amount of gas produced in your intestines."
"The stool softener will help prevent you from straining during bowel movements, which could cause injury."
A nurse is caring for a patient who has been prescribed a bulk-forming laxative for constipation. The nurse should instruct the patient to take which of the following actions to prevent complications associated with the use of this medication?
A) Increase fluid intake to at least 2 liters per day.
B) Limit fluid intake to avoid diarrhea.
C) Avoid ambulating after taking the medication to prevent injury.
D) Take the medication with a high-fat meal to improve absorption.
Increase fluid intake to at least 2 liters per day.