Metro Community College
Nursing Program
Nancy Pares, RN, MSN
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Terms used for expelling urine
◦ Urination
◦ Micturition
◦ Voiding
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Know anatomy and physiology
◦ Kidney, nephron, glomerulus
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Stage of growth and development
Psychological factors
Sociocultural factors
Personal habits
Muscle tone
Fluid intake
Disease conditions
Surgical procedures
Medications
Diagnostic procedures
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Urinary retention
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Lower UTI
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incontinence
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Total
Functional
Stress
Urge
reflex
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Urgency
Dysuria
Frequency
Hesitancy
polyuria
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Oliguria
Nocturia
Hematuria
Retention
residual
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Intake and output
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Color
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Clarity
odor
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Ph
Protein
Glucose
Ketones
Blood
Specific gravity
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Clean voided
Midstream
Sterile
24 hour
Culture and sensitivity
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Positioning
Run water
Immersion
Privacy and time
Adequate fluids
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Intermittent
Indwelling
Bladder distention
Prevent skin breakdown
Obtain sterile speciman
Assess residual
Relieve obstructed flow
Surgical procedure
Accurate intake and output
Bladder irrigation
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Keep system closed
Keep bag below bladder
Don’t let bag touch floor
Coil excess tube on bed
Check for kinks
Encourage fluid intake
Cath care x2 daily
Empty collection bag every shift
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Defecation
◦ Reflex occurs when the fecal mass enters rectum
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Voluntary and involuntary
Sphincter relaxation
Valsalva maneuver
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Age
Diet
Position
Pregnancy
Diagnostic tests
Fluid intake
activity
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Psychological factors
Habits
Pain
Medications
surgery
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Irregular habits
Inadequate fluids
Lack of exercise
Low fiber diet
Habitual laxative use
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No stool
Continual oozing
Loss of appetite
Abdominal distention
Cramping
Rectal pain
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Emotional stress
Intestinal infection
Allergies or intolerances
Medications
Colon disease
Surgical procedures
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Spinal cord trauma
Multiple sclerosis
Cerebral vascular accident (CVA)
Muscle tone decreased
pathological
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Accumulation of gases
Increased with decreased mobility or
obstruction
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Increased venous pressure
Excessive straining
Pregnancy
Congestive heart failure
Liver disease
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Infant---yellow
Adults---brown
◦ soft formed
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Additional notations
◦ Frequency
◦ Shape
◦ constituents
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Guaic/hemacult
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Melena
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Ova and parasites
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Diet
positioning
Exercise
Digital stimulation
Timing of defecation
Cathartics/laxatives/enemas
privacy
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Tap water
◦ Stimulates by distention
◦ 750-1000 cc
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Saline
◦ Stimulates by distention
◦ 1 tsp salt
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Hypertonic
◦ Draws fluid into the colon (distention)
◦ 4 ounces of fluid
◦ Ex: fleets
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Soapsuds
◦ Irritates mucosa
◦ Castile soap
◦ 7500-1000 cc
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Oil retention
◦ Low volume
◦ Softens feces
◦ Must retain for extended time
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Up and down flush
◦ Aids expulsion of gas
◦ Small amt of fluid introduced, lower bag--repeat
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Explain procedure
Sim’s position
Lubrication tube 3-4 in.
Insert tube gently toward umbilicus
Do not raise container more than 18 in above
anus
Ask client to retain as long as tolerable
Record type and amount of soln and content
return
Observe for intolerance: