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Altered Elimination (Urinary Dysfunction (General manifestations (altered…

- - - - In kidneys
      - In bladder
      - renal tubules
    - - low flow rate
      - increased [sodium]
      - low pH
      - can block essential urinary and renal function
        
        trapped RBC can indicate glomerulonephritis
        
        Epithelial cells may indicate sloughing tubular cells
        
        acute tubular necrosis
        
        increased WBC
        
        pylenephritis
  - - - neuronal control involving
        
        Neurons of PNS and CNS
        
        Neurotransmitter production and availabitiy
        
        Coordination of neuronal impulses from initiation to action
      - from generation of impulse to action potential to nerve impulse, failure to provide appropriate stimulus for desired response results in limited or absent ability to eliminate urine.
      - Exaggerated neuronal response leads to increased premature urine release
      - peristalsis in renal tubles
      - contraction or relation of smooth muscle
      - conscious control of circumstance involving the timing of urination may impair elimination as a consequence of altered mobility or resting reduction of toileting independence.
  - - - can lead to necrosis of tissue
        
        leads to pain, bleeding, and obstruction of branches of venous system.
  - - - degree of obstruction (either partial or complete)
      - duration of obstruction
      - acuity or chronic nature of condition
    - - Ischemia and necrosis can be caused due to obstruction adding perfusion impairments
      - can be caused by precipitants in smaller lumen structures
      - structural blockages resulting from exogenous or endogenous sources
        
        like polyps, or tumors
        
        Mechanical blockages result
        
        altered urine output
        
        adhesion
        
        tumors
        
        inflammation
  - - - oliguria
      - anuria
    - - sharp pains due to distention in renal capsule and pain is due to the stretching cause activation of nociceptive pain receptors
    - - increased RBC in urine
        
        kidney disorders
        
        glomerular damage
        
        UTI
        
        Acute tubular necrosis
    - - w/ fever => Pylenonephritis
- - - - development of edema in wall of large intestine
        
        reduces absorption capacity
    - - gas
      - fluid
    - - can cause bacteria to get into circulation
        
        leading to sepsis
  - - - loss of propulsive activity
        
        abdominal surgery
        
        electrolyte imbalance
        
        affecting contractile function
        
        peritonitis
        
        spinal trauma
      - emotional stress can alter stool elimination
        
        influence on CNS and integrative process involved in elimination
        
        reduction in activity would also reduce elimination
        
        walking, swimming, being active enhances neuromuscular activity and coordination with the large intestine promoting elimination
        
        longer feces remain in large intestine, more water is drawn out of it,
        
        abdominal pain can be caused by increased distention due to impaired flatus elimination as a byproduct of digestion
  - - - alter nutrition
      - impair water and nutrient absorbtion
      - enhance water loss and electrolyte loss
    - - alters storage time in large intestine
      - promotes waste products to recirculate
    - - Lactobacillus acidophillus and Bifidobacterium bifidum promote motility
      - Escherichia coli inhibits motility
    - - Diarrhea
      - constipation
  - - - Pain and altered bowel function as a result
      - ischemia
    - - can be due to infection or excessive perfusion demands
  - - - Barium Enema
      - Colonoscopy
      - Sigmoidoscopy