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Alterations of Elimination (Urine (Perfusion (Increased perfusion…
Alterations of Elimination
Bowels
Neuromuscular Function
Altered signal transduction
Altered muscle response
caused by
Electrolyte imbalance
Reduced activity/loss of mobility
Abdominal Surgery/Spinal Trauma
treatment
Assistive devices and retraining programs for bowel habits
Gas build-up, painful flatulence, reduced smooth muscle contraction
Patency
Space occupying lesion (tumor, cyst, polyp) impacted feces
Causes
Edema
increased hydrostatic force behind obstruction moves fluid and potentially bacteria into Peritoneum
Sepsis
Abd distention/pain
Treatment includes surgery, lifestyle changes, stool softener, laxative, enema,
Motility
Increased
Impaired nutrition/absorption
L. acidophilus and B. bifidum
Diarrhea
Increased transit time
Treatments: Antidiarrheal, antibiotics, Kaopectate (absorb causing agent), Psyllium (absorb fluid)
Decreased
prolonged storage/absorption
absorption of waste
E. Coli
Constipation
Treatement: Change lifestyle (diet, exercise, fluid intake), Stool softener, laxative, enema, lubricant
Urine
Neuromuscular Function
Can be caused by
Alteration in neurotransduction
Alteration in coordination of impulse
loss of mobility, no appropriate stimulus (loss of elimination), increased response (peristalsis in renal tubules: muscle contractions)
Treatments involve: bladder training, support devices, pelvic muscle strengthening strategies
Alteration in neurons of the PNS/CNS
Perfusion
Caused by
Ischemia, infarction, decreased blood supply
Decreased vascular volume
Embolism: decreased patency
Pain or bleeding
Increased perfusion
Increased work load/stress on heart
can cause atrophy, structural damage
Treatment includes surgery (reduce obstruction, NSAIDS, Diuretic drugs)
Motility
filtrate
stasis occurs in the renal tubules
Urine
Stasis in Bladder
Bacteria growth
Cast Formation
Blockage of Renal Structures
RBC: glomerulonephritis
Epithelial cells: acute tubular necrosis
WBC: Pyelonephrities
Low flow rate, sodium concentration, and low pH
Treatments include antibiotics, surgery, diuretics, increased water intake
Patency
is a build up of pressure behind a blockage
Structural
Tumor
Small diameter of lumen
Polyp
Complete urethral obstruction
Hydroureter (fluid accumulation), increased pressure (hydronephrons), decrease in Glomerular Filtration Rate.
Treatment includes: surgery in order to reduce the blockage, Fluid increase in order to try to move blockage and increase filtration rate.
Ischemic
scar tissue
adhesions
Inflammation
leads to altered