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Urinary and Bowel Dysfunction (Altered Bowel Motility (increased motility…
Urinary and Bowel Dysfunction
Altered Urinary Motility
promotes stasis of filtrate in renal tubules/ urine in the bladder
can result in
casts(meshwork of proteins in the distal convulted/collecting ducts
growth of bacteria
caused from
precipitation of urinary fluid
low pH
increased sodium
Urolithiasis
caused by
elevated urinary levels of calculi-forming substances
high oxalate intake
low fluid,calcium intake
stasis from urinary filtrate
Clinical Manifestations
localized pain
described as
colic
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noncolic
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nausea
vomiting
treatment
calcium channel blockers
surgical removal
alpha blockers
Altered Urinary Neuromuscular Function
impaired neural control in the CNS or PNS
leads to
limited or absent response to eliminate urine
impaired conscious control in the timing of urinary elimination
increased peristalsis in the renal tubules in exaggerated responses
urinary incontinence
caused from
in women, relaxation of pelvic structures(after pregnancy)
in males, mechanical obstruction by the prostate
both genders, neurological disease(parkinsons, MS, spinal cord injury, and stroke)
obesity
caused from
lack of neurotransmitter production
no coordination between neurons and nerves
Altered Urinary Patency
blockage of structures involved in the passage of urine
prolonged damage can lead to
structural damage
impaired function
Hydroureter
results in
ischemia
necrosis
caused from
polyps
tumors
precipitation of substances
Kidney Stones
Altered Urinary Perfusion
caused by
inadequate blood supply
constricted arterioles
inadequate vascular volume
Polycystic Kidney Disease
either is
acquired
inherited(autosomal dominant is the most common)
mutations to the PKD1 or PKD2 genes lead to altered protein production of polycystin 1 or 2. recessive form is a mutation in the PKHD 1 gene, encoding the fibrocystin protein
condition characterized by growth of fluid-filled cysts in kidney tissues
leads to
decreased renal blood flow
tubular cell damage
glomerular damage
Clinical Manifestations
pelvic pain
headaches
anorexia
Treatment
fluid intake
ACE inhibitors
hemodialysis(uses special filters to removes wastes the kidney can no longer do on their own
results in
ischemia
infarction
damage to renal structures
obstruction of the branches of the venous system
Manifestations
pain
bleeding
necrosis
Altered Bowel Motility
increased motility leads to
impaired nutrition
preventing water/nutrient absorption
may enhance loss of water and electrolytes
decreased motility leads to
prolongs storage time in large intestine
loss of fluid matter
return of waste products to the circulation
transit time of stool is altered by
certain foods serve as irritants, enhancing the speed at which the feces moves from the cecum to the anus
shortened transit time limits water reabsorption
treated by
slowing passage of stool
absorbents
Alteration in Bowel Neuromuscular function
alteration in neural signal transduction or muscle responsiveness
caused from
abdominal surgery
peritonitis
spinal trauma
sedentary lifestyle
Alteration in Bowel Perfusion
disruption of blood perfusion
can be reduced or absent to a portion of bowel
resulted from
clot
pressure from a tumor
inadequate vascular volume
ventilation-perfusion mismatch
causes
necrosis
ischemia
Diverticular Disease
small sac/outpouching forming along the wall of the colon(usually ascending)
caused from
chronic constipation
slow movement of fecal matter leads to increased, prolonged pressure on the wall of the large intestine
Clinical Manifestations
bleeding
fever
ischemia
treatment
diet high in fiber/low in fat
control of the infection
resting of the bowel
Altered Bowel Patency
due to obstruction thats blocks the intestinal lumen
Manifestations
distended abdomen
edema in the wall of the large intestine(reduces absorption ability)
Abdominal pain
somatic-sharp, localized
referred
visceral-diffuse, radiating, and generalized
results in
continued fluid and gas accumulation because of the movement of water and gas into the bowel lumen
hydrostatic forces increase so that fluid enters from the bowel wall into the peritoneum