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Altered Elimination (Urinary Elimination (Altered urinary perfusion (cause…

- - - - inadequate blood supply related to excessive constriction of arterioles, inadequate vascular volume, or obstruction
    - - ischemia, infarction, damage to renal structures
    - - renal embolism
        
        diagnosis
        
        obstructive blood clot causes reduced perfusion to urinary structures
        
        treatment
        
        surgery
        
        pharmacologic: anti-clot, blood thinners, etc
  - - - dependent on
        
        duration of obstruction
        
        ischemia, necrosis, structural damage, impaired function
        
        acuity or chronicity of the condition
        
        degree of obstruction
    - - blockage of structures involved in transport of urine
    - - urolithiasis
        
        treatment
        
        pharmocologic therapy: antispasmodic, calcium channel blockers, alpha blockers
        
        surgical removal
        
        fluid increase
        
        diagnosis
        
        development of calculi in renal system that may block urine transport
  - - - impaired neural control via: neurons of peripheral and central nervous systems, neurotransmitter production/availability, or coordination of neural impulses
    - - urinary incontinence
      - urinary retention
    - - urinary incontinence
        
        treatment
        
        behavioral strategies
        
        medications
        
        surgery
        
        diagnosis
        
        spinal cord injury, stroke, parkinson's, or MS may cause inability to hold urine
  - - - Formation of casts, increased na, low pH
    - - stasis of filtrate and urine
    - - pyelonephritis
        
        treatment options
        
        antibiotics
        
        increased fluid intake
        
        diagnosis
        
        WBC casts present in urine
- - - - impaired neural control via: neurons of peripheral and central nervous systems, neurotransmitter production/availability, emotional stress, trauma, or coordination of neural impulses
    - - fecal retention
      - fecal incontinence
    - - bowel incontinence
        
        diagnosis
        
        incontinence related to spinal injury, abdominal trauma, electrolyte imbalances impairing contractile function
        
        treatment
        
        surgical
        
        pharmocologic
        
        behavioral strategies/pt
  - - - reduced or absent perfusion to a portion of the bowel related to obstruction in vessels or space-occupying mass, or global etiology
    - - ischemia, necrosis, structural damage
    - - appendicitis
        
        treatment
        
        surgery
        
        diagnosis
        
        infection of appendix in relation to trapped fecal matter causes excessive perfusion demands, resulting in obstruction and risk of perforation
  - - - decreased motility
      - increased motility
    - - hard, formed stools
      - impaired nutrition, loss of water and electrolytes
    - - gastroenteritis
        
        diagnosis
        
        viral intestinal infection resulting in bowel inflammation, diarrhea, vomiting, and fever
        
        treatment
        
        fluid increase
        
        viral treatments
        
        anti-diarrheal medications
  - - - blockage of structures involved in removal of feces; space occupying lesion that blocks intestinal lumen
    - - fluid and gas accumulation, bowel distention, pain, edema, perforation
    - - bowel obstruction
        
        diagnosis
        
        blockage of the bowel by impacted fecal matter because of infections, tumors, etc.
        
        treatment
        
        sugery
        
        pharmacologic; laxatives, stool softeners, enemas
        
        nasogastric tube