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Altered Elimination - Coggle Diagram
Altered Elimination
Altered Urinary Elimination
Alteration in Urinary Motility
Causes
low flow rate
increased sodium concentration
low pH
Disease Processes
stasis of filtrate in renal tubules can promote Urolithiasis
stasis of urine in bladder = growth of bacteria = local and ascending infection in the kidneys (Pyelonephritis)
Acute Tubular Necrosis
Treatment
increased fluids
pain control
surgical removal of stones
alpha blockers
calcium channel blockers
antispasmodic agents
antibiotics
Alteration in Urinary Neuromuscular Function
Treatment
bladder training
intravaginal support devices
strengthening of pelvic muscles
alpha blockers
5-alpha reductase inhibitors
catheter
Causes
altered function of neurons in PNS and CNS
altered neurotransmitter production and availability
altered coordination of neural impulses from initiation to action
Disease Processes
urinary retention
incontinence (Enuresis)
Alteration in Urinary Perfusion
Causes
decreased oxygen delivery by arterial blood supply = damage to renal structures
enhanced perfusion can stress the urinary system
embolism or blockage in the kidney
Disease Processes
renal ischemia
renal infarction
Treatment
angioplasty and stenting
long term anticoagulants
thrombolytics or intravenous heparin
catheter
Alteration in Urinary Patency
Causes
obstruction in the passage of urine
caused by precipitation of substances in smaller lumen structures
structural blockage from endogenous or exogenous sources (polyps, tumors, inflammation, scar tissue)
Disease Processes
Hydronephrosis
infection
Treatment
antibiotics
catheter
nephrostomy placement
stent placement
Altered Bowel Elimination
Alteration in Bowel Motility
Causes
Escherichia coli in intestinal flora (inhibits motility); Lactobacillus acidophilus and Bifidobacterium bifidum in the intestinal flora promotes motility
food slows or speeds transit time to increase water movement out of the feces or limit water reabsorption respectively
prolonged storage time in large intestine (decreased motility); impaired nutrition and loss of water and electrolytes (increased motility)
Disease Processes
functional fecal incontinence
Diverticular disease
Treatment
bowel training and toileting skills
dietary modifications and supplements
antibiotics
fluid therapy
Alteration in Bowel Neuromuscular Function
Causes
abdominal surgery or electrolyte imbalances affecting contractile function, peritonitis, or spinal trauma
emotional stress
reduced activity (walking, running, swimming, active movements) leads to reduced intestinal smooth muscle contractions
Disease Process
Irritable Bowel Syndrome
Treatment
increased physical activity
decrease emotional stress
fiber supplements
tricyclic antidepressants
cholinergic agents
Alteration in Bowel Perfusion
Treatment
surgical removal of dead tissue or blockage (bowel resection, colostomy placement)
antibiotics to treat or prevent infections
thrombolytic agents
anticoagulants
angioplasty and stenting
Causes
reduced or absent perfusion from obstructed flow (clot or pressure from space-occupying mass)
erosion of blood vessels due to ulceration or trauma
impaired oxygenation
increased perfusion demands from infection
Disease Processes
intestinal ischemia (e.g. ischemic colitis)
intestinal infarction
Alteration in Bowel Patency
Causes
obstruction caused by space-occupying lesion (tumor, polyp, impacted feces) blocking the intestinal lumen
Treatment
dietary modifications and supplements
antibiotics
fluid therapy
warm mineral enema
digital disimpaction
Disease Processes
Fecal impaction
Diverticular disease