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Altered Elimination - Coggle Diagram
Altered Elimination
Urinary Dysfunction
Motility
Alteration in motility can promote stasis of filtrate in the renal tubules or bladder - stasis in the bladder can promote bacterial growth leading to local and ascending infection in the kidneys
casts may form due to low flow rate
- specific type of cell trapped in cast mesh lends to what pathology is occurring
RBC trapping - glomerulonephritis
Epithelial cell trapping - acute tubular necrosis
WBC trapping - pyelonephritis
Treatment:
Glomerulonephritis - antibiotics
acute tubular necrosis - treat underlying perfusion problem
Pyelonephritis - antibiotics
Neuromuscular Function
Impaired neural control of urinary elimination may involve the neurons of the peripheral and central nervous systems, neurotransmitter production and availability, or coordination of neural impulses from initiation to action
- failure to provide appropriate stimulus will result in urinary retention
- exaggerated responses may prompt stimulation to prematurely release urine resulting in incontinence
Urinary incontinence
Pathophysiology - neurologic diseases contribute including Parkinson Disease, multiple sclerosis, spinal cord injury, and stroke
Treatment:
- anticholinergic drugs can help with urge incontinence
- underlying neuromuscular pathology must be corrected
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Bowel Dysfunction
Motility
- increased motility may impair nutrition, preventing adequate opportunity for nutrient and water absorption, and may enhance loss of water and electrolytes
- decreased motility prolongs storage time n the large intestine, promoting an enhanced loss of fluid from fecal matter and potentially promoting the return of waste products to the circulation
Treatment:
- constipation - stool softeners, laxatives', enemas
- diarrheas' - bulk-forming agents,
neuromuscular function
Any alteration in neural signal transduction or muscle responsiveness may result in altered bowel function
May result from abdominal surgery or from electrolyte imbalances affecting contractile function, peritonitis, spinal trauma, or narcotic analgesia
Treatment:
- walking, running, swimming, and other active movements enhance neuromuscular activity and coordination in the large intestine, promoting peristalsis and bowel elimination
Patency
Bowel obstruction is due to a space-occupying lesion which blocks the intestinal lumen, either partially or totally
- tumors, polyps, and impacted feces
Treatment:
- goal of removing the obstruction through surgery or medication