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Pathophysiology of Elimination - Coggle Diagram
Pathophysiology of Elimination
Urinary Dysfunction
Alteration in urinary motility
Urolithiasis
Treatment
FLUIDS
Medical therapy- antispasmodic agents, calcium channel blockers, and alpha blockers
surgical procedure
promotes stasis of filtrate in renal tubules and stasis of urine in bladder
Cause:
low flow rate, increased sodium concentration, and low pH
lead to blockage of essential renal structures forming casts
may promote growth of bacteria, that may lead to local and ascending infection in the kidneys
Alteration in urinary neuromuscular function
Urinary incontinence
Treatment
behavioral strategies, use of medication, and surgery
bladder training, intravaginal support devices, and strengthening of pelvic muscles
urinary retention or incontinence may result
result in limited or absent ability to eliminate urine, peristalsis in renal tubules, reduction in toileting independence
Cause:
impaired neural control of urinary elimination by neurons of PNS or CNS, neurotransmitter production and availability or coordination of neural impulses from initiation to action
Alteration in urinary perfusion
Polycystic kidney disease
Treatment
symptomatic care, strategies to promote renal function, and supportive care during end-stage renal disease
maintenance of healthy weight, physical activity and nutritious diet, fluid intake for thirst satisfaction, and quit smoking
ACE inhibitor and ARB for blood pressure, kidney transplantation, analgesics for pain, antibiotics, dialysis or transplant
growth of fluid-filled cysts in kidney tissue bilaterally, that may lead to progressive loss of renal nephrons
may result in increasing loss of renal function
Cause:
cysts increase in size and numbers and replace functional tissue
pressure on renal blood vessels obstructs perfusion
leading to tissue degeneration and obstructed tubular flow
genetic autosomal dominant, genetic autosomal recessive, acquired
Alteration in urinary patency
Obstructive uropathy
Treatment
determined by condition underlying clinical manifestations
controlling fluid balance through supplemental fluids to correct body fluid deficit or use of diuretics
may lead to ischemia, and necrosis, urine flow is impeded, dilation and stasis, accumulation of fluid
Causes:
blockage of structures involved in passage of urine, leading to obstruction
consequences- degree of obstruction, duration of obstruction, acuity or chronicity of condition
leads to structural damage and impaired function, impaired perfusion develops within 24 hours
Bowel Dysfunction
Alteration in bowel motility
Diverticular Disease
Treatment
immediate goal to control infection, rest the bowel, and prevent complications
clear liquid diet for 2-3 days until resolved
antibiotics, anti-inflammatory therapy, laxatives and antispasmodic drugs, surgical treatment for emergencies
increased motility
impaired nutrition, prevent adequate opportunity for nutrient and water absorption, and may enhance loss of water and electrolytes
decreased motility
prolongs storage time in large intestine, promoting enhanced loss of fluid from fecal matter and potentially promoting return of waste products to the circulation
Cause:
potential stressors, certain foods, forms of bacterial intestinal flora
Alteration in bowel neuromuscular function
Functional fecal incontinence
Treatment
addressing and using strategies to promote positive and more enjoyable bathroom experience
soft stool to help with discomfort or fear of pain association
scheduled times, relaxed atmosphere, incentives for positivity/motivation, possible mental health analysis
coordination of neurologic and muscular functional components is essential to optimal bowel function
Cause:
may result from abdominal surgery, or electrolyte imbalances affecting contractile function, peritonitis, or spinal trauma, or emotional stress, reduced activity or loss of mobility
time feces remains in large intestine, the more water is removed and stool hardens leading to build up
Alteration in bowel patency
Small bowel obstruction
Treatment
determined by condition underlying clinical manifestations
antidiarrheal drugs, exercise, high dietary fiber, adequate fluid intake, stool softeners, laxatives, and enemas, possibly surgical treatment for removal
obstruction- tumors, polyps, and impacted feces
leads to development of edema in the wall leading to reduced absorptive capacity
bacteria may gain access to circulation, promoting development of sepsis
Cause:
space-occupying lesion that blocks intestinal lumen, partially or totally