Altered elimination

Altered Urinary Elimination

Altered Bowel Elimination

Alteration in urinary motility

Alteration in urinary neuromuscular functions

Altered in urinary perfusion

Alteration in urinary patency

Caused by increased sodium concentration, low pH, and precipitation of urinary fluid.

fail to provide an appropriate stumulus from nerve impulse

result in limited or absent ability to eliminate urine

blockage of essential renal structures

may result in glomerulonephritis, acute tubular necrosis, phyelonephritis.

Decreased oxygen delivery by the arterial blood supply

may result in decreased perfusion

blockage of structures

stasis of filtrate in the renal tubules or stasis of urine in the bladder

caused by ischemia, precipitation, and impaired perfusion.

increased pressure

may cause hydronephrosis and renal failure.

Urinary Incontinence

Alteration in Bowel Motility

Alteration in Bowel Neuromuscular Function

Alteration in Bowel Perfusion

Alteration in Bowel Patency

increased bowel motility

may impair nutrition, fluid and electrolyte imbalance

Decreased bowel motility

composition of forms of bacteria

result in Diarrhea or constipation

enhanced loss of fluid from fecal matter

Result from alteration in neural signal transduction and muscle reponsiveness

loss of propulsive activity, side effect of analgesia

reduced activity

more water is removed and stool becomes harder

Obstructed blood flow and ischemia

Erosion of blood vessles

Ventilation/Perfusion mismatch

inflammatory response, followed by infection

Space-occupying lesion from tumors, polyps, or impacted feces.

Develop edema of large intestine wall

reducing absorptive capacity

fluid is forced through bowel wall into peritonium

may result in perforation.

Polycystic Kidney Disease

Functional Fecal Incontinence

Diverticular Disease

Urolithiasis

Caused by

Dietary factors(high oxalate, high protein, high sodium, and low fluid

stasis from urinary filtrate

Elevated urinary levels of calculi-forming substances

All the causation of urinary stone may promote development of calculi

result in obstruction of narrow lumen structures.

Treatment

Pharmacology(antispasmodic agents, calcium channel blocker, alpha blocker)

Surgical procedure

Extracorporeal shockwave lithotripsy

Percutaneous Nephrolithotomy

Ureteroscopic stone removal

Caused by

relaxation pelvic structure in women

Inability to voluntarily prevent the discharge of urine

mechanical obstruction because of prostate hyperplasia

Neurologic disease(parkinson's disease and multiple sclerosis)

process of continence

Treatment

muscular contraction, neural transmission, hormonal stimulation, or mechanical factors

impair voiding

Bladder Training

Surgical procedure

MMK, TVT procedure

growth of fluid-filled cysts in kidney tissue

cysts of increasing size and number

Decreased renal blood flow, tubular cell damage, Glomerular damage

replace normal kidneys into pathologic forms like ESRD

caused by

Gene mutation

Treatment

Pharmacologic management

Hemodialysis

angiotensin-converting enzyme inhibitor

angiotensin receptor blocker

Process that characterize diverticular disease include decreased motility, obstruction, and impaired perfusion.

caused by

high pressure within the colon

weak areas of the colon

bulge out and form the sacs(diverticulum)

Treatment

Diet high fiber and low in fat

increase fluid intake

Bowel resection

inability control the bowel movement, resulting from involuntary soiling

caused by

feel sudden go to the toilet but inability to go to toilet in time

Treatment

solid foods, toileting program, and start of school attendance, stress associated with defecation

promoting soft stool to minimize discomfort

having scheduled time in the toilet and creating relaxation atmosphere.