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Module 8: Urinary Elimination

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Ryerson University

MOD 8 Urinary Elimination September3010947 PMReview and discuss the various factors that influence urination eg privacy culture etc Explain the assessment and 1documentation requirements for clients with alterations in urinary functionDisease conditionParkinsons lead to overactive baldder symptoms or hypocontractile bladderDiabetes affecting the peripheral nervous systemcause impaired bladder contractility reduce sensation of bladder fullness imcomplete emptyingCognitive impairment ie Alzheimers lose the ability to sense unable to recall the procedure for voiding RA rheumatoid arthritis unable to sit onrise Alteration prerenaldehydrtion hemorrhage congestive heart failure oliguria anuria renaldiabetes M cause injury to the glomeruli or renal tubule interfering with their normal filtering reabsorptive and secretory functions postrenal obstruction to the flow of urine in the urinary collecting system between renal pelvisurethral meatus male has high chanceEndstage renalSymptoms uremic syndrome increase in N2 in blood altered regulatory functions nausea vomiting headache coma convulsions MedicationsInterfere with the production of urineaffect the act of urination Diuretics continence Anti imcomplete emptyingurinary retention reduce coughstress incontinence Nursing must make sure the COT medications client and affect bladder function Diagnostic ExaminationInfluence micturition Ie intravenous pyeplogram limit FI before test Laxative Surgical procedureStress of surgery initially triggers the general adaptation syndrome Client after surgery often in alter condition bz of disease or preoperative fasting Stress stimulate the ADH release which increase the water reabsorption Some surgery with affecting the lower body strunk mobility will cause the impaired urination Psychological factorsAnxietyemotional stress will increase urination Emotional tension make the abdominalperineal muscle too tight to form pressure to expel the urine Personal habitis oOwn schedule is disrupted feel no privacy in hospital Lack of knowledge of habits of hygiene Not taking too much fluids or waterAgingochildrensmall bladderincrease in urination coordinated effort of bladderurethral closure mechanism may not be developed act of micturtion may not be learnedpoor control of micturtion may be due to limited muscle tone in pelvic floor as neurological system matures able to associate sensations of full bladder daytimeeasier to control micturtion reflex if urge to void is repeatedly ignored bladder capacity is reached and becomes physically impossible to hold itadult womanpregnancy interferes with normal voiding increase in frequency menopause hormonal changes maydifficulties with urination disrupting normal patternsadult mannormal prostate enlargement40s and onwardincrease in urinary frequency and retentionelderlyloss of musclesphincter control bladder loses muscle tonecapacity which increase in frequency bladder cannot contract as effectively therefore increase in residual urine disruption to CNS ie stroke may impact ability to maintain continence slower reaction timemobility impairments andor environmental barriers ie proximityavailability of nearest toilet meds ie diureticsincrease urine anticholinergicurinary retention sedativeshypnoticsless awareness of urge to void kidneys ability to concentrate urine or reabsorb H20Na decreasesCulturedictates whenwhere it is appropriate to urinate may influence patternsoIdentify and explain the common symptoms of urinary alterations3Refer to table 441 on page 1082Incontinence involuntary loss of urineUrgency sudden and compelling urge to void that cannot be postponedDysuria Painful or difficult urinationFrequency voiding more than 8 times in 24 hoursHesitancy difficulty initiating urinationPolyuria voiding large amounts of urine NSE22 Page 1
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