For first year students. Keep reading and i will keep uploading. thanks

2. Abhishek A Joshi
Nursing Tutor
GCON, Bhavnagar

4.  Introduction & Definition of Elimination
 Importance of Elimination
 Characteristics of Urine
 Factors affecting normal urinary elimination
 Alterations in Urinary Elimination
 Physical Assessment of urine by Nursing
Process

5.  As dietary intake digestion and elimination is
important for the quality of life, similarly
elimination of metabolic waste products is very
important.
 Elimination is equally important to the ingestion of
food, fluids etc.
 IF the organs of elimination like Kidney, Intestines
are functioning normally, the waste will be
eliminated as fast as form, if not then excessive
accumulation waste in body and irritates the vital
organs.

6.  Elimination is defined as “The removal of waste
material from the body like urine, feces, sweat,
discharge etc. through the kidneys, intestine, lungs
and skin”

7.  Nurse should teach the healthful habits of elimination &
to prevent the disease by encouraging the periodical
Health Examination.
 It is responsibility of the nurse to provide the patient
proper facilities and also the privacy during elimination
of bowel & Bladder.
 Noting the number, quantity and character of
elimination.
 As the nurses plays an important role in the observing
and recording the quantity and quality of body waste,
hence she must be aware of the normal physiology of
elimination process.

8.  Volume: 2000 to 2500 ml of urine excreted in
24 Hours. It depends on water intake.
 Output increases in cold weather and
decreases in hot weather.
 Color: Normally urine is pale yellowish/amber
in color.
 When quantity increase it become pale yellow,
when quantity decrease it become deep
yellow.

9.  Appearance: normally clear with no deposits.
 Odour: Aromatic odour, Strong Ammoniac.
 Reaction: Acidic in nature
 Specific Gravity: 1.016 to 1.025
 Constituents: Water (96%), Urea (2%), remaining
2% consists of uric acid, creatinine, chlorides,
phosphates and oxalates.

10.  Fluid intake
 Loss of body fluid
 Nutrition
 Body position
 Psychological factor

11.  (1) Dysuria: it means painful voiding.
 Pain may be associated with UTI ( Urinary
Tract Infection) and as felt burning sensation
during urination.
 May be due to inflammation of
bladder/urethra, after sexual activity and
often due to STD (Sexual Transmitted
Disease).

12.  (2) Polyuria: it is formation and excretion of
excessive amount of urine in the absence of
concurrent increase in fluid intake.
 When Urine output increase to 2500 to 3000
ml/day, it’s called polyuria.
 It may be due to Diabetes, diuretics ,
caffeine/alcohol.

13.  (3) Oliguria: the formation and excretion of
decreased amount of urine.
 Urine output is less than 500 ml/day.
 Due to vomiting, diarrhea, burns etc.
 (4) Anuria: As the kidney approaches the
complete failure as a functioning organs, the
person become auric.
 Urine output is less than 100 ml/day.

14.  (6) Nocturia: Voiding during normal sleeping
hours is called nocturia.
 When lying and supine, edema decreases as
fluid enters the circulation.
 This increases blood flow to the kidneys thus
increase Glomerular filtration and urine
output.
 (7) Hematuria: indicates blood in urine.
 Due to UTI, trauma, renal stone, cancer etc.

15.  (8) Pyuria: it means urine contains pus. Which is the
accumulation of an end products of an inflammatory
response.
 These may be microorganisms and WBcs occurs in
presence of UTI.
 Presents in UTI.
 (9) Urinary Retension: it is the inability to empty the
bladder of urine.
 The person is either unable to relax the bladder or
unable to external urethral sphincter to allow passage
for urine.
 Inability to void within 8 to 10 hours of last voiding.

16.  (10) Urinary Incontinence: it is involuntary
loss of urine from the bladder.
 (11) Urgency (Overactive Bladder): occurs
when the pressure in the bladder builds
suddenly, and it becomes difficult to hold in
the urine.
 You have the urge to pee even though your
bladder is not full.
 “Gotta go Now” feeling.

17.  (12) Frequency of urine: Voiding in frequent
intervals is known as frequency.
 Each void usually contains less than 250 ml
of urine.
 Sometimes urgency and frequency often
occurs together.

19.  Assess Temperature, Pulse, Respiration,
Blood pressure and Weight.
 General Inspection: skin integrity, color,
peripheral edema.
 Examination of the abdomen, pelvis, genitelia
and rectum.
 Diagnostic Test

20.  Body image disturbances
 Incontinence stress
 Self care deficit
 Impaired skin integrity
 Altered urine elimination
 Urinary retention

21.  Health promotion
 Client education
 Promoting normal micturition
 Stimulating micturition reflex
 Maintaining elimination habit
 Provide bladder training
 Maintain adequate fluid intake
 Preventing infection
 Promotion of comfort
 Teach Kegel (Pelvic floor exercise)

22.  “A rubber tube through the urethra and to the
bladder.”
 It’s provides a continuous flow of urine in clients,
when clients are unable to control micturition.
 There is two types:
 (i) Intermittent technique is a straight single use
catheter introduced to drain the bladder.
 When the bladder is empty, the nurse
immediately withdraws the catheter.
 It can be repeated if necessary.

23.  (ii) Indwelling/Foley Catheter remains in place
for an extended period until a client is able to
completely and voluntarily.
 It should be change periodically.

30.  Relieve discomfort of bladder distention
 Obtain sterile urine specimen
 Assess presence of residual urine
 Long term management of clients with spinal
cord injury.
 Obstruction of urine flow Sever urinary
retention

31.  Incontinent males may wear a condom
catheter to collect urinary drainage.
 This device consists of a condom connected
to the tubing which drains into a collection
bag.

33. Frequency 1-2 per day
Color Brown
Consistency Soft, formed
Shape Cylindrical
Amount 100-300 gm/day
Odor Pungent

34.  Water
 Solids
 Bacteria
 Undigested food fiber
 Fat
 Inorganic martial
 Protein

35.  Nutrition: nature & type of food
 Age & Development
 Drugs
 Lifestyle & Habit
 Fluid Intake
 Medical Problems
 Stress & Emotions
 Body Position
 Privacy

36.  (i) Constipation
 (ii) Diarrhea
 (iii) Flatulence

37.  Constipation is a symptom not a disease.
 It is a decrease in frequency of bowel
movements.
 It results by prolonged or difficult passage of
hard, dry stool.

38.  Irregular bowel habits & ignoring the urge to
defecate can cause constipation.
 Client who have a low fiber diet, low fluid intake
slows peristalsis.
 Lengthy bed rest or lack of regular exercise.
 With increased age the abdominal muscle
elasticity loses and reduces intestinal mucus
secretion.
 Bowel Obstruction

39.  An enema is an injection of solution into
lower bowel for washing and evacuating its
content.
 Introduction of solution into large intestine
through anus for removing feces and
cleansing the bowel.

40.  It is a procedure of introduction of
medication into the rectum in the form of
suppository.
 Purposes:
 To stimulate peristalsis
 To promote defecation
 To act as analgesic/antipyretic

42.  It may be defined as washing the colon with
large quantities of solution in order to clear
the colon of feces.

43.  Colostomy is an operation in which an
artificial opening is made into the colon on
the anterior abdominal wall.
 It will permit the escape of feces and flatus.
 It permits the healing of the bowel distal to
the colostomy opening since it diverts the
fecal contents from affected area.
 It provides when a rectum or anus are non
functional.
 Ex. Traumatic condition, birth defect.

46.  It is an increase in the number of stools and
the passage of liquid, unformed feces.
 It’s a symptom of disorder affecting
digestion, absorption and the secretion in the
GI tract.
 Intestinal contents pass through the small
and large intestine too quickly, irritation the
colon can result in an increased mucus
secretion.
 As a result, feces become water and client
may be unable to control to urge defecate.

47.  Harded stool that’s stuck in the rectum or
lower colon due to chronic constipation.
 Fecal impaction often occurs in people
who’ve been constipated for a long time.
 Fiber added to the diet, exercise, laxatives
may prevent inspection.
 If not then Per Rectal examination (PR) or
enema should be given.

56. 1. PEE VEE ; ‘‘ FUNDAMENTALS OF NURSING’’
SECOND EDITION;PUBLISHED BY JAYPEE BROTHERS
MEDICAL PUBLISHERS (P) LIMITED;NEW DELHI;
P NO.-196-210.
2. LOTUS PUBLISHERS; ‘‘A TEXT BOOK OF NURSING
FOUNDATIONS’’2ND EDITION;EDITED
BY CELESTINA FRANCIS & KRITIKA
;P.NO. 377to 380.
3. WEBPAGE; WWW.WIKIPEDIA.COM: THE TOPIC OF “NURSING
CARE FOR PATIENT WITH PAIN” BY DR ARJAN SHAH.