UNIT X
Title: Elimination
Overview: Bowel and Fecal Elimination; Diagnostic Testing
Chapter 34, "Diagnostic Testing", pages 728-737.
Chapter 49, "Fecal Elimination".
Chapter 48, " Urinary Elimination ".
Key Terms
Anuria: is the failure of the kidney to produce urine, resulting in a total lack of urination production or
output of less than 100 mL/day in an adult.
bladder retraining: which requires that the client postponing voiding, resist or inhibit the sensation of
urgency, and voids according to timetable rather than according to the urge to void
Blood urine nitrogen: a measure of blood level or urea, the end product of protein metabolism
Cathartics: are drugs that induce defecation
Chyme: is the waste product leaving the stomach through the small intestine and the passing through
the ileocecal valve.
Colostomy: a temporary or permanent opening into the colon (large bawel) with a colonoscope
Constipation: passage of small, dry stool or passage of no stool for a period of time
Creatinine clearance: Is a test that uses 24-hours urine and serum creatinine levels to determine the
glomerular filtration rate, a sensitive indication of renal function.
Dialysis: Is a filtering technique by which fluids and molecules pass through a semipermeable membrane
according to the rules of osmosis
Diarrhea: refers to the passage of liquid feces and an increased frequency defecation
Diuresis: it refers to the production of abnormally large amounts of urine by the kidney, often several
liters more than the client’s usual daily output.
Dysuria: it means voiding that is either painful or difficult. It can accompany a stricture (decrease in
caliber) of the urethra, urinary infections, and injury to the bladder and urethra.
Elimination
Enuresis: (bed-wetting) Is define as the involuntary passing of urine in children after bladder control is
achieved.
Fecal impaction: is a mas or collection of hardened feces in the fold the rectum.
,Fecal incontinence: refers to the loss of voluntary ability to control fecal and gaseous discharges through
the anal sphincter.
Flatulence: is the presence of excessive flatus in the intestines and leads to stretching ad inflation of the
intestines (intestinal distention
Functional incontinence
Gastrostomy: is an opening through the abdominal wall into the stomach
Ileostomy: is an open in the ileum (small bowel)
Jejunostomy: opens through the abdominal wall into the jejunum
Melena- Black tarry stools. (this was our vocab word in lab)
Mass peristalsis: involves a wave of powerful muscular contraction that moves over large areas of the
colon, usually occurs after eating.
Micturition, voiding and urination, all refers to the process of emptying the urinary bladder.
Neurogenic bladder: An interference with the normal mechanism of urine elimination in which the client
does not perceive bladder fullness and is unable to control the urine sphincters; the result of impaired
neurologic function.
Nocturia: is voiding two or more times at night. Like frequency, it is usually expressed in terms of the
number of times the person gets out of bed to void, for example,” nocturia x 4”
Oliguria: is a low urine output, usually less than 500 mL a day or 30mL an hour for an adult. Although
oliguria may occur because of abnormal fluid losses or a lack of fluid intake, it often indicates impaired
blood flow to the kidneys or impending renal failure and should promptly reported to the primary
provider.
Ostomy: Opening for the gastrointestinal, urinary, or respiratory tract onto the skin
Peristalsis: is a wavelike movement produce by the circular and longitudinal muscle fibers of the
intestinal walls, it propels the intestinal contents forward
Polydipsia: An excessive fluid intake (excessive thirst)
Polyuria: see diuresis
Post void residual urine: (Is the urine remaining in the bladder following voiding) is normally 50 to 100
mL. However, a bladder outlet obstruction (e.g., enlargement of the prostate gland) or loss of bladder
muscle tone may interfere with complete emptying of the bladder during urination.
Reflux: is the backflow of urine up the ureters
Stress incontinence
Suppositories: a solid, cone-shaped, medicated substances inserted into the rectum, vagina or urethra.
, Suprapubic catheter: an indwelling catheter that has been surgically placed in the bladder through the
abdominal wall, either with or without a urethrally placed catheter
Types of laxatives
Urinary frequency: is voiding at frequent intervals, that is more than four to six times per day. An
increased intake of fluid causes some increase in the frequency of voiding.
Glomerulus: a tuft of capillaries in the kidney surrounded by Bowman's capsule.
Haustral churning: Involves movement of the chyme back and forth within the haustra.
Urinary incontinence: or involuntary leakage of urine or loss of bladder control, is a health symptom, not
a disease. (Glossary definition) --A temporary or permanent inability of the external sphincter muscle to
control the flow of urine from the bladder.
Urinary retention: the accumulation of urine in the bladder and inability of the bladder to empty itself
Valsalva's maneuver
Catheter Associated Urinary Tract Infection (CAUTI) is a Urinary tract infection that occurs while an
indwelling catheter is in place or within 48 hours of its removal.
UNIT OBJECTIVES
1. Understand the physiology of defecation and urinary elimination.
PHYSIOLOGY OF DEFECATION:
Large intestine – Rectum anal canal – Defecation
LARGE INTESTINE
The large intestine extends from the ileocecal valve, which lies between the small and large
intestines, to the anus. The colon is about 125 to 150 cm (50 to 60 in) long. It has been seven parts:
the cecum; ascending, transverse, and descending colons; sigmoid colon; rectum; and anus.
The large intestine is a muscular tube lined with mucous membrane. The muscle fibers are both
circular and longitudinal, permitting the intestine to enlarge and contract in both width and length.
The longitudinal muscles are shorter than the colon and therefore cause the large intestine to form
pouches, or haustra.
Title: Elimination
Overview: Bowel and Fecal Elimination; Diagnostic Testing
Chapter 34, "Diagnostic Testing", pages 728-737.
Chapter 49, "Fecal Elimination".
Chapter 48, " Urinary Elimination ".
Key Terms
Anuria: is the failure of the kidney to produce urine, resulting in a total lack of urination production or
output of less than 100 mL/day in an adult.
bladder retraining: which requires that the client postponing voiding, resist or inhibit the sensation of
urgency, and voids according to timetable rather than according to the urge to void
Blood urine nitrogen: a measure of blood level or urea, the end product of protein metabolism
Cathartics: are drugs that induce defecation
Chyme: is the waste product leaving the stomach through the small intestine and the passing through
the ileocecal valve.
Colostomy: a temporary or permanent opening into the colon (large bawel) with a colonoscope
Constipation: passage of small, dry stool or passage of no stool for a period of time
Creatinine clearance: Is a test that uses 24-hours urine and serum creatinine levels to determine the
glomerular filtration rate, a sensitive indication of renal function.
Dialysis: Is a filtering technique by which fluids and molecules pass through a semipermeable membrane
according to the rules of osmosis
Diarrhea: refers to the passage of liquid feces and an increased frequency defecation
Diuresis: it refers to the production of abnormally large amounts of urine by the kidney, often several
liters more than the client’s usual daily output.
Dysuria: it means voiding that is either painful or difficult. It can accompany a stricture (decrease in
caliber) of the urethra, urinary infections, and injury to the bladder and urethra.
Elimination
Enuresis: (bed-wetting) Is define as the involuntary passing of urine in children after bladder control is
achieved.
Fecal impaction: is a mas or collection of hardened feces in the fold the rectum.
,Fecal incontinence: refers to the loss of voluntary ability to control fecal and gaseous discharges through
the anal sphincter.
Flatulence: is the presence of excessive flatus in the intestines and leads to stretching ad inflation of the
intestines (intestinal distention
Functional incontinence
Gastrostomy: is an opening through the abdominal wall into the stomach
Ileostomy: is an open in the ileum (small bowel)
Jejunostomy: opens through the abdominal wall into the jejunum
Melena- Black tarry stools. (this was our vocab word in lab)
Mass peristalsis: involves a wave of powerful muscular contraction that moves over large areas of the
colon, usually occurs after eating.
Micturition, voiding and urination, all refers to the process of emptying the urinary bladder.
Neurogenic bladder: An interference with the normal mechanism of urine elimination in which the client
does not perceive bladder fullness and is unable to control the urine sphincters; the result of impaired
neurologic function.
Nocturia: is voiding two or more times at night. Like frequency, it is usually expressed in terms of the
number of times the person gets out of bed to void, for example,” nocturia x 4”
Oliguria: is a low urine output, usually less than 500 mL a day or 30mL an hour for an adult. Although
oliguria may occur because of abnormal fluid losses or a lack of fluid intake, it often indicates impaired
blood flow to the kidneys or impending renal failure and should promptly reported to the primary
provider.
Ostomy: Opening for the gastrointestinal, urinary, or respiratory tract onto the skin
Peristalsis: is a wavelike movement produce by the circular and longitudinal muscle fibers of the
intestinal walls, it propels the intestinal contents forward
Polydipsia: An excessive fluid intake (excessive thirst)
Polyuria: see diuresis
Post void residual urine: (Is the urine remaining in the bladder following voiding) is normally 50 to 100
mL. However, a bladder outlet obstruction (e.g., enlargement of the prostate gland) or loss of bladder
muscle tone may interfere with complete emptying of the bladder during urination.
Reflux: is the backflow of urine up the ureters
Stress incontinence
Suppositories: a solid, cone-shaped, medicated substances inserted into the rectum, vagina or urethra.
, Suprapubic catheter: an indwelling catheter that has been surgically placed in the bladder through the
abdominal wall, either with or without a urethrally placed catheter
Types of laxatives
Urinary frequency: is voiding at frequent intervals, that is more than four to six times per day. An
increased intake of fluid causes some increase in the frequency of voiding.
Glomerulus: a tuft of capillaries in the kidney surrounded by Bowman's capsule.
Haustral churning: Involves movement of the chyme back and forth within the haustra.
Urinary incontinence: or involuntary leakage of urine or loss of bladder control, is a health symptom, not
a disease. (Glossary definition) --A temporary or permanent inability of the external sphincter muscle to
control the flow of urine from the bladder.
Urinary retention: the accumulation of urine in the bladder and inability of the bladder to empty itself
Valsalva's maneuver
Catheter Associated Urinary Tract Infection (CAUTI) is a Urinary tract infection that occurs while an
indwelling catheter is in place or within 48 hours of its removal.
UNIT OBJECTIVES
1. Understand the physiology of defecation and urinary elimination.
PHYSIOLOGY OF DEFECATION:
Large intestine – Rectum anal canal – Defecation
LARGE INTESTINE
The large intestine extends from the ileocecal valve, which lies between the small and large
intestines, to the anus. The colon is about 125 to 150 cm (50 to 60 in) long. It has been seven parts:
the cecum; ascending, transverse, and descending colons; sigmoid colon; rectum; and anus.
The large intestine is a muscular tube lined with mucous membrane. The muscle fibers are both
circular and longitudinal, permitting the intestine to enlarge and contract in both width and length.
The longitudinal muscles are shorter than the colon and therefore cause the large intestine to form
pouches, or haustra.
