Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • Eliminasi Meliputi Informasi / Riwayat Pasien Pemeriksaan - Pola BAB, BAK

    Uploaded by

    Nareswari Keniten
    52 views7 pages
    This document discusses elimination and factors that affect it. It covers common urinary and bowel alterations including urinary incontinence, urinary retention, constipation, diarrhea, and fecal incontinence. It describes how age, diet, exercise, and medications can impact elimination. For urinary issues, it defines types of incontinence and lists common causes. For bowel issues, it provides more detail on constipation and diarrhea. Assessment involves taking a health history and physical exam including diagnostic tests to evaluate underlying causes of elimination problems.

    Original Description:

    uytreedfghhvddewwwee

    Original Title

    Eleminasi

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document discusses elimination and factors that affect it. It covers common urinary and bowel alterations including urinary incontinence, urinary retention, constipation, diarrhea, and fecal incontinence. It describes how age, diet, exercise, and medications can impact elimination. For urinary issues, it defines types of incontinence and lists common causes. For bowel issues, it provides more detail on constipation and diarrhea. Assessment involves taking a health history and physical exam including diagnostic tests to evaluate underlying causes of elimination problems.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    52 views7 pages

    Eliminasi Meliputi Informasi / Riwayat Pasien Pemeriksaan - Pola BAB, BAK

    Uploaded by

    Nareswari Keniten
    This document discusses elimination and factors that affect it. It covers common urinary and bowel alterations including urinary incontinence, urinary retention, constipation, diarrhea, and fecal incontinence. It describes how age, diet, exercise, and medications can impact elimination. For urinary issues, it defines types of incontinence and lists common causes. For bowel issues, it provides more detail on constipation and diarrhea. Assessment involves taking a health history and physical exam including diagnostic tests to evaluate underlying causes of elimination problems.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 7

    ELIMINASI

    Meliputi Informasi / riwayat pasien Pemeriksaan


    Pola BAB, BAK
    bacteriuria
    constipation
    defecation
    detrusor muscle
    diarrhea
    dysuria
    extraurethral incontinence
    fecal incontinence
    flatulence
    functional incontinence
    hematuria
    hemorrhoids
    impaction
    instability incontinence
    nocturia
    peristalsis
    pyuria
    specific gravity
    stoma
    stool
    stress urinary incontinence
    urge urinary incontinence
    urinalysis
    urinary incontinence
    urinary retention
    voiding

    CTORS
    AFFECTING ELIMINATION
    Age
    A clients age or developmental level will affect control
    over urinary and bowel patterns. Infants initially lack a
    pattern to their elimination. Control over bladder and
    bowel movements can begin as early as 18 months of age

    Diet
    Adequate fluid and fiber intake are critical factors to a
    clients urinary and bowel health. Inadequate fluid
    intake is a primary cause of constipation, as is ingestion
    of constipating foods such as certain dairy products.
    Diarrhea and flatulence (discharge of gas from the rectum)

    are a direct result of foods ingested, and clients


    need to be educated as to which foods and fluids promote
    healthy elimination and which foods may inhibit it.

    Exercise
    Exercise enhances muscle tone, which leads to better
    bladder and sphincter control. Peristalsis is also aided
    by activity, thus promoting healthy bowel elimination
    patterns.

    Medications
    Medications can have an impact on a clients elimination
    health and patterns and should be assessed during the
    health history interview. Cardiac clients, for instance, are
    commonly prescribed diuretics, which increase urine
    production. Antidepressants and antihypertensives may
    lead to urinary retention.

    COMMON ALTERATIONS
    IN ELIMINATION
    Urinary Elimination
    Urinary incontinence and urinary retention are the
    most common causes of altered urinary elimination patterns.
    Urinary incontinence is the uncontrolled loss of
    urine that constitutes a social or hygienic problem.
    Urinary retention is the inability to completely evacuate
    urine from the bladder during micturition. There are
    two primary types of urinary incontinence, acute and
    chronic. In addition, chronic urinary incontinence can
    be subdivided into several distinctive types. Because
    each has its own etiology and management, it is important
    to determine the type of incontinence before subjecting
    the client to the expense, potential risks, and
    rigors of a treatment program.

    Acute Urinary Incontinence

    Acute urinary incontinence is a transient and reversible


    loss of urine. It may occur during an acute illness or
    after an injury. Common causes of acute urinary incontinence
    include urinary tract infection, atrophic vaginitis,
    polyuria related to diabetes, acute confusion,
    immobility, and sedation. Medications that increase or
    decrease bladder or urethral sphincter tone also may
    contribute to acute incontinence.

    Chronic Urinary Incontinence

    Acute incontinence is distinguished from established or


    chronic incontinence. There are four predominant
    types of chronic urine loss: stress urinary incontinence,
    instability incontinence, functional incontinence, and
    extraurethral incontinence.
    TABLE 39-1
    Common Causes of Stress Urinary Incontinence
    Urethral hypermobility Multiple vaginal deliveries
    Forceps-assisted deliveries
    Pelvic muscle denervation
    Estrogen deficiency
    Obesity (exacerbating factor)
    Intrinsic sphincter Iatrogenic
    deficiency Multiple bladder suspensions

    (women)
    Radical prostatectomy (men)
    Transurethral resection of prostate
    (rare in men)
    Y-V plasty surgery (both genders)
    Neuropathic
    Lesion of lumbosacral spine
    Cauda equina syndrome
    Pelvic fracture

    TABLE 39-2
    Common Causes of Instability Incontinence
    Urge urinary Neuropathic (sensations
    incontinence preserved)
    Cerebrovascular accident
    Brain tumor
    Hydrocephalus
    Organic brain syndrome (also
    associated with functional urinary
    incontinence)
    Incomplete spinal lesions (when
    sensations of bladder filling are
    preserved)
    Bladder inflammation
    Bladder calculi
    Bladder tumor (particularly
    carcinoma in situ)
    Cystitis (may exacerbate
    subclinical instability)
    Atrophic vaginitis
    SUI (39% of women with SUI
    experience instability and urge
    incontinence; cause of
    relationship unclear)
    Bladder outlet obstruction
    Idiopathic (may represent subtle
    neuropathy or other undiagnosed
    disorder)
    Reflex incontinence Spinal lesions above neurologic
    level S-2
    Complete cord injury
    Transverse myelitis
    Multiple sclerosis

    Urinary Retention
    Urinary retention is caused by two conditions: bladder
    outlet obstruction and deficient detrusor muscle contraction
    strength.
    TABLE 39-3
    Common Causes of Urinary Retention
    Bladder outlet Prostatic enlargement
    obstruction Benign prostatic hyperplasia
    Prostate cancer
    Prostatitis
    Bladder neck dyssynergia
    (dyssynergia of the smooth
    muscle of the sphincter
    mechanism)
    Detrusor sphincter dyssynergia
    (typically indicates dyssynergia
    between detrusor and striated
    muscle of sphincter)

    Urethral stricture
    Urethral tumor (rare)
    Deficient detrusor Transient conditions
    contraction strength Fecal impaction
    Acute immobility
    Side effects of drugs including
    anticholinergics, tricyclic
    antidepressants
    Side effect of recreational drugs
    including hallucinogens
    Herpes zoster of sacral
    dermatomes
    Established conditions
    Lesions of sacral spine
    Cauda equina syndrome
    Diabetes mellitus (late stages)
    Tabes dorsalis
    Poliomyelitis

    Bowel Elimination
    Many diseases and conditions affect bowel function.
    Although many alterations in bowel elimination patterns
    may be observed, this discussion is limited to three
    common alterations: constipation, diarrhea, and fecal
    incontinence.

    Constipation

    Colonic constipation is the infrequent and difficult passage


    of hardened stool. (Perceived constipation, influenced
    by psychological and emotional stress, is not
    included in this discussion.)
    Dietary factors may contribute to constipation.
    Dehydration causes drying of the stool as the body
    increases the reabsorption of water and sodium from
    the bowel. Inadequate dietary bulk also dehydrates the
    stool. Diverticular disease, a common problem in the
    elderly, also reduces colonic transit, further increasing
    the risk of constipation

    Constipation

    Colonic constipation is the infrequent and difficult passage


    of hardened stool. (Perceived constipation, influenced
    by psychological and emotional stress, is not
    included in this discussion

    Diarrhea

    Diarrhea is the passage of liquefied stool that, because of


    its increased frequency and consistency, represents a
    change in the persons bowel habits. The primary causes
    of diarrhea include infectious agents, malabsorption disorders,
    inflammatory bowel disease, short bowel syndrome,
    side effects of drugs, and laxative or enema
    misuse.

    Fecal Incontinence

    Fecal incontinence is the involuntary loss of stool of sufficient


    magnitude to create a social or hygienic problem.
    The primary mechanisms that predispose the adult
    to incontinence of stool are dysfunction of the anal
    sphincter, disorders of the delivery of stool to the rectum,
    disorders of rectal storage, and anatomic defects.

    ASSESSMENT
    Health History
    Physical Examination
    frekwensi karakter BAB, BAB terakhir
    frekwensi, karakteristik ekskresi urin, kesulitan BAK, penyakit ginjal / liver
    penggunaan laksative / diuretic
    penggunaan alat Bantu ekskratory, missal : colostomy, ureterostomy
    derajat berkeringat
    tempat ekskratory lain missal; drain, Water Seal Drainage, NGT, muntah
    hasil lab termasuk : urinalisis, feses, rutin, kultur feses, test fungsi ginjal, test fungsi liver,
    OBGYN catat adanya kelainan, mual, konstipasi, hemoroid, sering kencing, stress
    inkontinensia
    PEDIATRIK catat penggunaan popok atau rutinitas toileting, catat kata-kata khusus yg
    digunakan Periksa jika ada indikasi, warna konsistensi, karakter, frekwensi dan kualitas
    feses dan urine
    Periksa jika ada indikasi, warna, karakter dan kualitas output dari tempat ekskratori lain
    Pengkajian abdomen, termasuk suara usus, flatus, softnes, distensi, massa, hemoroid, drain
    atau alat Bantu pengumpulan lain

    Diagnostic and Laboratory Data


    When significant urinary or fecal elimination problems
    are observed, further testing is needed to evaluate
    the underlying cause of the condition and to determine
    treatment options. When urinary incontinence
    exists, a dipstick urinalysis is obtained and evaluated
    for nitrites, leukocytes, hemoglobin, glucose, and specific
    gravity. When nitrites or leukocytes are present, a
    microscopic analysis is completed to determine the
    presence of white blood cells in the urine (pyuria) and
    bacteria in the urine (bacteriuria). Urine culture and
    sensitivity testing are completed and the client is
    treated for a urinary tract infection. If glucose is noted
    in the urine, the patient may undergo further evaluation
    for diabetes mellitus, or methods of glucose control
    may be reviewed and adjusted in the client with
    known diabetes. If the specific gravity (weight of urine
    compared with weight of distilled water) of the urine is
    abnormally low (below 1.010), the volume of fluid
    consumed by the client over a 24-hour period is evaluated
    further. Hematuria (blood in the urine) may be
    noted.

    DOMAIN 3. ELIMINATION/EXCHANGE
    CLASS 1 : URINARY SYSTEM
    00016. Kerusakan eliminasi urine
    00023. Retensi urine
    00020. Inkontinensia urine fungsional
    00017. Inkontinensia urine stress

    00019. Inkontinensia urine urgensi


    00018. Inkontinensia urine refleks
    00022. Risiko Inkontinensia urine urgensi
    00166. Kesiapan untuk meningkatkan eleminasi urine
    00176. Inkontinensia urine overflow
    CLASS 2 : GASTROINTESTINAL FUNGTION
    00014. Inkontinensia usus
    00013. Diare
    00011. Konstipasi
    00015. Risiko untuk konstipasi
    00012. Konstipasi dirasakan
    00196. Disfungsi motilitas gastrointertinal
    00197. Risiko disfungsi motilitas gastrointertinal

    You might also like