Frequently Asked Questions
Chapter 37: Urinary and Bowel Elimination

What are the functions of the kidneys?

The kidneys filter the flood and produce urine, and is thereby important in fluid and electrolyte balance. The kidneys also produce erythropoietin, a hormone that assists in the production of red blood synthesis, and has a role in vitamin D synthesis.

What is the difference between small intestine and large intestine functions and actions?

The small intestine digests and absorbs nutrients, vitamins, minerals, fluids, and electrolytes found in the digestive chime (mixture of partially digested food and secretions), which moves through the small bowel until it passes into the large bowel (colon) through the ileocecal valve. The large intestine (colon) collects, concentrates, transports, and eliminates waste (feces).

What is the rationale for the nurse to include a medication history for a client who has incontinence or another problem with urinary elimination?

The nurse should include a medication history for a client who has incontinence or another problem with urinary elimination because some medications affect urination. Specifically, diuretics increase urine production and some antidepressants, antihypertensives, antihistamines, and over-the-counter cold medicines cause urinary retention.

What is the difference between urge urinary incontinence and reflex urinary incontinence?

Both urge urinary incontinence and reflex urinary incontinence are forms of urge incontinence (overactive bladder). The difference between the two is in the cause. Urge urinary incontinence is caused by detrusor overactivity, and reflex urinary incontinence is caused by a spinal lesions above S-2.

What are the types of urinary retention and how do they differ?

The types of urinary retention are those caused by bladder outlet obstruction and those caused by deficient detrusor contraction strength. Those caused by bladder outlet obstructions are caused by enlargement of the prostate gland in men, problems with the urinary sphincters, urethral stricture, urethral tumor, constipation, or pelvic organ prolapse. Those caused by deficient detrusor contraction strength are caused by transient conditions, such as fecal impaction and acute immobility, and by medical conditions, such as lesions of the sacral spine, late-stage diabetes mellitus, or poliomyelitis.

What should the nurse include when teaching the prevention of constipation?

When teaching the prevention of constipation, the nurse should include the following points: (1) increase fiber in the diet, (2) increase intake of fluids in the diet, and (3) get plenty of exercise.

What are some strategies for managing diarrhea?

The following strategies are used to manage diarrhea: (1) elimination of foods that may irritate the bowel, such as raw fruits; (2) destroy any pathogens with antimicrobials; (3) administer anti-inflammatory drugs; (4) administer bulking agents; (5) administer antidiarrheal drugs; (6) give oral fluids as tolerated, particularly those containing glucose and electrolytes; (7) withhold fluids containing caffeine, which stimulate colonic motility; (8) monitor the perianal skin for integrity and apply skin barriers, if necessary; (9) use a rectal pouch or rectal tube for severe problems; and (8) evaluate for the need for intravenous fluids and electrolytes.