The basic concept

of the need for

elimination
M.Maulidin ikhsan 1901021
Nurul Auza 1901025
Melvina Sabrina 1901020
Elimination is the process of removing the rest of
the body's metabolism either in the form of urine
or bowel (feces). Micturition is the process of
emptying the bladder when the bladder is filled
The body systems that play a role in the process of
eliminating urine are the kidneys, ureters, bladder,
and urethra
This process occurs in two main steps: The bladder
is progressively filled until the tension in its walls
increases above a threshold value, which then
triggers the second step, which is a neural reflex
called the micturition reflex (micturition reflex)
which attempts to empty the bladder or, if this
fails, at least raise awareness of the urge to urinate.
URINE ELIMINATION
DISORDER
 Urinary elimination disorder is a condition in
which an individual experiences or is at risk of
experiencing urinary elimination dysfunction.
Usually people who experience urinary
elimination disorders will have a urinary
catheterization, which is the act of inserting a
catheter tube into the bladder through the urethra
with the aim of removing urine.
Retention, namely the accumulation of urine in the bladder and
Urinary
the inability elimination
of the bladder problems
to empty itself. b. Urinary
incontinence, which is a temporary or permanent inability of
the external sphincter muscle to control the discharge of urine
from the bladder. c. Enuresis, often occurs in children,
generally occurs at night (nocturnal enuresis), can occur one
or more times a night.
LANJUTAN ………

d.Urgency, adalah perasaan seseorang untuk berkemih.

e.Dysuria, adanya rasa sakit atau kesulitan dalam berkemih
f.Polyuria, Produksi urine abnormal dalam jumlah besar oleh
ginjal,seperti 2.500 ml/hari, tanpa adanya peningkatan intake
cairan.
g.Urinari suppresi, adalah berhenti mendadak produksi urine
Etiologi
a. Jumlah intake cairan dan type makanan
b.Aktivitas
c.Obstruksi
d.Infeksi
e.Kehamilan
f. Penyakit : pembesaran kelenjar prostat
g.Trauma sumsum tulang belakang
h.Operasi pada daerah abdomen bawah, pelviks, kandung
kemih,urethra.
i. Umur  
 Tanda dan gejala
Retensi Urin
1). Ketidak nyamanan daerah pubis.
2). Distensi dan ketidaksanggupan untuk berkemih.
3). Urine yang keluar dengan intake tidak seimbang.
4). Meningkatnya keinginan berkemih dan resah
5). Ketidaksanggupan untuk berkemih
Lanjutan tanda dan gejala….

 Urinary incontinence
 1). the patient can't hold the urge to urinate before
reaching the toilet
 2). patient often wets the bed
Supporting investigation
1. Ultrasound examination
2. X-ray examination 00
3. Laboratory examination of urine and feces
Defecation is the expulsion of feces from the anus
and rectum. The frequency of defecation in each
person varies greatly from a few times per day to 2
or 3 times per week. The amount of feces also varies
from person to person. When peristaltic waves
propel feces into the sigmoid colon and rectum,
sensory nerves in the rectum are stimulated and the
individual becomes aware of the need to defecate
ELEMINATION DISORDERS
Impaired faecal elimination is a condition in which an
individual experiences or is at high risk of experiencing
stasis in the large intestine, resulting in infrequent bowel
movements, hard, dry stools.
To overcome faecal elimination disorders, huknah is
usually carried out. Inserting warm fluid through the anus
to the descending colon using a cannula
Faecal elimination problems that are often found are:
a.     Constipation is a symptom, not a disease, namely a
decrease in the frequency of bowel movements accompanied
by difficult, hard, and straining stools.
b. Impaction, is the result of irregular constipation, so the hard
stool in the rectum cannot be expelled. Severe impaction,
piles of feces up to the sigmoid colon
c. Fecal incontinence, which is a condition of not being able to
control bowel movements and air from the anus, loose stools
and large numbers of them.
d. Flatulence, which is the accumulation of gas in the intestinal
lumen, the intestinal wall is stretched and distended, feeling
full, pain and cramping. Gas usually comes out through the
mouth (burping) or anus (flatus).
e. Hemorrhoids, namely dilatation of swollen veins in the
rectal wall (can be internal or external). This occurs in hard
defecation, pregnancy, heart failure and chronic liver disease
Fecal Elimination Disordera.
a. Inadequate/imperfect diet
b. Fluid
c. Increased psychological stress
d. Lack of activity, lack of exercise, lying down for a
long time
The concept of
fluid and
electrolyte
requirements
FUNGSI CAIRAN TUBUH

 Means for transporting nutrients to cells

 Removing cell waste
 Helps in cell metabolism
 As a solvent for electrolytes and non-electrolytes
 Helps maintain body temperature
 Helps digestion
 Easier elimination
 Transporting substances such as (hormones, enzymes, SDP,
HR)
Distribusi Cairan Tubuh
 COMPOSITION OF BODY
FLUIDS
1. Intracellular fluid (CIS) = 40% of total body weight fluid contained in cells
2. Extracellular fluid (ECE) = 20% of total body weight Is fluid outside the cells
transport electrolytes, enzymes, hormones & blood (platelets, leukocytes)
3. interstitial fluid (CIT): Fluid around cells (ex. lymph fluid)
4. intravascular fluid (CIV): Fluid contained within the blood vessels3.
Transcellular Fluid (CTS)
 fluid contained within special cavities of the body ex. cerebrospinal, pericardial,
pleural, synovial, and intraocular fluids and gastric secretions.
 ISF
INTERSTITIAL FLUID

. . . . . . . . . .
.. . . . . . . . . . . . . . .
.
Pembuluh INTRA VASCULAR FLUID . ..
. . . . . .
Darah IVF

. .. .. . . .. . . . ..
. . . . ..
INTRA CELLULER FLUID
ICF
Dewasa : 15 cc/kg BB/hr
Contoh:
Menghitung IWL
Tn. A BB 60 kg dengan suhu tubuh 37⁰C
15. 60= 900 cc

Jika ada kenaikan suhu

Tn.A BB 60 kg, suhu= 39⁰C
900 + 200 (39 - 36.8oC)
= 900 + 440
=1340 cc