ELIMINATING

Kelompok 8:
Aida Rafika Amna
Azka
Febriana Ulfa
Marfirah Aulia Riska
 Introduction
.The act of elimination is a fundamental human
process essential to life. Being able to meet clients'
elimination needs is therefore an essential nurs- ing
function and can help to both maintain and/or
restore a client's well- being and preserve life.
many of the nursing interventions required are of a
very intimate nature, for example cleans- ing the
perineum following defecation or dealing with a
client's menstrual flow. Gaining the client's trust and
confidence, along with their permis- sion, is
therefore crucial.
 Elimination of urine
The urinary system is an excretory system of the body and consists
of a
number of structures. We have two kidneys responsible for water
and
electrolyte balance and the formation of urine by simple filtration,
selec-
tive reabsorption and secretion.We also have
two ureters, responsible for carrying the urine from the kidneys to
the
urinary bladder by peristaltic contraction of their muscle walls; and
one
urinary bladder, which acts as a reservoir where urine is stored prior
to
being excreted. Finally, we have one urethra, a channel leading from
 Elimination of faecal waste

The waste products of digestion are excreted through

the bowel. They
pass from the ileum through the ileo-caecal valve into
the caecum. In the
large intestine absorption of water occurs until the
semi-solid consistency
of faeces is achieved.
The factors that affect elimination may be:
• physical arising from alteration in the structure, function or processes of
the urinary, gastro-intestinal or associated bodily systems.

• psychological such as intellect, anxiety and stress.

• sociocultural, for example different words used for elimination and

products
of elimination

• environmental including poor food storage, personal hygiene and toileting

facilities.

• politico-economic, for example lack of finances for a healthy high-fibre

diet, political influences on availability of certain foods and genetically
modified products.
 Assisting clients to use toileting facilities
Adaptations can be made to the toilet if required to enable a
person to continue to use the toilet if, due to mobility problems,
this is becoming difficult.
Raised toilet seats and rails can help some people to get on and
off the toilet and help them to continue to meet their elimination
needs independently.
 Using a commode
If a person is unable to get to the toilet then a commode can be
used. The nurse can either wheel the client to the toilet on the
commode, or the client can use the commode at the side of their
bed.
When a person is using a commode the nurse or other carer
needs to ensure that the commode is cleaned before and after
use.
Using a bedpan or urinal
If a client is unable to go to the toilet then a bedpan or urinal will be
required.
When assisting a client with their elimination needs, standard precau-
tions should be applied. You should wear a plastic apron and gloves if
you are likely to come into contact with body fluids.

Applying/changing a nappy Rationale

To maintain personal hygiene and comfort, to monitor urinary and faecal output
and to assess and/or maintain skin integrity.
Care of an indwelling urinary catheter
A urinary catheter is a hollow tube that is inserted into the bladder to
drain urine. They can be used intermittently, short term or long term.
However, insertion of a urinary catheter should only ever be performed if sound
justification can be advanced, as the risk of infection both during and following
insertion is very high and can lead to prolonged hospital-ization and even death in
susceptible individuals.
Cleaning the catheter and surrounding area
To reduce the risk of infection, the area of the client’s body around the following
a bowel action. Clients with an indwelling catheter should betine.
Removing a urinary catheter
To restore client comfort and promote normal functioning.
Monitoring urinary output
Normal urinary output is approximately 1.5 litres in 24 hours and the usual
frequency of micturition is between 5 and 10 times in that period.However,
this can be influenced significantly by the amount of fluid a per son drinks
and how much fluid they are losing through sweating, mental state and
lifestyle.Urine normally consists of
96% water
2% urea
2% uric acid, creatinine, sodium, potassium, chlorides, phosphates,
sulphates, oxalates
Performing urinalysis
Urinalysis, or analysis of urine, is important as disturbances of
normal physiological functions are often reflected in the urine.

Appearance of the urine

Urine is usually clear but may vary from straw colour to darkish
yellow or orange. Uncharacteristic colours are due to a variety of
naturally occurring pigments from endogenous substances or
various exogenous chemicals.
Odour
Fresh urine has very little smell, but will begin to smell of ammonia if left to stand.

• Infected urine has a foul, fishy smell.

• The sweet smell of acetone (pear drops or nail varnish remover) indicates
the presence of ketones.
• Eating fish, curry or other strongly flavoured foodstuff can also make the urine
smell.
• Certain medications, such as menthol antibiotics, and some vitamins can also
affect the odour of urine.
If any abnormality is suspected it is usual to obtain a specimen of urine.
Monitoring bowel actions
Bowel habits are variable between individuals and are influenced by
lifestyle, eating habits and mental state. The average adult will pass
100–150 g of faeces once per day; change in this pattern and change in
the nature of faeces passed can indicate disease. The health care profes-
sional will therefore need to monitor the bowel action of clients where
Actual or potential problems are indicated.

Monitoring vomitus
Monitoring a client’s vomiting pattern along with the amount and con-
sistency of the vomit can help in determining the nature of their condition
as well as assisting in helping us determine a client’s potential for malnu-
trition and dehydration, and subsequently their replacement needs.
Thanks