1. Elimination Elimination is the process of removing waste from the body. Hubbs Pre-CNA Elimination Unit SP2-AP2

2. Two Elimination Systems The Urinary System removes liquid waste (urine) from the body and maintains fluid balance. The Gastrointestinal (Digestive) System removes solid waste (feces) from the body.

3. The Urinary System 1. ______________ 2. ______________ 3. ______________ 4. _______________

4. The Digestive System 1.___________ 9.______________ 3._____________ 4.______________ 5.______________ 6._____________________________ 7.___________________________ 8.______________ 2.______________

5. Urinary System Topics covered: Normal urine characteristics Factors affecting urinary elimination Urinary system changes with aging Urinary problems Urinary tract infections

6. Normal Urine Color Pale yellow Straw- colored Amber color Clarity Clear Particles No Odor Faint

7. Factors Affecting Urinary Elimination A healthy person produces about 1500 cc’s of urine per day Age Disease Foods eaten Salt intake Body Temperature Perspiration Medication

8. Urinary System Changes With Aging Kidney function decreases Waste removal is less efficient Bladder muscles weaken Bladder size decreases – holding less urine Prostate gland in men enlarges

9. Common Urinary Problems Urinary Incontinence: inability to control the bladder. Urinary frequency: voiding at frequent intervals Urinary urgency: the need to void immediately Urinary retention – the bladder does not empty completely

10. Urinary Tract Infection (UTI) SYMPTOMS Urinary frequency Urgency Pain or burning on urination Blood or pus in the urine Foul-smelling urine fever What the CNA can do to help Encourage fluids Provide good peri-care Accurate observation of urine

11. Women are more susceptible to UTIs than men because the female urethra is shorter than the male’s.. bladder urethra bladder urethra FemaleMale

12. Digestive (GI) System Topics covered: Factors affecting bowel elimination Normal bowel movement observations Common GI disorders

13. Factors Affecting Bowel Elimination Privacy Habits Diet Fluid intake Activity Medications Disability Age

14. Bowel Movements Observations Observe:Normal colorbrown consistencysoft/formed/moist odoryes shapelike the rectum size varies frequency varies-some people have BMs daily, others every 2-3 days

15. Common GI Disorders Fecal incontinence – inability to control the passage of feces through the anus. Diarrhea – frequent passage of liquid stools. Emesis-Vomiting is a sign of illness Constipation – the passage of a hard, dry stool. Fecal impaction - a build up of feces in the rectum.

16. Enemas Enemas (the placing of fluid into the rectum to soften and remove stool) can be used to relieve constipation and fecal impaction.

17. Elimination Equipment

18. Male Urinal Bedridden men (not women) use to urinate.

19. Incontinence Products Incontinence products help keep the person’s skin dry.

20. Standard Bedpan Bedridden women use for urinating and defecating. Bedridden men use for defecating.

21. Fracture Bedpan Fracture pans are used for persons with: Casts Limited back motion or spinal cord injury Surgery Hip fracture or replacement surgery Painful joints

22. Commode A commode is a chair or wheelchair with an opening for bedpan or container. It allows for normal sitting positioning for elimination.

23. Urinary Catheters Also called a FOLEY A tube inserted into the bladder to drain urine. Can promote comfort and prevent skin breakdown for person with urinary incontinence.