NCLEX Review Guide: Fundamentals, Elimination & Procedures, Restorative Elimination Care

Urinary Elimination

• Normal urine output is 30 mL/hr or 0.5-1 mL/kg/hr for adults, indicating adequate kidney function and hydration status.
• Urine should be pale yellow to amber in color, clear without sediment, and have a mild ammonia odor.
• Normal voiding frequency is every 3-4 hours during the day with minimal nighttime voiding.

Bowel Elimination

• Normal bowel movements range from 3 times daily to 3 times weekly, depending on individual patterns and dietary habits.
• Stool should be soft, formed, and brown due to bile pigments, without blood, mucus, or unusual odor.

Urinary Issues

• Oliguria (urine output <400 mL/24 hours) may indicate dehydration, kidney dysfunction, or urinary obstruction requiring immediate assessment.
• Dysuria (painful urination) often suggests urinary tract infection and requires urinalysis and culture.
• Urinary retention involves inability to empty bladder completely, leading to overflow incontinence and potential UTI.

Bowel Issues

• Constipation is fewer than 3 bowel movements weekly with hard, dry stools requiring increased fiber, fluids, and mobility.
• Diarrhea involves loose, watery stools >3 times daily, risking dehydration and electrolyte imbalance.

Catheter Care

1. Perform hand hygiene and don clean gloves before any catheter manipulation
2. Clean catheter insertion site with soap and water during daily hygiene care
3. Keep drainage bag below bladder level to prevent backflow and infection
4. Empty drainage bag when 2/3 full using sterile technique
5. Document urine color, clarity, amount, and any sediment or odor

Bowel Training Programs

• Establish regular toileting schedule every 2-3 hours and after meals to promote natural gastrocolic reflex.
• Position patient upright on toilet or bedside commode when possible to facilitate gravity-assisted elimination.
• Provide privacy, adequate time, and call light within reach to reduce anxiety and promote relaxation.