PROBLEMS (a) Write a diet order for patient operated upon for gastric ulcer. (b) Formulate diet to be used after a gall bladder operation. (c) Outline diet used after operation upon the kidney. FOOTNOTES: [106] "Some Gastro-intestinal Notes," "The Medical Clinics of North America," Vol. I, No. 1, pp. 192-193, by Thomas R. Brown, Johns Hopkins Hospital. [107] See Formulas for Nutrient Enemas, p. 145. [108] See Albumen Water with Brandy, p. 141. [109] "Diet in Health and Disease," p. 555, by Friedenwald and Ruhraeh. CHAPTER XVII URINALYSIS The importance of the kidney functions has been clearly demonstrated. Urine, which is the fluid secreted by these organs, is one of the most important sources of information, not only as to the manner in which the body utilizes food in health, but as an index to certain pathological conditions, the processes of which are more or less indicated by the products excreted in the urine. ~Function of the Kidneys.~--The kidneys, as has already been stated, furnish a means by which the greater part of the waste products of the body are eliminated and in addition to this function they adjust the salts in the body. In an early chapter the function of the salts in food was explained. A certain amount of these substances, we know, is absolutely necessary to carry on the work in the body, but harm comes when a surplus is retained in excess of that which can be used in performing the various processes. Consequently the function of the kidneys to adjust the salts balance is by no means their least important one. ~Elimination of the Toxins.~--The toxic substances manufactured in the body and those resulting from bacterial action upon unabsorbed proteins are likewise eliminated in the urine. Thus it can be readily understood how necessary it is to keep these organs in good repair, that they may continue their work in an efficient manner. It is necessary from a pathological standpoint for the nurse to understand the making of some of the simpler tests, that she may simplify her own work and that of the physician. ~Excretion of Carbon Dioxide and Water.~--We have already spoken of the combinations of carbon and hydrogen compounds. These substances being oxidized, the carbon dioxide produced is eliminated by way of the lungs and the water is excreted partly by way of the lungs and skin, but chiefly by way of the kidneys. ~Oxidation and Excretion of Nitrogenous Substances.~--When the nitrogenous substances are oxidized, the used-up oxygen products are eliminated by the kidneys in the form of urea and more or less highly oxidized substances, such as ammonia and other salts, purin bases, and creatinin. ~Uric Acid~, the chief of the oxidation products of nucleoproteins, is produced in the body and from food, and is always in the urine, being one of its normal constituents. It is only when this substance is in excess in the urine that a pathological condition is indicated.