Bowel Flashcards

1
Q

What is meconium?

A

first feces from a newborn

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2
Q

what is newborn stool color dependent upon?

A

type of milk ingested

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3
Q

When do you develop duodenocolic reflex?

A

toddler/preschool age

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4
Q

What age do you typically do toilet training after?

A

22 months

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5
Q

Black tarry stool means

A

upper GI bleed

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6
Q

Clay colored stool means

A

liver disfunction- lack of bilirubin

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7
Q

What does yellow/green stool mean?

A

high fat content

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8
Q

normal amount of stool is

A

100-300 g/day

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9
Q

norm stool consistency is

A

soft, formed

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10
Q

What do intestines do besides make stool?

A

segmentation, peristalsis, absorption

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11
Q

what stimulates peristalsis?

A

walls of intestines

-duodenocolic reflex

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12
Q

where are nutrients and electrolytes absorbed?

A

duodenum and jejunum

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13
Q

what is the valsalva maneuver

A
  1. deep breath
  2. contract abd muscles
  3. contract pelvic floor
    - stimulates vagal response
    - can happen in response to bearing down when constipated
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14
Q

what effects does valsalva maneuver have on other body systems?

A
  • slow heart rate
  • unclog ears
  • lower BP initially
  • reset heart rhythm
  • dizziness
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15
Q

which kind of fiber increases GI transit time? and examples

A

solube

-oat bran, barley, nuts

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16
Q

what kind of fiber decreases GI transit time? (and examples)

A

insoluble

-whole grains, fruit/veg

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17
Q

Which kind of fiber promotes loose stools?

A

insoluble

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18
Q

____% of stool is water

A

75

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19
Q

If you have increased GI motility will stool be solid or loose?

A

loose

-not enough water being absorbed by body

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20
Q

factors impacting bowel elimination

A
  • activity
  • ignoring urge leads to weakening urge over time
  • change in routine
  • pregnancy
  • medications
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21
Q

When pregnant women take iron supplement, what happens to bowel habits?

A

constipation

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22
Q

when colon is diverted through a stoma?

A

colostomy

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23
Q

when ileum is diverted through a stoma?

A

ileostomy

-no large intestine

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24
Q

which is more likely to have issues with fluid and electrolyte loss- colostomy or ileostomy?

A

ileostomy b/c no large intestine

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25
Q

What are kock and j pouches?

A

surgical pouches to give patient control over ostomy bowel movement timing

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26
Q

Normal stoma is

A

pink

on abd surface

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27
Q

how much space b/w stoma and bag?

A

1/8- 1/4”

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28
Q

what does a dusky/blue stoma indicate?

A

poor circulation

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29
Q

what does a stoma that is retracting indicate?

A

potential for feces in ABD cavity –> peritonitis

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30
Q

when should ostomy pouch be emptied (volume in bag)

A

1/4-1/3 of way full

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31
Q

what do you rinse the pouch with after cleaning it?

A

clea warm water with 60 mL syringe

32
Q

what if fecal contents leak around the pouch where it is attached to skin?

A

-change entire device

33
Q

Scaphoid shaped ABD indicates

A

malnutrition

34
Q

Distended ABD indicates

A

obstruction

35
Q

Normal bowel sounds are heard within

A

5-15 seconds

36
Q

when is auscultation preformed in ABD assessment?

A

before palpation!

37
Q

if bowel sounds occur more than every 5 seconds =

A

hyperactive

38
Q

how to listen to confirm absent bowel sounds

A

3-5 minutes = 1-2 minute/quadrant

39
Q

what is most important factor for determining if someone is constipated or not?

A

routine

-3 days since last bowel movement might be normal for someone

40
Q

signs of constipation

A
bloating
fullness
urge to defecate without ability to pass stool
malaise
loss of appetite 
nausea
vomiting 
abd distention
41
Q

definition of chronic constipation

A

constipation persistent for at least 12 weeks in a years time

42
Q

common causes of constipation

A

meds, opioids, fiber, inactivity

43
Q

what is usually the cause of fecal impaction?

A

result of untreated and unrelieved constipation

44
Q

signs and sxs of fecal impaction

A

-several day constipation followed by INVOLUNTARY, LOOSE BM that does not relieve feeling of constipation

45
Q

how is fecal impaction diagnosed?

A

digital rectal exam

46
Q

what type of gastric motility causes diarrhea?

A

increased

47
Q

What type of bowel sounds with diarrhea?

A

hyperactive

48
Q

causes of diarrhea

A

meds, medical conditions, emotional changes

49
Q

symptoms of diarrhea

A

cramping
nausea
Prolonged: burning sensation, anal inflammation, bleeding/breakdown

50
Q

causes of fecal incontinence

A
  • neurological injury
  • spinal cord injury
  • altered mental status
51
Q

what causes gas?

A

bacteria activity in large intestine

52
Q

Surgery and gas

A
  • see gas when ambulating after surgery

- see gas with all surgery but more with ABD

53
Q

what foods increase flatulence? what can help with that?

A

high fiber

-introduce new high fiber diet gradually

54
Q

Distention requires…..

can be caused by…..

A

investigation and follow up

obstruction or tumor

55
Q

What type of bowel activity could lead to an order for a stool specimen and culture?

A

-diarrhea or altered color

56
Q

what is a fecal occult blood test

A

-tests presence of blood in stool

57
Q

fecal occult blood test is screening test for

A

colorectal cancer b/c blood in stool may indicate cancer or polyps in rectum or colon

58
Q

considerations for after a barium swallow

A

-impaction, constipation, increase fluids, chalky/white stool, adminster laxative

59
Q

test for upper GI?

A

EGD

60
Q

Lower GI tests and frequency for colorectal cancer screening

A

sigmoidoscopy- every 5 yrs

colonoscopy - every 10 years

61
Q

After lower GI tests monitor for…

A

Dull abd pain (perforation)

bleeding

62
Q

which is used more often? sigmoid or colon oscopy?

A

colonoscopy since it visualizes the entire colon

63
Q

bulk laxative examples and fxn

A

metamucil, fibercon

-nonabsorbable fiber attracts water into large intestine

64
Q

emollient (stool softeners) examples and fxn

A

colace, surfak

  • allow more water to enter stool
  • short term usage
65
Q

osmotic laxative and fxn

A

milk of magnesia, fleet enema, miralax

  • increase colon motility through release of CCK causing water retention in stool
    • more frequent and softer stool
66
Q

stimulant laxative and fxn

A

castor oil, senokot, ex-lax

-direct stimulation of intestinal mucosa

67
Q

2 antidiarrheal treatments

A

loperamide

bismuth subsalicylate

68
Q

medications to treat cause of diarrhea

A
  • antimicrobials

- steroids used for inflammatory bowel disease

69
Q

how do you treat CDiff?

A

fecal microbiota transplantation

-90% effective in treating

70
Q

when should use use bowel training?

A

for people with neurological impairment

71
Q

tools for bowel training

A

-schedule

partial sphincter control: pelvic floor exercise, abd massage, biofeedback

72
Q

enema indication

A
  • promote bowel movement

- clear bowel area before a procedure

73
Q

Types of enemas (3)

A

small volume- mineral oil and steroids
large volume- tap water/saline
return flow- removes flatus

74
Q

NG tube indications

A
  • gastric decompression
  • gastric lavage
  • gastric feeding
75
Q

how do you confirm NG tube placement?

A

xray!

**confirm before use!