Nutrition and Bowel Elimination Exam IV

Question 1

risk factors affecting nutrition

Answer 1

Environmental - obesity, genetics, lack of access
Pregnancy - poor nutrition causes low birth weight
-practices and beliefs
- presence of chronic illness
- medications
Age
- functional ability/dysphagia

Question 2

risk factors affecting bowel elimination

Answer 2

Age
Diet
Fluid intake
Psychological factos
Personal habits
Position during defecation
Pain
Pregnancy
Surgery/Anesthesia
Meds ~ opioids decrease peristalsis, NDSAIDS ulcers, Iron supps constipation

Question 3

What are the diagnostic tests/exams for bowel elimination

Answer 3

Endoscopy
Colonoscopy
Hematocrit/hemoglobin help determine anemia from GI bleeding
Fecal specimens (FOBT) - measures microscopic blood in feces
- Fluid baance
- Skin integrity
- Pain
- Bristol stool chart

Question 4

What are the diagnostic tests/exams for nutrition

Answer 4

• albumin levels : 3.5-5g/dL
• (+) nitrogen balance (Urine Urea Nitrogen UUN)
• diet/health history
• physical examination ~ affects all body systems
  Lipid profile
  HbA1c: <6%
  Transferrin 200-400mg
  BUN: 10-20 mg/dL

Question 5

For enteral feedings what are the assessments before starting?

Answer 5

• verify tube placement - gastric juice residual /sounds

Question 6

For enteral feedings what are the priority interventions ?

Answer 6

• confirm placement by x-ray
• assess for s/sx of intolerance (abdominal distension/cramping)

Question 7

For enteral feedings what are the complication preventions?

Answer 7

• monitor pt for first 24hrs ffor s/sx of pulmonary disress

Question 8

How deos a nurse care for a pt with an intestinal diversion?

Answer 8

• change the ostomy bag

Question 9

When pts. have alterations in bowel elimination such as constipation what are the steps of care?

Answer 9

add fiber to diet
increase fluid intake
encourage activity
provide privacy
give meds like metamucil

Question 10

When pts. have alterations in bowel elimination such as impaction what are the steps of care?

Answer 10

digital remval using gloved/lubed finger often with an osmotic enema to soften before manual disimpaction

Question 11

When pts. have alterations in bowel elimination such as diarrhea what are the steps of care?

Answer 11

adjust diet - limit caffeine, high fiber foods, fruits and or milk,
anti diarrheal med - imodium
increase fluids if dehydrated
monitor perianal area

Question 12

When pts. have alterations in bowel elimination such as hemorrhoids what are the steps of care?

Answer 12

• apply prescribed ointments/cream
  -diet modification and increased activity
  prevention throuhg: more bulk and more fluids