Exam 3 BM Flashcards
What GI disease kidney disease pt usually have?
Anorexia and GI bleed
List 5 causes of pt to more likely to have constipation
- Uncontrolled DM = cause gastroparesis = decrease of food from stomach to small intestines without physical obstruction
- HF pts condition
- Older pts (due to decrease mobility, fluid and fiber intake)
- Barium or other types of contrast IV drinking for diagnostic procedure
- Pt went through a surgical procedure with anesthesia and opioids intake
How to know if GI have any activity?
If auscultation hear hypoactivity GI
Can ask pt if they burped or passed any gas
List 12 factors affecting BM
- Age (infants - toddler - children age - adult - geriatric)
- Fluid and intake
- Physical activity
- Pathological conditions
- Pain
- Medications and laxatives
- Position during defecation
- Personal habits
- Diagnostic testing
- Surgical operations
- Psychological factors
- Pregnancy
Do infants have immature GI that causes soft stool and involuntary?
Yes
True or false: at toddler age, they have neuromuscular development, so they are aware of privacy and when having a BM but still need potty trained?
True
How is school age children vs adult in BM?
Same awareness and behavior as adult but still need to encourage them because they tend to be not getting up or not going on urge when playing.
What is the benefit of physical activity to GI?
Increase in GI peristalsis = Helps to eliminate waste and absorb food nutrients better
What 3 medications can lead to diarrhea?
Antibiotics, lactulose, laxatives & cathartics (if abusing because of habit forming)
What 4 medications can cause constipation?
Opioids, acids, iron meds, (antidiarrheal meds)
What 3 diagnostics testing can affect GI?
Endoscopy, barium swallowing CT scan, X-ray
Describe position can help better BM?
Knees higher than butt, pressure on the abdomen by squad sitting position slight leaning forward, thigh constricts = straighten angle of the anal canal & rectum = easier to have BM
Range of fiber intake?
24-38 g/day, depends on gender, sizer, occupation of a person
Does surgery and anesthesia cause decrease in GI mobility because it blocked PNS?
Yes
True or False: pt with depression = more likely to have constipation: pt with anxiety, stress = more likely to have BM or diarrhea
True
Do pregnancy at third semester tend to have constipation?
Yes
Why pain cause constipation?
Pt might refrain bc of pain so avoid to go. Or when using narcotics/pain meds causing hard to go bc they decrease in GI.
Describe constipation
Having less than 3 BM/week. Tend to cause excessive straining
When applied pressure to a closed glottis, what happened?
Cause vasovagal response called valsalva maneuver = cause bradycardia & syncopal episodes (fainting)
What do hospital give when pt having constipation?
Commonly laxatives or prune juice
List 3 effective ways for constipation implementation
- Encourage fluid, fiber intake and mobility
- Provide environment that is relaxing and comfortable
- Less narcotics intake
Define impaction
Is unrelieved constipation, hard feces that has soft oozes around it.
Cause of impaction (hint: give 3 causes)
- Cause of narcotics/opioids intake
- Decrease in fluid, fiber intake and decrease in mobility
- Anticholinergic, antihistamine meds (bc they decrease in GI activity)
2 ways to treat impaction
Can do enemas or manual/digital disimpaction
Define diarrhea
Involuntary spasmodic cramps that is associated with GI disease.
Give 4 causes of diarrhea
- Antibiotics
- Irritating food like spicy food; contaminated food or fluid
- Lactulose
- C.diff
2 implementations for treatments of diarrhea?
Give fluids for dehydration status
Give antidiarrheal meds
Define incontinence
It is the inability to voluntarily control the passage of feces and flatus
3 causes of incontinence
Anal sphincter problems
GI disease
Nerve impairement
Define flatulence
Accumulation of gas due to swallowing of gas or due to production of gas from bacteria in the GI tract
2 Treatments of flatulence
Antiflatulence
mobility
Define hemorrhoids
Vasodilation of the Gorge veins in the rectum that can be internal or external. It will cause discomfort/pain when having a BM.
3 Causes of hemorrhoids
- Straining
- Pregnancy
- Heart and liver disease
Treatment of hemorrhoids
Can give a sitz bath and give topical vasoconstriction meds like prep H (however this can cause pruritis, so can give 1% hydrocortisone cream for externally only)
What is bowel diversions?
A different passageway of feces than traditional way through surgery by creating a stoma
Causes of bowel diversions
Colon cancer, anus/rectum cancer, perforated bowel, knife/trauma to the abdomen, diverticulosis, other GI disease
True or false: stoma should be red, beefy, moist, no bleeding and no sensation
True
Is post op edema normal?
Yes. Around 1-3 cm above skin = normal