38 Bowel Elimination

Question 1

part of the GI that digests protein and carbs

Answer 1

Small intestines

Question 2

digestive juices fr liver + pancreas enter the ___

Answer 2

small intestines thru opening in duodenum

Question 3

small intestines is responsible for…

Answer 3

digestion of food + absorption of nutrients into bloodstream

Question 4

controls the mvmt of chyme fr stomach to sm.intestines

Answer 4

pyloric sphincter

Question 5

connection bw ileum (sm.intstn) + lrg intestines

Answer 5

ileocecal or ileocolic valve

Question 6

which colon contains feces?

Answer 6

sigmoid colon (comes after descending colon)

Question 7

large intestines are responsible for…

Answer 7

absorption of water, formation of feces, expulsion of feces

Question 8

bacteria in the large intestines act on food residue to produce…

Answer 8

vitamin K + some B complex

Question 9

nervous system + effects on GI mvmt

Answer 9

autonimic NS- innervates muscles of colon
parasympathetic- stim mvmt
sympathetic- inhibits mvmt

Question 10

nervous system on defecation

Answer 10

parasymph- intrinsic anal sphincter relaxes, colon contracts, allows fecal mass to enter the rectum
symph- motor impulses

Question 11

feces vs stool

Answer 11

stool is when feces is expelled out of the body

Question 12

fecal impaction

Answer 12

prolonged retention or an accum of fecal material that forms a hardened mass in the rectum

Question 13

Black stool may be caused by

Answer 13

• upper GI bleeding like peptic ulcers
• iron salts fr oxidation of iron
• bismuth subsalicylate

Question 14

opiods causes medication-induced constipation

Answer 14

enteric neurons control major body functions like bowel control

• opiod-binding receptors are found in enteric neurons in GI tract
• binding interrupts peristalsis
• slow mvmt of stool> incr absorption of h20>

Question 15

meds that cause constipation

Answer 15

• opioids
• antacids w Al, FeS
• anticholinergic
• inhaled anesthesia for surgery (does NOT apply to local or regional anesthetics)

Question 16

meds that cause diarrhea

Answer 16

• antibiotics like amoxicillin
• antacids w Magnesium
• metmorfin (for diabetes)
• broad-spectrum antibiotics can cause C.diff to multiply

Question 17

signs of intestinal obstruction

Answer 17

• distention (inflation)
• potrusion (projection)
• visible waves of peristalsis on the abdomen (usually not visible except in v thin patients)
• hypo(late), hyper(early/partial), absent bowel sounds

Question 18

HYPOactive bowel sounds

Answer 18

sign of abdominal surgery ot LATE bowel obstruction

Question 19

HYPERactive bowel sounds

Answer 19

• diarrhea
• gastroenteritis
• early/partial bowel obstruction

Question 20

Absent bowel sounds (2 mins+)

Answer 20

• peritonitis
• paralytic ileus
• prolonged mobility

Question 21

Guaiac Fecal Occult Blood Test

[gFOBT]

Answer 21

chemical test that detects the enzyme peroxidase in hemoglobin molecules when blood is present in stool sample

Question 22

false positives in gFOBT readings may be caused by

Answer 22

• salycate of 325mg+
• nonsteroidal antiinflammatory
• steroids
• iron
• anticoagulants

Question 23

false negative in gFOBT readings even when blood is present may be caused by

Answer 23

ingestion of vitamin C

Question 24

Collecting stool samples

Answer 24

asepsis technique, don gloves

• void first
• defecate into container
• avoid contact w soaps, detergents disinfectants, or toilet paper
• notify nurse when specimen is available
• use 2 clean tongue blades
• send to lab immediately or refrigerate

Question 25

Endoscopy

Answer 25

direct visualization of body organs or cavities | -long, flexible used w fiberoptic tube that transmits light into organs + returns image

Question 26

Endoscopy is useful for detecting...

Answer 26

- integrity of mucosa, bld vssls, organ parts - inflammatory, ulcerative, + infectious diseases - benign/malignant neoplasms - lesions of esophageal, gastric, intestinal mucosa

Question 27

3 types of Endoscopy

Answer 27

``` 1 esophagogastroduodenoscopy [EGD] 2 colonoscopy (lrg intstn: anus to ileocecal valve) 3 sigmoidoscopy (sigmoid colon, rectum, anal canal) ```

Question 28

Barium Enema

Answer 28

series of radiographs that examine the large intestine after rectal instillation of Barium sulfate -do not use if hx of ulcerative colitis or active GI bleeding

Question 29

Abdominal Ultrasound

Answer 29

uses ultrasound waves to visualize organs via small transducer placed against skin

Question 30

____ must be performed before studies involving Barium

Answer 30

abdominal ultrasound -retained barium might compromise study

Question 31

which endoscopy will let you view the distal small bowel?

Answer 31

colonoscopy

Question 32

which endoscopy will let you view the duodenum?

Answer 32

esophagogastroduodenoscopy

Question 33

fecal impaction

Answer 33

most often caused by constipation | -prevents passage of normal stools

Question 34

sign of fecal impaction

Answer 34

liquid fecal seepage w no passage of normal feces | -small amt of liquid may pass around the impacted mass

Question 35

high risk for fecal impaction

Answer 35

- frequent use of stimulant laxative - immobile - spinal cord injury - parkinson's - diabetes mellitus - malignancies - chronic kidney disease

Question 36

Ileostomy

Answer 36

allows LIQUID fecal content fr ileum of SMALL INTESTINE be eliminated thru stoma

Question 37

Colostomy

Answer 37

permits FORMED FECES in colon to exit thru stoma

Question 38

Urostomy

Answer 38

stoma attaches to the tubes that transport urine away from the bladder.

Question 39

Stoma appearance

Answer 39

NORMAL: dark pink to red, moist, protrude 0.5-1in - pale>anemia - dark, purple, blue>ischemia - minimal bleeding is normal, contact provide if bleeding persist - flush stoma>erosion

Question 40

J Pouch

Answer 40

type of bowel diversion that does NOT require a stoma. | -aka restorative prctocolectomy ileal pouch-anal anastomosis [IPAA]

Question 41

J pouch or IPAA are best for patients w...

Answer 41

inflammatory bowel disease or ulceritive colitis

Question 42

J pouch or IPAA involves the removal of ______ + ____ but leaves the ____ intact

Answer 42

removal of colon + rectum | leaves the anus intact