Bowel

Question 1

What is meconium?

Answer 1

first feces from a newborn

Question 2

what is newborn stool color dependent upon?

Answer 2

type of milk ingested

Question 3

When do you develop duodenocolic reflex?

Answer 3

toddler/preschool age

Question 4

What age do you typically do toilet training after?

Answer 4

22 months

Question 5

Black tarry stool means

Answer 5

upper GI bleed

Question 6

Clay colored stool means

Answer 6

liver disfunction- lack of bilirubin

Question 7

What does yellow/green stool mean?

Answer 7

high fat content

Question 8

normal amount of stool is

Answer 8

100-300 g/day

Question 9

norm stool consistency is

Answer 9

soft, formed

Question 10

What do intestines do besides make stool?

Answer 10

segmentation, peristalsis, absorption

Question 11

what stimulates peristalsis?

Answer 11

walls of intestines

-duodenocolic reflex

Question 12

where are nutrients and electrolytes absorbed?

Answer 12

duodenum and jejunum

Question 13

what is the valsalva maneuver

Answer 13

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

Question 14

what effects does valsalva maneuver have on other body systems?

Answer 14

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

Question 15

which kind of fiber increases GI transit time? and examples

Answer 15

solube

-oat bran, barley, nuts

Question 16

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

Answer 16

insoluble

-whole grains, fruit/veg

Question 17

Which kind of fiber promotes loose stools?

Answer 17

insoluble

Question 18

____% of stool is water

Answer 18

75

Question 19

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

Answer 19

loose

-not enough water being absorbed by body

Question 20

factors impacting bowel elimination

Answer 20

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

Question 21

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

Answer 21

constipation

Question 22

when colon is diverted through a stoma?

Answer 22

colostomy

Question 23

when ileum is diverted through a stoma?

Answer 23

ileostomy

-no large intestine

Question 24

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

Answer 24

ileostomy b/c no large intestine

Question 25

What are kock and j pouches?

Answer 25

surgical pouches to give patient control over ostomy bowel movement timing

Question 26

Normal stoma is

Answer 26

pink | on abd surface

Question 27

how much space b/w stoma and bag?

Answer 27

1/8- 1/4"

Question 28

what does a dusky/blue stoma indicate?

Answer 28

poor circulation

Question 29

what does a stoma that is retracting indicate?

Answer 29

potential for feces in ABD cavity --> peritonitis

Question 30

when should ostomy pouch be emptied (volume in bag)

Answer 30

1/4-1/3 of way full

Question 31

what do you rinse the pouch with after cleaning it?

Answer 31

clea warm water with 60 mL syringe

Question 32

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

Answer 32

-change entire device

Question 33

Scaphoid shaped ABD indicates

Answer 33

malnutrition

Question 34

Distended ABD indicates

Answer 34

obstruction

Question 35

Normal bowel sounds are heard within

Answer 35

5-15 seconds

Question 36

when is auscultation preformed in ABD assessment?

Answer 36

before palpation!

Question 37

if bowel sounds occur more than every 5 seconds =

Answer 37

hyperactive

Question 38

how to listen to confirm absent bowel sounds

Answer 38

3-5 minutes = 1-2 minute/quadrant

Question 39

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

Answer 39

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

Question 40

signs of constipation

Answer 40

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

Question 41

definition of chronic constipation

Answer 41

constipation persistent for at least 12 weeks in a years time

Question 42

common causes of constipation

Answer 42

meds, opioids, fiber, inactivity

Question 43

what is usually the cause of fecal impaction?

Answer 43

result of untreated and unrelieved constipation

Question 44

signs and sxs of fecal impaction

Answer 44

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

Question 45

how is fecal impaction diagnosed?

Answer 45

digital rectal exam

Question 46

what type of gastric motility causes diarrhea?

Answer 46

increased

Question 47

What type of bowel sounds with diarrhea?

Answer 47

hyperactive

Question 48

causes of diarrhea

Answer 48

meds, medical conditions, emotional changes

Question 49

symptoms of diarrhea

Answer 49

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

Question 50

causes of fecal incontinence

Answer 50

- neurological injury - spinal cord injury - altered mental status

Question 51

what causes gas?

Answer 51

bacteria activity in large intestine

Question 52

Surgery and gas

Answer 52

- see gas when ambulating after surgery | - see gas with all surgery but more with ABD

Question 53

what foods increase flatulence? what can help with that?

Answer 53

high fiber | -introduce new high fiber diet gradually

Question 54

Distention requires..... | can be caused by.....

Answer 54

investigation and follow up | obstruction or tumor

Question 55

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

Answer 55

-diarrhea or altered color

Question 56

what is a fecal occult blood test

Answer 56

-tests presence of blood in stool

Question 57

fecal occult blood test is screening test for

Answer 57

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

Question 58

considerations for after a barium swallow

Answer 58

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

Question 59

test for upper GI?

Answer 59

EGD

Question 60

Lower GI tests and frequency for colorectal cancer screening

Answer 60

sigmoidoscopy- every 5 yrs | colonoscopy - every 10 years

Question 61

After lower GI tests monitor for...

Answer 61

Dull abd pain (perforation) | bleeding

Question 62

which is used more often? sigmoid or colon oscopy?

Answer 62

colonoscopy since it visualizes the entire colon

Question 63

bulk laxative examples and fxn

Answer 63

metamucil, fibercon | -nonabsorbable fiber attracts water into large intestine

Question 64

emollient (stool softeners) examples and fxn

Answer 64

colace, surfak - allow more water to enter stool - short term usage

Question 65

osmotic laxative and fxn

Answer 65

milk of magnesia, fleet enema, miralax - increase colon motility through release of CCK causing water retention in stool - - more frequent and softer stool

Question 66

stimulant laxative and fxn

Answer 66

castor oil, senokot, ex-lax | -direct stimulation of intestinal mucosa

Question 67

2 antidiarrheal treatments

Answer 67

loperamide | bismuth subsalicylate

Question 68

medications to treat cause of diarrhea

Answer 68

- antimicrobials | - steroids used for inflammatory bowel disease

Question 69

how do you treat CDiff?

Answer 69

fecal microbiota transplantation | -90% effective in treating

Question 70

when should use use bowel training?

Answer 70

for people with neurological impairment

Question 71

tools for bowel training

Answer 71

-schedule | partial sphincter control: pelvic floor exercise, abd massage, biofeedback

Question 72

enema indication

Answer 72

- promote bowel movement | - clear bowel area before a procedure

Question 73

Types of enemas (3)

Answer 73

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

Question 74

NG tube indications

Answer 74

- gastric decompression - gastric lavage - gastric feeding

Question 75

how do you confirm NG tube placement?

Answer 75

xray! | **confirm before use!