bowel elimination

Question 1

alterations in regular bowel elimination are early signs of

Answer 1

problems in the gastrointestinal tract or other body systems

Question 2

parts of digestive system

Answer 2

mouth
esophagus
stomach
small intestine
large intestine (colon)
anus
defecation

Question 3

the human mouth, esophagus, stomach, small intestine, colon, and rectum contain

Answer 3

millions of non harmful bacteria

Question 4

are GI tract procedures we perform as nurses sterile

Answer 4

no

Question 5

mouth

Answer 5

digestion begins with mastication (chewing)

Question 6

esophagus

Answer 6

peristalsis moves food into the stomach

Question 7

stomach

Answer 7

stores food, mixes food, liquid, and digestive juices, moves food into small intestines

Question 8

small intestine

Answer 8

duodenum
jejunum
ileum

Question 9

large intestine

Answer 9

primary organ of bowel elimination

Question 10

anus

Answer 10

expels feces and flatus from the rectum

Question 11

digestion

Answer 11

begins in the mouth and ends in the small and large intestines
mechanical breakdown that results from chewing, churning, and mixing with fluid and chemical reactions in which food reduces to its simplest form

Question 12

absorption

Answer 12

intestine is the primary area of absorption, then metabolism and storage of nutrients
the small intestine is lined with fingerlike projections called villi
absorption of carbs, protein, minerals, and water soluble vitamins occurs in the small intestine

Question 13

metabolism

Answer 13

all biochemical reactions within the cells of the body

anabolic vs catabolic

Question 14

elimination

Answer 14

chyme is moved through peristalsis and is changed into feces
chyme moves by peristaltic action through the ileocecal valve into the large intestine, where it becomes feces
water absorbs in the mucosa as feces move toward the rectum

Question 15

peristalsis

Answer 15

series of involuntary wave-like muscle contractions which move food along the digestive tract

Question 16

what increases and decreases peristalsis

Answer 16

stress and anxiety increase

surgery and anesthesia decrease

Question 17

factors influencing bowel elimination

Answer 17

age
diet
fluid intake
physical activity
psychological factors
personal habits
position during defecation
pain
surgery and anesthesia
medications

Question 18

what drug can cause constipation

Answer 18

opioids

Question 19

constipation

Answer 19

symptom, not a disease; infrequent stool and/or hard, dry, small stools that are difficult to eliminate

Question 20

impaction

Answer 20

results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel

Question 21

diarrhea

Answer 21

an increase in the number of stools and the passage of liquid, unformed feces

Question 22

incontinence

Answer 22

inability to control passages of feces and gas to the anus

Question 23

flatulence

Answer 23

accumulation of gas in the intestines causing the walls to stretch

Question 24

hemorrhoids

Answer 24

dilated, engorged veins in the lining of the rectum

Question 25

bowel diversions

Answer 25

temporary or permanent artificial opening in the abdominal wall (stoma) surgical opening in the ileum or colon ileostomy or colostomy location of an ostomy determines stool consistency

Question 26

ileostomy stool consistency

Answer 26

thin to thick liquid

Question 27

large intestine ostomy

Answer 27

ascending - thick liquid transverse - thick liquid to soft descending -soft to formed sigmoid - more formed

Question 28

three types of ostomies

Answer 28

colostomy ileostomy urostomy

Question 29

colostomy types

Answer 29

ascending transverse descending sigmoid

Question 30

what characteristics should the stoma have if patient has a bowel diversion

Answer 30

beefy bright red, moist | blue or purple means decreased blood flow and is an emergency

Question 31

effective pouching system for ostomies

Answer 31

protects skin, contains fecal material, remains odor free, and is comfortable and inconspicuous

Question 32

nutritional considerations for ostomies

Answer 32

consume low fiber for the first few weeks eat slowly and chew food completely drink 10-12 glasses of water daily eat food slowly and chew food completely so food breaks down easier patient may choose to avoid gassy foods

Question 33

psychological considerations with ostomies

Answer 33

serious body changes/self image intimacy needs odor

Question 34

assessment for ostomies

Answer 34

``` nursing history physical assessment mouth abdomen identifying normal and abnormal patterns, habits, and the patient's perception of normal and abnormal with regard to bowel elimination not everyone eliminates feces everyday - after 3 days, we worry laboratory tests fecal specimens test stool for blood, parasites, etc diagnostic examinations ```

Question 35

review box 47.3

Answer 35

47.3

Question 36

collection of a stool sample

Answer 36

hat or collect stool from brief wear gloves while collecting use tongue depressor or a spoon to pick up stool and place collect in a dry, clean, leak-proof container usually don't need much make sure there's no urine or water seal specimen well place specimen in a biohazard bag for transport look for parasites, ovum, blood, black/tarry stool, in sample notice color and consistency send stool to lab don't let it go into the toilet

Question 37

promotion of normal defecation

Answer 37

``` sitting position positioning on bedpan develop and promote routine privacy safety ```

Question 38

bedpan use

Answer 38

if patient is immobile or it is unsafe to allow them to raise their hips, they remain flat and roll onto the bedpan

Question 39

standard bedpan position

Answer 39

wide side up

Question 40

fracture bedpan position

Answer 40

wide side down

Question 41

cathartics and laxatives

Answer 41

medications that initiate and facilitate stool passage empty the bowel cathartics have a stronger and more rapid effect on the intestines than laxatives laxatives can be administered via oral route or suppository route suppositories may act more quickly than oral medications (stimulate rectal mucosa)

Question 42

antidiarrheal agents

Answer 42

decrease intestinal muscle tone to slow passage of feces

Question 43

enemas

Answer 43

instillation of a liquid solution into the rectum and sigmoid colon promote defecation by stimulating peristalsis fluid breaks up fecal mass, stretches rectal wall and initiates the defecation reflex can also give medications via enema route

Question 44

rectal suppository admin

Answer 44

sterile technique not necessary explain procedure position the patient laying left lateral sims hand hygiene and apply gloves lubricate finger and medication insert approx one inch or once you feel medication bypass sphincter place on wall of rectum - not stool med will melt when it reaches body temp and will be absorbed

Question 45

common meds given suppository route

Answer 45

acetaminophen | dulcolax

Question 46

enema admin

Answer 46

sterile technique is unnecessary wear gloves explain procedure, positioning, precautions to avoid discomfort, length of time necessary to retain solution before defecation administer slowly cramping is likely position patient on left lying position with top leg bent upwards - sim's position

Question 47

digital removal of stool

Answer 47

provider or nurse removing stool with fingers when fecal mass is too difficult for patient to pass las resort in managing severe constipation due to discomfort and risks involved already tried other measures and they failed order is necessary

Question 48

purpose of digital removal of stool

Answer 48

break up fecal mass and remove it so patient can voluntarily pass stool on their own

Question 49

what needs to be assessed before digitally removing stool

Answer 49

heart rate

Question 50

digital removal of stool process

Answer 50

position patient side lying, educate, hand hygiene, gloves lube finger, insert into rectum slowly gently loosen fecal mass by massaging around it and remove all pieces slowly what are characteristics of initial stool pieces being removed what are characteristics of stool after hard fecal mass has been removed patient should be able to have a bowel movement after

Question 51

risks/complications of digital removal of stool

Answer 51

irritation to mucosa, bleeding | possible stimulation of vagus nerve (causes bradycardia); if this happens, nurse must stop procedure

Question 52

bowel training

Answer 52

performed with patients who have chronic constipation or fecal incontinence secondary to cognitive impairment

Question 53

implementing bowel training

Answer 53

routine - keep patient on a schedule with bowel movements diet - increase fluids to decrease constipation and fecal impaction promote regular exercise - improves peristalsis management of hemorrhoids - patient will avoid a bowel movement due to pain with hemorrhoids skin integrity - fecal incontinence will cause skin breakdown assess skin frequently, keep area clean, use barrier ointment to protect the skin