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Foundations 3 > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

(64 cards)

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1
Q

Newborn/ Infant stool considerations

A

Meconium
Stool color dependent upon type of milk ingested
Frequent and multiple bowel movements a day

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2
Q

Toddler stool

A

Duodenocolic reflex

Toilet training after 22 months

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3
Q

School age stool

A

Bowel function reaches adult standard

Peer pressure may contribute to constipation

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4
Q

Adult/ Older stool

A

Bowel movement frequency decreases, GI motility slows

Increased fluid and fiber in diet

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5
Q

Normal Feces

A 
Frequency: 1-2x a day and 1 every 2-3 day 
Color: Brown 
Consistency: Soft, formed 
Shape: Cylindrical 
Amount: 100/300 g/d 
Odor: aromatic, pungent
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6
Q

Abnormal Feces

A 
Frequency: depends on usual pattern 
Guideline: > 3/d and <1 every 3 days 
Consistency: Hard, loose liquid, high mucus content 
Shape: Narrow, pencil thin 
Amount:<100 g/d or >300 g/d 
Odor: foul, objectionable
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7
Q

Functions of the Intestines: Peristalsis& segmentation

A

Alternating contraction and relaxation of intestinal smooth muscle
Propels the intestinal contents along the entire length of the small and large intestines

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8
Q

What stimulates peristalsis?

A

walls of intestine

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9
Q

Absorption

A

Nutrient and electrolytes in duodenum and jejunum

Vitamins, iron, and fluid in ileum

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10
Q

Valsulva Maneuver

A
  • Take a deep breath against a closed glottis
  • Contract the abdominal muscles
  • Contract pelvic floor muscles
  • It drops HR and blood pressure
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11
Q

Nutrion impact on elimination

A 
Soluble fiber (increases GI transit time)
Oat bran, barley, and nuts

Insoluble fiber (decreases GI transit time)
Whole grains, fresh fruits and vegetables
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12
Q

Which fiber type promotes loose stools?

A

Insoluble

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13
Q

Food intolerances

A

Lactose

Gluten

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14
Q

Fluid impact on elimination

A

75% of feces is water

  • If body is alcking water it will take from feces
  • Increased GI motility= loose stools
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15
Q

Exercise impact on elimination

A

Move less, defecate less

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16
Q

Lifestyle and ignoring urge to defecate

A
  • Emotional extremes
  • Changing daily routine
  • Ignoring the urge leads to the urge weakening over time
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17
Q

Pregnancy

A

Iron supplements + growing fetus = constipation

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18
Q

Opioids cause

A

constipation

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19
Q

ABX cause

A

diarhea

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20
Q

To examine the lower GI tract with a camera, what must be out of the lower GI tract?

A

Stool

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21
Q

When the colon is diverted through a stoma

A

Colostomy

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22
Q

When the ileum is diverted through a stoma

A

ileostomy

-No large intestine, potential issue with loss of fluid and electrolytes

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23
Q

Pouches can be created surgically to give the patient control over when a bowel movement occurs

A
  • Kock pouch

- J-pouch

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24
Q

Normal stoma findings

A

red pink, beefy

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25
Abnromal stoma findings
bluish tint, drainage around it
26
Fecal Collection
Pouch connected to a stoma | The part that covers a stoma is called an appliance
27
When should the pouch be emptied?
When it becomes 1/4 full
28
What do you rinse the pouch with after emptying it?
Clean warm tap water | - 60 ml syringe
29
What if fecal contents leak around where the pouch is attached to the skin?
Entire bag must be removed and replaced
30
Abd inspection Normal
Normal Findings: Symmetric Slightly rounded
31
Ab inspection abnormal
Malnutrition? Hollow or scaphoid Obstruction? Distended
32
Normal auscultation
Heard within 5-15 seconds
33
Abnormal auscultation
More frequent than 5 seconds? Hyperactive
34
How long do you listen to confirm absent?
Listen to each quadrant 1-2 mins
35
Constipation
Common GI issue Patients experience bloating, fullness, an urge to defecate without an ability to pass stool, malaise, loss of appetite, nausea, vomiting, and abdominal distention. Dependent upon a person’s baseline functioning Less frequent Harder stool Persistent for at least 12 weeks in a year’s time
36
What is important in determining if its constipation?
Ask about the patient's normal routine
37
Fecal impaction
Usually, the result of untreated and unrelieved constipation Several days of constipation followed by an involuntary loose bowel movement that does not relieve feeling of bloating or fullness Similar symptoms to constipation
38
How is fecal impaction diagnosed?
Digital rectal exam
39
Diarhea
- Loose and more frequent stools - increased gastric motility - hyperactive bowel sounds
40
Causes of diarhea
``` Medications, medical conditions, emotional changes Symptoms: Cramping Nausea Burning sensation Anal inflammation Bleeding and breakdown ```
41
Neurological injury, spinal cord injury, or altered mental status can lead to.....
fecal incontinence
42
Gas or flatulence is caused by
bacterial activity in the large intestine
43
What food increases flatulence
Introduce a person gradually into new diet high in fiber
44
An obstruction or tumor can lead to
distension | -requires a follow-up and investigation
45
What type of bowel activity could lead to an order for a stool specimen and culture?
Diarrhea | -Altered color
46
Stool specimen and culture
-collected by the nurse Educate patient to avoid mixing urine with sample Have urinal or a second bedpan nearby
47
Fecal occult blood test
A type of test that detects the presence of blood -More common now for this test to be sent to the lab to be performed from a regular stool specimen rather than a bedside procedure
48
Recommended screening tool for colorectal cancer | Blood in stool may indicate cancer or polyps in the colon or rectum
Fecal occult blood test
49
XRay considerations
A radiopaque substance is swallowed or instilled in the rectum and then imaging is performed as it proceeds through the GI tract Detects abnormalities in the large and small bowel
50
What is done before the test?
clear the bowels with laxatives or enemas
51
What is done after the test?
- Barium can harden stool and cause constipation or an impaction, increase fluids and administer a laxative - Barium cam make the stool appear chalky or white
52
EGD
upper gi test
53
Lower GI tests
-Sigmoidoscopy Colorectal cancer screening every 5 years Colonoscopy - Colorectal cancer screening every 10 years - If high risk though, screening can be every 5 years - Colonoscopy used more often for screening since its visualizes the entire colon
54
What is used in both procedures?
A flexible fiber-optic instrument to visualize certain parts of the GI tract -Tests are used for diagnosis and treatment
55
What is done before lower GI tests?
Bowel- preparation: use of laxative solution to clear the bowels of stool
56
What is done after lower Gi tests?
Monitor for bleeding or dull abdominal pain
57
Tx for diarrhea
-Antidiarrheals Loperamide Bismuth subsalicylate
58
Medications that treat the cause of diarhea
Loperamide and Bismuth subsalicylate (peptmo bismal)
59
Fecal microbiota transplant
Used for persistent clostridium difficile infection Healthy stool from a human donor placed in GI tract 90% effective in reducing infection rate
60
Bowel training
Used for individuals with a neurological impairment Routine developed around a specific time of day to achieve a soft stool consistency Modified for individuals with partial sphincter control Can utilize pelvic floor exercises, abdominal massage, and biofeedback
61
Enema indication
Promote bowel movement | Clear bowel area before a procedure
62
Types of enema demonstrated
Small-volume: Mineral oil and steroids Large-volume: tap water or saline Return-flow: removes flatus
63
NG tubes indications
Gastric decompression, gastric lavage, or gastric feeding
64
Placement must be confirmed using?
Radiographic confirmation is the gold standard

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