Bowel Elimination Flashcards
(152 cards)
1
Q
Structures of the Small intestine:
A
the duodenum, jejunum & ileum
2
Q
Structures of the Large intestine:
A
cecum, colon, rectum & anus
3
Q
Structures of the colon
A
Ascending, transverse & descending & sigmoid colon
4
Q
Function of the intestines
A
Motility
Absorption
Defecation
5
Q
A forced expiration against a closed glottis, may be used when needed to initiate a bowel movement.
A
The Valsalva maneuver
6
Q
Two types of motility:
A
Segmentation
Peristalsis
7
Q
Daily fiber needs for a woman
A
24-25 grams
8
Q
Daily fiber needs for a man
A
35-38 grams
9
Q
Length of small intestine
A
20ft long
10
Q
Length of large intestine
A
6ft long
11
Q
The anus has how many sphincters?
A
Two
12
Q
What type of response does the internal anal sphincter have?
A
Involuntary
13
Q
What type of response does the external anal sphincter have?
A
Voluntary
14
Q
A sphincter muscle valve that separates the small intestine and the large intestine
A
Ileocecal valve
15
Q
Type of people that have problems with gut transit
A
Older adults
16
Q
Intestinal motility is controlled by
A
The autonomic nervous system
17
Q
Absorption takes place in the
A
Small intestine
18
Q
Motility that propels/ pushes feces through
A
peristalsis
19
Q
Contraction of intestinal circular smooth muscles that mixes chyme is called
A
Segmentation
20
Q
Process of digestion, in which food, gastric acid and pepsin are turned from mush into a semi-digested acidic liquid called
A
Chyme
21
Q
Contracting (pinching) and relaxing of intestinal muscles
A
Segmentation
22
Q
Autonomic nervous system innervation:
A
Sympathetic
Parasympathetic
23
Q
Sympathetic-
A
Slows down
24
Q
Parasympathetic-
A
Speeds up
25
Partially digested food (chyme), empties from the stomach to the _________ for __________
Small intestine for absorption
26
Where most nutrients an electrolyte absorption occurs
Duodenum & jejunum
27
Absorbs some vitamins, iron & fluids.
Ileum
28
Final absorption of nutrients especially fluid & electrolytes
Large Intestine
29
The process begins when peristalsis propels feces into the rectum causing rectal distention.
Defecation
30
___________________ are stimulated causing contraction of the descending & sigmoid colon, rectum, anus & the relaxation of the internal & external sphincter
Parasympathetic nerve fibers
31
The external anal sphincter can remain closed until the person decides
To defecate
32
Speed of passage affects __________
Absorption. The slower the better.
33
Normal feces consist of ___% water & ___% solids
75% water & 25% solids
34
Solids within normal feces includes:
Bacteria, undigested fiber, fat, inorganic matter & some protein
35
The major undigested fiber of feces
Cellulose
36
The color in feces comes from
Bilirubin
37
Bilirubin comes from
The liver
38
White stool has low
Bilirubin caused by gallbladder condition
39
Feces has an aromatic, pungent odor due to
Bacterial breakdown of proteins
40
Yellow or green feces is an indicator of
A virus
41
Normal feces color should be
Yellowish brown
42
Factors affecting elimination
Nutrition- fiber gives bulk, ( fruits, vegetables &grains)
Food intolerances
Fluid intake- 2000ml per day
Activity & exercise-promotes muscle tone & peristalsis
Body position
Ignoring the Urge to Defecate
43
Best body position for elimination
Sitting or squatting
44
Ignoring the urge to defecate can lead to
Constipation
45
Steatorrhea
Greasy stool
46
Lifestyle factors affecting elimination
Individual pattern any changes in ADLS or emotions such as stress or traveler's diarrhea or constipation
47
Pregnancy factors affecting elimination
Hormonal changes, fetus, iron supplements can cause constipation or frequent smaller stools
48
Medication factors affecting elimination
Can cause constipation or diarrhea
Ex. antibiotics cause diarrhea
Narcotics constipation
49
Diagnostic procedure factors affecting elimination
Barium is binding and can cause problems with elimination
50
Patients should start on a _____ diet right after surgery
light diet
51
An inflammation of the peritoneum that is usually due to a bacterial or fungal infection.
Peritonitis
52
A silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen
Peritoneum
53
A stoma through the small intestine
ileostomy
54
A stoma through the colon
Colonostomy
55
The portion of the intestine that is brought through the abdominal wall
Stoma
56
Reasons for fecal diversion
Colitis, Trauma, chronic disease or diverticulitis
57
Proper position of a stoma
Above the skin or level with skin (flat)
58
Ostomy at end descending colon may not need
A bag because they have more control
59
Patients with a ileostomy may not have
a large intestine
60
Patients with an ileostomy have liquidly stool which causes
fluid and electrolyte imbalances
61
Two stomas on ab wall
Double barrel colostomy
62
Double barrel colostomy:
Stoma that evacuates stool
Proximal stoma
63
Double barrel colostomy:
Stoma that evacuates mucus
Distal stoma
64
Double barrel colostomy:
Stoma that does not need a bag
Distal stoma
65
Double barrel colostomy:
Stoma that needs a bag
Proximal stoma
66
Can a double barrel colostomy be reversed?
Yes
67
Reason for double barrel colostomy
Tumor removal
68
Loop of bowel with two openings
Loop colostomy
69
Temporary colostomy where a pin is used to keep a loop of bowel above the skin, then removed after a couple of weeks
Loop colostomy
70
Is a loop colostomy permanent?
No it is temporary
71
Internal pouch where a catheter is needed for bowel elimination
Koch pouch or "K pouch"
72
Patient with this kind of pouch does not have a rectum or anus (possibly because of disease)
K Pouch
73
Is a Koch pouch permanent?
Yes
74
Type of pouch needed to be drained 4-5 times a day and patient does not feel fullness
Koch pouch
75
Type of internal pouch where the patient can feel pressure and fullness
J pouch
76
Type of pouch where the patient has an anus but no rectum or large intestine
J pouch
77
Type of pouch where a valve at the anus is opened to go
J pouch
78
Type of pouch where the patient has kidneys but no bladder
Ileal conduit
79
Type of pouch where the ureters are attached to the ileum to drain urine
Ileal conduit
80
Is the ileal conduit a sterile system?
Yes
81
Continent ileostomy
Kock pouch
82
Ileoanal reservoir
J pouch
83
Type of altered bowel function that can lead to impaction
Constipation
84
Type of altered bowel function that is very dry at the end
Slow transit constipation
85
Antibiotics disrupt gut flora for
3 months
86
Shoes should be bleached after leaving this patient's room
C-Diff
87
This type of problem is a risk for cardiac patients with constipation
Vasovagal problem
88
CDAD a type of antibiotic associated diarrhea
Clostridium Difficile Associated Diarrhea
89
Constipation problem caused by poor nursing
Impaction
90
Best body position for manual disimpaction
Left side lying
91
Stool that is green in color and very contagious
C-diff
92
Flatulence is caused by
Foods or talking too much
93
Excessive amounts of gas, liquids, or intestinal contents
Abdominal distention
94
An intestinal blockage without an actual physical obstruction
Paralytic ileus
95
Blockage that can occur 72 hours after abdominal surgery
Paralytic ileus
96
Risks for altered bowel function
Patients who are immobile, poor fluid or diet, or on pain meds
97
How to assess for abdomen
Look for contour, listen, and palpate
98
Pain after palpating
rebound pain
99
Measure of abdominal girth is
doc ordered and done first thing in the morning
100
Exam to look for hardened stool, hemorrhoid's, or bleeding
Perirectal exam
101
Abrasion or tearing of skin
Excoriation
102
Diagnostic tests
Stool culture must not be contaminated with
Urine or toilet paper
103
Diagnostic tests
Preliminary results within __ hr
24 hours
104
Diagnostic tests
Final results given after __ hr
48 hours
105
Diagnostic tests
Length of time needed to know if antibiotics are needed
48 hours
106
Hidden blood in stool
Occult blood
107
Diagnostic tests
Stool for ova or parasites must be
Warm and go direct to lab
108
Diagnostic tests
For salmonella, shigella, or c-diff
stool culture
109
FOBT
Fecal Occult Blood Test
110
A procedure that uses a guaiac paper slide test to detect fecal occult blood.
Hemoccult test
111
When is the hemoccult test done?
Samples are taken from three bowel movements on three different days
112
Guaiac test paper turns this color if there is blood present in stool
Blue
113
Things that can cause a false positive in FOBT testing and should be stopped at least 3 days prior to testing
ASA (aspirin), Nsaids, steroids, and rare meats
114
This can inhibit color reaction and cause a false negative in FOBT testing
250mg/day of Vit C
115
Radiologic exam of the upper GI
UGI
116
Radiologic exam where the radiologist follows barium from the esophagus through the ileum.
GI with small bowel
117
Type of enema needed for visualization of the lower tract
Barium
118
Patients may need this to pass the barium out of body
Laxatives
119
These two radiologic tests are sometimes done together
GI with small bowel and barium enema
120
Type of exams done under conscious sedation
Endoscopic Examinations
121
20 minutes exam done with a flex scope through the mouth up to the duodenum, gas discomfort is expected after
EGD - Esophagogastroduodenoscopy
122
Type of diagnostic test done under complete sedation
colonscopy
123
Type of diagnostic test that visualizes the colon to ileocecal valve. Prep is done the day before
Colonoscopy
124
Diagnostic tests to visualize the sigmoid colon & rectum
Sigmoidoscopy
125
Type of diagnostic tests where the patient is conscious but may be given valium and enema prior
Sigmoidoscopy
126
Helps to reestablish normal bowel movements in persons who suffer from constipation, diarrhea, incontinence, or irregularity
Bowel training
127
Fluids needed for health
1500 – 2000 ml a day
128
Saline laxative that contains Magnesium
Milk of magnesia
129
Medication that can be habit forming and cause electrolyte imbalance
Laxatives
130
Medication given when there is slow bowel motility- contra indicated when viral or bacterial agents cause diarrhea
Antidiarrheal
131
Type of medication given to patients with colitis or Chron's
Antidiarrheal
132
Simethicone
Antiflatulence-gas relief ( no eating for 20 minutes)
133
When healthy feces is transplanted in a sick patient to treat c.diff
FMT - Fecal Microbiota Transplant
134
It is the cleansing of a portion of the large bowel by the insertion of fluid rectally.
Enema
135
Small volume enema that draws water into the colon to promote peristalsis
Hypertonic (fleet)
136
Small volume enema using mineral oil- good for fecal impaction and softens stool
Oil Retention
137
Time it takes for small volume enema to act
5-10 minutes
138
Large volume enemas can only be given ___ times due to risk of electrolyte imbalance
Three times
139
Procedure for large volume enema
750-1000ml, can be tap water, soapsuds or saline.
Luke warm – 105-110 degrees F
Pt. Must be on LT side with knees flexed
Prime tubing- no air
Container – 18 in. above anus
Lubricate 2-3 in of tubing & insert tip in rectum ( adult 3-4 in) towards the umbilicus.
Run slowly- helps prevent cramping & allows for retention
Have client hold as long as possible
Cleansing enemas can only repeat 3x.
140
Type of enema used to treat flatus (gas)
Return-flow Enema ( Harris Flush)
141
This is 10 inches long and used for gas relief
Rectal tube
142
A bag used with adhesive to collect a sample
Fecal collection during incontinence
143
Involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid. Used during overdoses
Gastric lavage
144
Is the introduction of nourishment into the stomach by means of a tube passed through the nose or mouth
Gastric gavage or feeding
145
Draining the stomach contents
Gastric decompression
146
A double-lumen nasogastric tube used for suction and irrigation of the stomach
Salem sump
147
If there is no drainage coming from a Salem sump this should be done
Move tube to unblock or get doc ordered irrigation
148
intermittent suction is done to prevent
trauma
149
Suction set to suction every ___
60 sec
150
NG should not be used when there is
nausea or vomiting present
151
Nursing Considerations for NG tube
Maintaining suction
Maintaining patency
Ensuring accurate placement
152
Tube where end tip is weighted
Nasointestinal tube
