Bowel Elimination

Question 1

what is elimination

Answer 1

removal, clearance or separation of matter

Question 2

what is bowel elimination

Answer 2

removal or excretion of waste product of the intestines from the body

Question 3

what is the gi tract responsible for

Answer 3

removal of digestive waste in the form of stool

Question 4

what is the process of bowel elimination

Answer 4

fecal matter reaches rectum
stretch receptors initiate contraction of sigmoid colon/rectal muscles
internal anal sphincter relaxes
sensory impulse causes voluntary “bearing down”
external sphincter relaxes

Question 5

what are some variables influencing bowel elimination

Answer 5

developmental considerations
daily patterns
food and fluid
activity and muscle tone
lifestyle
psychological variables
pathologic conditions
medications
diagnostic studies
surgery and anesthesia

Question 6

how to promote regular defecation/daily patterns

Answer 6

provide privacy
assist w/ positioning
consider timing
food and fluid
encourage exercise
managing flatulence

Question 7

what are some constipating foods

Answer 7

cheese
eggs
lean meats
pasta

Question 8

what are some foods with laxative effetcs

Answer 8

greasy foods
alcohol
coffee
caffeine
chocolate
bran

Question 9

what are some gas producing foods

Answer 9

beans
cabbage
onions

Question 10

what does physical activity stimulate

Answer 10

peristalsis

Question 11

what does a sedentary lifestyle cause

Answer 11

constipation

Question 12

what is diarrhea caused by

Answer 12

food poisoning
ecoli
malabsorption

Question 13

what is constipation caused by

Answer 13

bowel obstruction
tumors
adhesions from scar tissue
hernias

Question 14

what is the effect of aspirin and anticoagulants on stool

Answer 14

pink to red to black stool

Question 15

what is the effect of iron salts on stool

Answer 15

black stool
can cause constipation

Question 16

what is the effect of bismuth subsalicylate on stool

Answer 16

used to treat diarrhea can also cause black stools

Question 17

what is the effect of antacids on stool

Answer 17

white discoloration or speckling in stool
can cause constipation
slows peristalsis

Question 18

what is the effect of antibiotics on stool

Answer 18

green/gray color
can cause cdiff

Question 19

what is the effect of opioids on stool

Answer 19

can cause constipation
slows peristalsis

Question 20

what do diagnostic studies affect in pt

Answer 20

normal patterns

Question 21

what do surgery and anesthesia inhibit

Answer 21

peristalsis

Question 22

what is a risk after abd surgy

Answer 22

paralytic ileus

Question 23

what are some common bowel elimination problems/alterations

Answer 23

diarrhea
constipation/fecal impaction
bowel incontinence
bowel diversions

Question 24

what is a bowel diversion

Answer 24

an ostomy

Question 25

Enemas may be needed Causes include nervous system problems, dysfunctional motility Avoid straining

Answer 25

constipation

Question 26

Caused by infections, contaminated food, medications, or changes in diet Monitor fluid and electrolyte balance Having loose stools often more than 3 or more in one day Monitor for skin breakdown

Answer 26

diarrhea

Question 27

Monitor for skin breakdown Inability to control the discharge of feces and flatulence

Answer 27

bowel incontinence

Question 28

Monitor for skin breakdown Done for cancer, ulcerations, trauma or inadequate blood supply Tarry stools are warning sign

Answer 28

bowel diversion

Question 29

how to manage a pt w/ diarrhea

Answer 29

teach hand hygiene Educate about foods that cause diarrhea Monitor stool output and color/consistency Monitor fluid balance Monitor electrolyte levels Monitor skin integrity Medications

Question 30

how to manage a pt w/ constipation

Answer 30

increase high fiber foods Increase fluid intake Increase activity/exercise Provide Privacy Allow time Assist patient to comfortable position Do not ignore urge Avoid straining enemas

Question 31

how to manage a pt w. bowel incontinence

Answer 31

Absorbent products External fecal collection Internal fecal collection Bowel training Monitor for skin breakdown

Question 32

what are some common diagnostic studies done

Answer 32

direct visualization indirect visualization labs

Question 33

what are some examples of direct visualization studies

Answer 33

Esophagogastroduodenoscopy Colonoscopy Sigmoidoscopy Wireless capsule endoscopy

Question 34

what are some diagnostic tests done

Answer 34

Upper gastrointestinal (UGI) Small bowel series Barium enema Abdominal ultrasound Magnetic resonance imaging (MRI) abd ct scan

Question 35

what lab studies are done

Answer 35

occult blood stool culture

Question 36

in an occult blood study what are they looking for

Answer 36

hidden blood in stool

Question 37

in a stool culture what are they looking for

Answer 37

bacteria in stool

Question 38

what are the types of ostomies

Answer 38

Sigmoid colostomy Descending colostomy Transverse colostomy Ascending colostomy Ileostomy

Question 39

what are some characteristics of a sigmoid colostomy

Answer 39

bowel is not working more solid more common

Question 40

what is a characteristic of a descending colostomy

Answer 40

bowel is not working

Question 41

what are some characteristics of a transverse colostomy

Answer 41

usually temporary crohn's disease cancer can have it reverse

Question 42

what are some characteristics of an ascending colostomy

Answer 42

liquid stool leakage

Question 43

what are some characteristics of an ileostomy

Answer 43

in small intestines liquidy

Question 44

what color is a stoma supposed to be

Answer 44

dark pink

Question 45

if a stoma is pale pink what does that indicate

Answer 45

anemia

Question 46

if a stoma is blue what does that indicate

Answer 46

o2 difficiency

Question 47

how do you take care of an ostomy

Answer 47

Keep the patient as free of odors as possible; empty the appliance frequently. Inspect the patient’s stoma regularly. Note the size, which should stabilize within 6 to 8 weeks. Keep the skin around the stoma site clean and dry. Measure the patient’s fluid intake and output. Explain each aspect of care to the patient and self-care role. Encourage patient to care for and look at ostomy

Question 48

when do you empty a liquidy stoma appliance

Answer 48

when it is 1/3 full

Question 49

when do you empty a solid stoma appliance

Answer 49

when it is 1/2 full

Question 50

what is some pt teaching for colostomies

Answer 50

explain reason for bowel diversion and rationale for treatment demonstrate self care behaviors that effectively manage the ostomy describe follow-up care and existing support resources report where supplies may be obtained in community verbalize related fears and concerns demonstrate positive body image