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Fluid and electrolytes > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

Mouth
Esophagus

A

Mouth: Digestion begins especially with the breakdown of carbohydrates through the secretion of amylase.
Esophagus: Collapsible tube, connecting the pharynx to the stomach

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2
Q

Stomach

A

mixes food and digestive juices (chyme) and hydrochloric acid causing a mechanical breakdown of food stuff before entering the small intestine.

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3
Q

Duodenum

A

Secretory functions consisting of hormones and triggers the release of pancreatic juice and bile.
protects the intestine by secreting chemicals that neutralize the acidity of the chyme

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4
Q

Jejunum

A

controls carbohydrate and protein absorption

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5
Q

Ileum

A

absorbs fats, bile salts, and water

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6
Q

After passing through the small intestine, undigested food stuff will pass and empty into the ________ quadrant of the abdomen.

A

Lower right

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7
Q

Large Intestine

A

absorption, secretion, and elimination

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8
Q

Peristalsis

A

mechanism of progressive contraction and relaxation of the walls of the intestine

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9
Q

Bowel sounds:
Normoactive
Hyperactive
Hypoactive
Absent

A

Normoactive: irregular, high-pitched, and gurgling sounds that occur every 5 to 15 seconds
Hyperactive: loud, high-pitched, and rushing most commonly associated with diarrhea or inflammatory disorders
Hypoactive: slow and sluggish, with occurrence of less than five sounds per minute.
Absent: may be a sign of obstruction or paralytic ileus.

listen for 5 full minutes before documenting the absence of bowel sounds

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10
Q

What is flatulence
How is it expelled?

A

Mixture of gases in the intestine, by-products of the digestive process
May be expelled by the mouth (belching)
May be expelled by the anus (flatus)

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11
Q

How does diet affect bowel elimination?
* Gas producing foods
* Food intolerance
*Fluid intake
* Spicy foods
* High fiber foods

A

Gas-producing foods-cause the intestinal walls to become distended, increasing the colon motility. Such foods are onions, cauliflower, and beans
Food intolerance- digestive upset, and in some instances, cause watery stools, cramps, or flatulence.
Fluid intake or loss- Increased water intake eases the passage of feces, while poor fluid intake increases the risk of constipation
Spicy foods- Diarrhea and flatus
Constipating-producing foods
High fiber foods- foods improves the likelihood of a normal elimination pattern such as whole grains, fresh fruits and vegetables

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12
Q

How does physical activity affect Bowel elimination?

A

Exercise: promotes peristalsis and facilitates movement of chyme through the colon
Regular Activity: maintains the tone of pelvic and abdominal floor muscles.
Immobility: Weakens the the tone of pelvic and abdominal floor muscles.

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13
Q

How does emotional stress affect bowel elimination?
How does depression affect bowel elimination?

A

Emotional stress accelerates the digestive process, and peristalsis is increased resulting in diarrhea, nausea and gastric distention.
Depression may slow peristalsis resulting in constipation.

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14
Q

How does pregnancy affect bowel elimination

A

As the fetus grows, pressure is exerted on the rectum, impairing the passage of stool.
Straining during delivery may result in hemorrhoids.
Prenatal vitamins high in iron may increase the risk of constipation.

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15
Q

Normal posture for bowel elimination is

A

Normal posture is squatting

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16
Q

How does anesthesia affect bowel elimination

A

Anesthesia blocks the parasympathetic stimulation to the muscles of the colon and causes peristalsis to slow or cease.

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17
Q

paralytic ileus

A

temporary cessation of intestinal movement.

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18
Q

Narcotics also contribute to development of ______

A

constipation

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19
Q

Hemorrhoids

A

swollen and inflamed veins in the anus or lower rectum

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20
Q

Laxatives

A

ease defecation often by stimulating bowel activity.

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21
Q

Carthatics

A

strong laxatives that stimulate evacuation of the bowel by causing a change in GI transit time.

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22
Q

Antibiotics

A

contribute to diarrhea by interfering with the normal bacterial flora in the GI tract.

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23
Q

Anticholinergics

A

inhibit gastric acid secretion and depress GI motility

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24
Q

Histamine anatgonists

A

suppress secretion of hydrochloric acid and interfere with digestion of some foods.

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25
Q

Calcium supplements and opioids

A

Slow colonic actions

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26
Q

NSAIDS

A

may cause red or black stools depending where the bleeding is occurring.

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27
Q

Iron suppliments

A

may cause constipation and may cause the stool to be black in appearance.

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28
Q

Antacids

A

whitish discoloration or white specks to appear in feces.

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29
Q

Prescribed bowel preparations

A

ensure emptying of the bowel are given to facilitate visualization at endoscopic, radiographic, or other examinations

gas and loose stools, may persist

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30
Q

Diarrhea

A

abnormal frequency and fluidity of bowel movements
hyperactive bowel sounds
Associated with disorders that affect digestion, absorption and secretion in GI tract
May be caused by allergies or intolerances to food, fluids, or certain medications

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31
Q

C-diff

A

foul-smelling, watery diarrhea three or more times a day for 2 or more days, accompanied by mild abdominal cramping and tenderness.

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32
Q

Incontinence

A

loss of voluntary control of fecal and gaseous discharge via anus

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33
Q

Constipation

A

Due to increased water absorption in the colon, constipation leads to difficulty passing stool, excessive straining at defecation, the inability to defecate at will, hard feces, and rectal pain.

34
Q

Straining during defecation can

A

induce elevations in intraocular pressure, increased intracranial pressure, changes in cardiac rhythms, and hemorrhoids.

35
Q

Valsalva maneuver consists of

A

“bearing down” while holding the breath. The person thus is exerting force against a closed windpipe, creating increased intrathoracic pressure.

36
Q

Impaction

A

The presence of hard fecal mass in the rectum or colon which the patient is unable to expel
Symptoms are loss of appetite, nausea, vomiting, distention, cramping, and rectal pain.
Other causes are Barium used in radiologic examinations contributes to the risk of impaction.
Diagnosis of impaction is through digital examination and palpation of fecal mass.

37
Q

Symptoms of gastroentitis

A

Nausea
Vomiting
Fever
Abdominal cramping

38
Q

Gastroenteritis
Most common cause

A

Inflammation of the mucosa of the stomach and small intestine
Viruses are the most common cause

39
Q

Colorectal Cancer
_____leading cause of cancer-related deaths
More common in _____ than ____

A

3rd leading cause of cancer-related deaths
More common in men than women

40
Q

Clinical manifestations of colorectal cancer

A

Early disease: None or no specific findings (fatigue, weight loss)
More advanced disease: Abdominal tenderness, palpable abdominal mass, hepatomegaly, and ascites
Bleeding can occur with both right and left-sided colorectal cancer
Complications include obstruction, bleeding, perforation, peritonitis, and fistula formation
Pencil-thin stools due to possible obstruction causing narrowing of colon for stool to pass

41
Q

Ileostomy
It bypasses the

A

Ileostomy-Surgically created opening in the small intestine, usually at the end of the ileum.
colon

42
Q

What is a Colostomy

A

The surgical opening is the remaining colon after a portion of the colon or the rectum has been removed.

43
Q

Features of ileostomy

A

Temporary or permanent
Stools are frequent and liquid
Ileoanal pouch is most common
With ileoanal pouch, there is no stoma
Ileoanal pouch also referred to as a pull- through, endorectal-pull-through, pelvic pouch, and J-pouch procedure
Kock pouch

44
Q

Features of colostomy

A

Temporary or permanent
Stools vary in consistency
Sigmoid and descending colostomies
Transverse colostomy
Ascending colostomy
Loop colostomy
Double-barrel colostomy

45
Q

first fecal material passed by the newborn
______ is ——– consistency

A

. Meconium
It is black, thick, and tarry in consistency

46
Q

Infants have ——– stomachs, ———secretion of enzymes, and a——— transit of food through the GI tract.

A

Infants have small stomachs, less secretion of enzymes, and a fast transit of food through the GI tract.

47
Q

Constipation may be an issue with a school-aged child due to

A

lack of privacy
risk for bullying
limited access
dirty bathrooms.

48
Q

Older adults are More susceptible to developing fecal impaction

A

Decreased bowel tone
Decreased fluid intake
Decreased activity

49
Q

Teach older adults about

A

Adequate fiber intake including fruits, vegetables, and breakfast cereal such as bran and oatmeal
Adequate fluid intake of at least 2 liters of water or juice daily

50
Q

Assess for these among older adults

A

Diarrhea or diarrhea-associated complications such as
Electrolytes imbalances
Dehydration
Skin breakdown

51
Q

Highest incidence of colorectal cancer

A

Black Americans
Eastern European Jewish

52
Q

Start auscultating at the——— quadrant then——- quadrant. Then move to the——–quadrant then move to the——–quadrant last.

A

Right lower
Right upper
Left upper
Left lower

53
Q

Stool culture

A

For culture, parasites, or ova,
To detect and for diagnosis of C. diff
To detect presence of microorganisms responsible for food-borne illness or contaminated foods
To determine causative factors of patient complaints of diarrhea for several days

54
Q

Fecal occult blood test

A

blood in feces. Blood may be associated with benign or malignant growths or polyps in the colon, hemorrhoids, anal fissures, intestinal infections, ulcerative colitis, Crohn disease, diverticular disease, and abnormalities of the blood vessels

55
Q

Foods that affect Fecal occult blood test

A

beets, broccoli, red food coloring, red meats, horseradish, fish, cantaloupe, carrots, poultry

56
Q

Stool culture: food-borne illnesses caused by

A

ingesting raw eggs, raw hamburger, etc. for salmonella, E. coli, and listeria, etc.

57
Q

Upper Gastrointestinal Series is also known as
It defines the anatomy of
Assists in the diagnosis of

A

Barium swallow
upper digestive tract including the esophagus, stomach, and duodenum
ulcers, tumors, hiatal hernias, scarring, blockages, and GI tissue abnormalities

58
Q
A
59
Q

Teachings for barium swallow
Side effects

A

Nothing by mouth for 4 to 8 hours
Major side effect is constipation
Stool may be gray or white in appearance
Patients are encouraged to drink extra fluids after test

Side effects are same as barium enema

60
Q

Lower Gastrointestinal Series is also known as

A

Barium enema

61
Q

Defines the anatomy of the
Assists in diagnosis of

A

lower GI tract including the rectum, colon, and lower portion of the small intestine
abnormal growths, ulcers, polyps, diverticula, and colon cancer

62
Q

Preparation for barium enema

A

Restricted diet for a few days beforehand, generally a liquid diet for 2 days prior to test
Clear liquids only for 24 hours before test
Laxative or enema just before test

63
Q

Colonoscopy
Visualizes
Procedure identifies
Procedure diagnoses

A

Inflamed tissue, ulcers, and abnormal growths in the anus, rectum and colon
Procedure identifies early signs of colorectal cancer Unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss

64
Q

Preparation for colonoscopy

A

Clear liquid diet for 1 to 3 days prior to test
Patients must abstain from eating foods and drinking beverages that contain purple or red dye
A laxative or an enema may be required the night before the test
Patient must inform prescriber of all medications, vitamins, or supplements taken daily including aspirin, arthritis medication, anticoagulants, diabetic mediations, and iron supplements
Nothing by mouth for several hours prior to test
As a nurse, inform prescriber if patient refuses or is unable to complete bowel prep for this test

65
Q

Side effects of colonoscopy

A

Cramping and bloating may occur during first hour following test
Driving is not permitted for 12 hours following test

66
Q

Endoscopy
What does it consist of

A

Esophagoscopy to view the esophagus
Gastroscopy to view the inside of the stomach
Duodenoscopy to view the inside of the duodenum
Consists of a small camera that passes through the mouth, down the throat, and into the stomach for pictures of GI tract
Prescribed for patients with swallowing problems, vomiting, bleeding, gastric reflux, abdominal pain, and chest pain
Biopsy may be obtained during test

67
Q

Preparation of endoscopy

A

Stomach must be empty
Nothing by mouth for at least 8 hours prior to test
Patient receives medication for sedation and relaxation during test
Throat is numbed with a numbing spray prior to introducing scope

68
Q

Side effects of endoscopy

A

Patient not permitted to drive for 12 hours following the test
Nurse assesses for swallowing and presence of gag reflex

69
Q

Bulk forming laxatives (Psyllium)

A

Temporary treatment of constipation
decrease diarrhea in clients with diverticulosis and IBS.
Control stool for clients who have an ileostomy or colostomy.

70
Q

Surfactant laxatives (Docusate sodium)

A

Treatment of constipation. Softening of fecal impaction.

71
Q

Stimulant laxatives (Bisacodyl, senna)

A

Bowel preparation prior to surgery or diagnostic tests including colonoscopy. Short-term treatment of constipation caused by high-dose opioid use or slow intestinal transit.

72
Q

Osmotic laxatives (Magnesium hydroxide, lactulose)

A

Draw water into the intestine to increase the mass of stool, stretching musculature, which results in peristalsis.
Low dose: prevents painful elimination

High dose: Client preparation prior to surgery or diagnostic tests

73
Q

Adverse effects of laxatives

A

Gi irritation, rectal burning sensation, toxic magnesium levels, fluid retention, dehydration, and obstruction

74
Q

Client Teaching/
Nursing Actions on laxatives

A
  • Do not crush or chew enteric-coated tablets
  • do not use bisacodyl suppositories on a regular basis,
  • nurses to monitor intake and output, nurse to assess for dehydration
  • instruct client to drink at least 8 to 10 glasses of water daily
75
Q

Antidiarrheals
Diphenoxylate

A

Treat underlying cause of diarrhea.
Nurse to administer initial dose 5 mg and monitor client response, administering further medication as needed. Maximum dose 8 tabs/day. Instruct client to drink small amounts of clear liquids or commercial oral electrolyte solution to maintain electrolyte balance. Avoid drinking plain water and avoid caffeine.

76
Q

Antidirrheal: Loperamide

A

To minimize manifestations of diarrhea
Instruct client to drink small amounts of clear liquids or commercial oral electrolyte solution to maintain electrolyte balance. Avoid drinking plain water and avoid caffeine.

77
Q

Position for enema

A

Left side lying sim’s position

78
Q

Foods contraindicated for colonoscopy

A

soup, milk and cream, coffee, red food coloring

79
Q

large intestine in elimination structures

A

Cecum, ascending, transverse, descending, sigmoid, and rectum

80
Q

clients is at greatest risk for serious complications when using the
Valsalva maneuver to expel feces

A

Clients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical
wound are at greater risk, such as cardiac irregularities and elevated blood pressure,

Fluid and electrolytes (6 decks)

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