bowel elimination Flashcards

(42 cards)

1
Q

What are hemorrhoids?

A

when the veins in the anal canal become abnormally distended

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2
Q

When is the rectum empty?

A

Immediatly before and after defecation

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3
Q

how much Chyme enters the large intestines daily?

A

1500 mL

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4
Q

how much water is absorbed in the large intestines?

A

800-1000 mL a day

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5
Q

how often does peristalsis take place?

mass sweeps?

A

every 3-12 minutes

one to 4 times in 24 hours

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6
Q

how much food is normally excreted in stool withing 24 hours?

A

about one third to one half

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7
Q

if someone has a heart condition, what should they be concerned about during defacation?

A

Bearing down too much can decrease blood flood to the atria and ventricles,

called the valasalva maneuver

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8
Q

what is an average count of BMs in a day for breast fed infants?

Bottle fed?

After they are one year old?

A

2-10

1 or 2

1 or 2

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9
Q

when does toddler bowel training become possible? when does it usually happen?

A

18-24 months

30 months

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10
Q

how much fluid is needed to facilitate good BM

A

2000-3000 mL

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11
Q

what are some constipating foods?

A

cheese, lean meat, eggs, pasta

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12
Q

what are some foods that have a laxative effect?

A

fruits and veggies, bran, chocolate, alcohol, coffee

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13
Q

what are some gas producing foods?

A

onions, cabbage, beans, cauliflower

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14
Q

what color would you expect to see the stool if a pt was taking aspirin or anticoagulants?

Iron salts?

antacids?

antibiotics?

A

pink to red to black stools

black

white discoloration or speckling in stool

green-grey color

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15
Q

what causes mechanical obstructions?

what are some?

A

pressure on the intestinal walls

tumors, stenosis, adhesions, hernias, and strictures

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16
Q

what causes functional obstructions?

what are some?

A

inability of the intestinal musculature to move the contents through the bowel

muscular systrophy, Parkinson’s, diabetes, and manipulation of the bowel during surgery

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17
Q

what is it called when the bowels stop moving because they were manipulated during surgery?

what considerations have to be made?

A

paralytic ileus

food and fluids are withheld for 24-28 hours

18
Q

what influences the volume of stool?

what is normal?

special considerations?

A

the amount, type, and nature of the diet

varies

more roughage = more stool

consisant large diarrheal stools suggest problem with in small bowel or proximal colon

small frequent stools with urgeny suggest a disorder of the left colon or rectum

19
Q

what is the normal color for stool?

what can influence this?

A
infant = yellow to bronw
adult = brown
red meat and spinach = black 
absence of bile = white or clay colored
medications 
bleeding (high in the tract is black low is fresh blood)
standing too long darkens the stool
20
Q

what is the normal odor of stool?

what can alter this?

A

pungent

affected by foods that are ingested
pH value (normal is neutral or slightly alkaline)
excessive putrefacation
presence of blood in stool

21
Q

what is the normal consistency of stool?

what can effect this?

A

soft, semi solid and formed

food and fluid intake, and gastric motility

less time in = more liquid

longer time in = harder

22
Q

what is the normal shape of stool and what can influence this ?

A

tubular, around 1 inch diameter

a obstruction can produce narrower stool, pencil shaped

rapid peristalisis thins stool

increased time in can result in a hard, marble like mass

23
Q

what are the normal constituents of stool?

what can alter this?

A

bile, intestinal secretions, epithelial cells, bacteria, inorganic material, seeds, meat fibers, fat

internal bleeding, infetion, inflammation, and other pathological conditions

24
Q

What foods can trigger a false positive for fecal occult blood?

what medications?

What can produce a false negative

A

red meat, liver, kidneys, fish, tomatoes, cauliflower, horseradish, turnips, melon, bananas, and soybeans.

salicylate of more than 325 mg, steroids, iron, anticoagulants

Vitamin C can produce a false negative even in the presence of bleeding

25
what is a common symptom of pinworms?
perianal itching
26
how should diagnostic tests be scheduled? give an example?
from least invasive to most invasive fecal occult blood, barium studies, then endoscopic examinations
27
What is the name of a bulk forming laxative? How does it work? onset time? Contraindications?
Metamucil causes stool to absorb water and swell within 24 hours can interfere with calcium and iron and some meds dont give to peoplewho are bedridden or have intestinal strictures can be expensive
28
what is the name of a stool softener? how does it work? advantage contraindications"?
Colace agents with detergent that allow water and fat to penetrate and lubricate stool Recommended for those who must refrain from straining lubricant can interfere with fat soluable absorption
29
What is the name of an emollient? how does it work advantages contraindications?
mineral oil lubricates the intestinal tract and stops colonic absorption of water effective within 8 hours can interfere with fat soluable absorbtion and can be aspirated
30
what is the name of a stimulant laxative? how does it work? advantages? contraindications?
Dulcolax promotes peristalsis by irritating the intestinal mucosa or stimulating nerve endings works faster than bulking agents ``` most abused causes lazy bowel syndrome can affect vitamin D and calcium absorption not recommended for elderly alters electrolyte transport ```
31
what is the name of a saline-osmotic laxative? How does it work? advantages? contraindications?
MOM draws water into intestines and stimulates peristalsis used when rapid clearing is desired no elderly can produce dehydration not recommended in patients with kidney disease or heart failure
32
what category does Paregoric belong to? how does it work? what are some cautions?
antidiarrheal, works on the smooth muscle increases smooth muscle tone decreases GI motility Diminishes GI secretions may be addictive ( opium) May cause drowsiness and lightheadedness discontinue after diarrhea subsides
33
how does Diphenoxylate and atropine work against diarrhea? (lomotil) what are some cautions?
slows gastric motility through local effect on GI wall is chemically related to morphine, can be addictive in high doses can cause drowsiness
34
How does loperimide work against diarrhea? advantages? cautions?
inhibits peristalsis via direct effect on GI wall not addictive, works longer than Lomotil may cause drowsiness must be discontinued of no improvemtn in 48 hours with acute cases
35
How doe Kaolin-pectin (Kaopectate) work to stop diarrhea? what is an advantage? cautions?
absorbs and soothes Nondrowsy can interfere with oral medications absorption and nutrient absorption
36
How does Bismuth-subsalicylate (Pepto) work to stop diarrhea? advantages? Cautions?
decreases GI secretions and has a antimicrobial action against bacterial and viral pathogens no drowsiness contains salicylate so check with physician before giving to children or administering asprin may decrease absorption of medications
37
For a tap water enema ( hypotonic) How much? How does it work? Onset? adverse effects?
500-1000mL distends intestines, increases peristalsis, softens stool 15 mins fluid and electrolye imbalances and water intoxication
38
For a Normal Saline enema (isotonic) How much? How does it work? Onset? adverse effects?
500-1000 mL distends intestines, increases peristalsis, softens stool. 15 mins fluid and electrolyte imbalances, sodium retention
39
For a soap enema How much? How does it work? Onset? adverse effects?
500-1000mL (concentrate is 3-5mL/1000mL) Distends intestines, irritates the intestinal mucosa, softens stool 10-15 minutes rectal mucosa irritation or damage
40
For a hypertonic enemea How much? How does it work? Onset? adverse effects?
70-130 mL distends intestines, irritates intestinal mucosa 5-10 minutes sodium retention
41
For an oil enema How much? How does it work? Onset? adverse effects?
150-200 mL lubricates stool and intestinal mucosa 30 mins none
42
What are the types of retention enemas and what are they for?
oil retention - lubrication carminiative - expel flatus (milk and molassas enema) Medicated - absorb mediation through the rectal mucosa Anthelmintic - destroy pathogens