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NURS 402: Lecture > Bowel elimination > Flashcards

Bowel elimination Flashcards

1
Q

Anatomy and Physiology of Bowel Elimination

A
  1. Stomach
  2. Small intestine
  3. Large intestine
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2
Q

What is the primary organ of bowel elimination

A

Large intestine

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3
Q

Where does the large intestine extend?

A

Extends from the ileocecal valve to the anus

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4
Q

Functions of the Large Intestine?

A

Absorption of water
Formation of feces
Expulsion of feces from the body

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5
Q

Peristalsis is under control of what?

A

Peristalsis is under control of the nervous system

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6
Q

How often do peristalsis contractions occur?

A

Contractions occur every 3 to 12 minutes

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7
Q

When do mass peristalsis occur?

A

Mass peristalsis sweeps occur one to four times each 24-hour period

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8
Q

How much food waste is expired?

A

One third to one half of food waste is excreted in stool within 24 hours

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9
Q

Variables Influencing Bowel Elimination

A

Developmental considerations
Daily patterns
Food and fluid
Activity and muscle tone
Lifestyle
Psychological variables
Pathologic conditions
Medications
Diagnostic studies
Surgery and anesthesia

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10
Q

Bowel elimination developmental considerations for infants:

A

Infants: Characteristics of stool and frequency depend on formula or breast feedings

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11
Q

Bowel elimination developmental considerations for toddlers:

A

Physiologic maturity is the first priority for bowel training

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12
Q

Bowel elimination developmental considerations for Child, adolescent, adult:

A

Child, adolescent, adult: Defecation patterns vary in quantity, frequency, and rhythmicity

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13
Q

Bowel elimination developmental considerations for older adults

A

Older adult: Constipation is often a chronic problem; diarrhea and fecal incontinence may result from physiologic or lifestyle changes

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14
Q

Foods Affecting Bowel Elimination do what?

A

Constipating foods:

Foods with laxative effect:

Gas-producing foods:

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15
Q

Constipating foods:

A

Constipating foods: cheese, lean meat, eggs, pasta

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16
Q

Foods with laxative effect:

A

Foods with laxative effect: fruits and vegetables, bran, chocolate, alcohol, coffee

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17
Q

Gas-producing foods:

A

Gas-producing foods: onions, cabbage, beans, cauliflower

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18
Q

Effect of Medications on Stool

A

Opioid-induced constipation

Antacids decrease GI motility

Antibiotics, magnesium, and metformin can cause diarrhea

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19
Q

Nursing History

A

Usual patterns of bowel elimination
Aids to elimination
Recent changes in bowel elimination
Problems with bowel elimination
Presence of bowel diversion

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20
Q

Physical Assessment of the Abdomen: Sequence of assessing

A

The sequence for abdominal assessment proceeds from :

inspection,
auscultation, and
percussion to
palpation

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21
Q

Physical Assessment of the Abdomen: Inspection

A

Inspection: observe contour, any masses, scars, or distention

22
Q

Physical Assessment of the Abdomen: Auscultation

A

Auscultation: listen for bowel sounds in all quadrants

23
Q

During auscultation, what should you note? Abdomen

A

Note frequency and character, audible clicks, and flatus

Describe bowel sounds as hypoactive, hyperactive, absent, or infrequent

24
Q

Physical Assessment of the Abdomen: Percussion

A

Percussion and palpations: performed by advanced practice professionals

25
Q

Physical Assessment of the Anus and Rectum: Technique used

A

Inspection and palpation

26
Q

Physical Assessment of the Anus and Rectum: Inspection and palpation

A

Lesions, ulcers, fissures (linear break on the margin of the anus), inflammation, and external hemorrhoids

Ask the patient to bear down as though having a bowel movement. Assess for the appearance of internal hemorrhoids or fissures and fecal masses

Inspect perineal area for skin irritation secondary to diarrhea or fecal incontinence

27
Q

Stool Collection: What is important?

A

Medical aseptic technique is imperative

Hand hygiene, before and after glove use, is essential

Wear disposable gloves

Do not contaminate outside of container with stool

Obtain stool and package, label, and transport according to agency policy

28
Q

Stool Characteristics

A

Volume
Color
Odor
Consistency
Shape
Constituents

29
Q

Types of Direct Visualization Studies (Endoscopy)

A

Esophagogastroduodenoscopy (EGD)

Colonoscopy

Sigmoidoscopy

Wireless video capsule endoscopy

30
Q

Indirect Visualization Studies

A

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

31
Q

Patient Outcomes for Normal Bowel Elimination

A

Soft, formed bowel movement without discomfort

Able to explain the relationship between bowel elimination and dietary fiber, fluid intake, and exercise

Able to relate the importance of seeking medical evaluation if changes in stool color or consistency persist

Skin integrity maintained

32
Q

Promoting Regular Bowel Habits

A

Timing
Positioning
Privacy
Hygiene
Nutrition
Exercise (Abdominal settings
Thigh strengthening)

33
Q

Individuals at High Risk for Constipation

A

Patients on bedrest or with decreased mobility

Patients taking constipating medicines

Patients with reduced fluids or bulk in their diet

Patients who are depressed

Patients with central nervous system disease or local lesions that cause pain while defecating

34
Q

Nursing Measures for the Patient With Diarrhea

A

Answer call bells immediately

Remove the cause of diarrhea whenever possible (e.g., medication)

If there is risk of impaction, hold antidiarrheal medications for further evaluation

Give special care to the region around the anus

35
Q

Preventing Food Poisoning #1

A

Take items requiring refrigeration home immediately

Wash hands and surfaces often

Use separate cutting boards for foods

Thoroughly wash all fruits and vegetables before eating

Do not wash meat, poultry, or eggs to prevent spreading microorganisms to sink and other kitchen surfaces

Never use raw eggs in any form

Do not eat seafood raw or undercooked

36
Q

Preventing Food Poisoning #2

A

Use a food thermometer to ensure cooking food to safe internal temperature

Keep food hot after cooking; maintain safe temperature of 140°F or above

Give only pasteurized fruit juices to small children

37
Q

Methods of Emptying the Colon of Feces

A

Enemas
Rectal suppositories
Oral intestinal lavage
Digital removal of stool

38
Q

Types of Enemas

A

Cleansing
Retention
Hypotonic large volume
Hypertonic small volume

39
Q

Types of retention enemas:

A

Oil
Carminative
Medicated

40
Q

Managing Bowel Incontinence

A

Note when incontinence is most likely to occur and assist patient to the bathroom or commode

Keep the skin clean and dry

Change bed linens and clothing as necessary

Bowel-training programs

Indwelling rectal tube

External anal pouch

41
Q

Bowel-Training Programs

A

Encourage adequate fluid intake and proper diet
Ensure privacy
Stimulating bowel movements if needed
Monitor
Set a regular time for daily bowel movements
Plan bowel program with patient and family/caregivers
Manipulate factors within the patient’s control (food and fluid intake, exercise and time for defecation) in order to eliminate soft, formed stool at regular intervals without laxatives

42
Q

Nasogastric Tubes- how are they put in?

A

Inserted to decompress or drain the stomach of fluid or unwanted stomach contents

43
Q

Nasogastric Tubes- what do they allow the GI tract to do?

A

Used to allow the gastrointestinal tract to rest before or after abdominal surgery to promote healing

44
Q

Nasogastric Tubes- Why are they inserted in?

A

Inserted to monitor gastrointestinal bleeding

45
Q

Types of Ostomies

A

Sigmoid colostomy

Descending colostomy

Transverse colostomy

Ascending colostomy

Ileostomy

46
Q

Colostomy Care

A

Keep the patient as free of odors as possible; empty the appliance frequently

Inspect the patient’s stoma regularly

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

Provide support for physical, psychological, and social activities

47
Q

Patient Teaching for Colostomies

A

Explain the reason for bowel diversion and the 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 the community

Verbalize related fears and concerns
Demonstrate a positive body image

48
Q

Colostomy Diet: When should you eat low fiber diet?

A

Low-fiber foods during first 6–8 weeks

49
Q

Colostomy Diet: How much water should you drink?

A

Drink at least 2.5 quarts of fluids, preferably water

50
Q

Colostomy Diet: What foods to avoid?

A

Avoid foods that cause blockage: nuts, corn, popcorn, coconuts, mushrooms, stringy vegetables, and foods with skins and casings

Avoid foods that may cause gas and/or produce odor

51
Q

Colostomy Diet: What foods to add/

A

Add foods that may help thicken stool: bananas, cheese, pasta, rice, yogurt, applesauce, potatoes

52
Q
A

NURS 402: Lecture (17 decks)

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