Bowel Elimination

Question 1

Constipation is…

Answer 1

a symptom, not a disease

Question 2

Constipation =

Answer 2

having fewer than 3 bowel movements a week**

Question 3

Position

Answer 3

very important for some, need to be in specific position to defecate

Question 4

Slowed peristalsis

Answer 4

less fluid in BM, harder

Question 5

Hemorrhoids

Answer 5

swollen veins

Question 6

Bulk Forming

Answer 6

daily
Methylcellulose (Citrucel)
Pysllium (Metamucil)
Polycarbophil (Fibercon)

Question 7

Emollient or Wetting

Answer 7

Docusate Sodium (Colace, Doss)
stool softeners

Question 8

Osmotic

Answer 8

Saline- based
Magnesium Citrate
Magnesium Hydroxide (Milk of Magnesia)
Sodium Phosphate (Fleet Phospho-Soda)
Polyethylene Glycol (Miralax)
Lactulose

Question 9

Stimulant Cathartics

Answer 9

Bisacodyl (Dulcolax)
Senna (Ex-Lax, Senokot)
stimulate movement of colon

Question 10

Left lateral sims side

Answer 10

enema side
- try to hold it in as long as they can

Question 11

Slow the enema rate

Answer 11

by lowering the bag
- pt may c/o cramping

Question 12

Enema precautions and complications

Answer 12

• fluid and electrolyte imbalances
• tissue trauma
• vagal nerve stimulation (fainting)
• pain
• perforation
• abd pain/cramping

Question 13

Impaction ->

Answer 13

can lead to intestinal obstruction if stool is not removed

Question 14

Individuals most at risk for impaction

Answer 14

• debilitated (spinal cord injury)
• confused
• unconscious

Question 15

Impaction s/s

Answer 15

• continuous oozing of liquid stool
• loss of appetite
• n/v
• abd distention
• cramping
• rectal pain

Question 16

Digital removal of stool

Answer 16

• lubrication
• use finger to break up fecal mass and remove it in sections
• very painful
• risks involved

Question 17

Enteral feeding can cause…

Answer 17

diarrhea, means they are not tolerating it

Question 18

Antidiarrheal agents

Answer 18

• decrease intestinal muscle tone to slow down the passage of feces
• body absorbs more water
• must determine cause of diarrhea to figure out if they need medicine
• loperamide or diphenoxylate w/ atropine

Question 19

Fecal management system

Answer 19

need HCP order
- can be effective, can be left in for too long

Question 20

C-diff at risk population

Answer 20

• abx pts
• elderly
• immunocompromised
• long term care facilities
• GI procedure
• previous had c-diff

Question 21

C-diff complications

Answer 21

• dehydration
• kidney failure
• toxic megacolon
• bowel perforation
• death

Question 22

C-diff prevention

Answer 22

wash hand w/ soap and water
clean with BLEACH

Question 23

Treatment of C-diff

Answer 23

Plenty of fluids & good nutrition
Antibiotics
Surgery
Fecal implantation
Probiotics

Question 24

Causes of bowel incontinence

Answer 24

• Muscle or nerve damage
• Any physical condition that impairs the anal sphincter function
• Constipation or diarrhea
• Large volume of stools
• Surgery
• Rectal prolapse

Question 25

Risk factors of bowel incontinence

Answer 25

Age Female Nerve Damage Dementia Physical disability

Question 26

Bowel incontinence tx

Answer 26

Anti-diarrheals Bulk laxatives

Question 27

Prevention of bowel incontinence

Answer 27

Reduce constipation Control diarrhea Avoid straining

Question 28

Flatulence prevention

Answer 28

- avoid foods that cause gas - eat small, more frequent meals - eat and drink slowly - eat more insoluble fiber

Question 29

Foods that cause flatulence

Answer 29

- beans - broccoli - turnips - brussel sprouts - carbonated drinks - straws

Question 30

Hemorrhoids definition

Answer 30

dilated or engorged veins in lining of rectum - external or internal - increased venous pressure from straining - pregnancy, sitting on toilet, liver disease, heart failure

Question 31

Colon cancer risk factors and warning signs

Answer 31

- Race: African Americans - Diet: High intake of red meat or processed meats, low fiber - Obesity - 50+ - Lack physical activity - Alcohol, tobacco use - Family history - History of inflammatory bowel disease

Question 32

Bristol stool chart

Answer 32

type 1 = pebbles type 4 = smooth sausage type 7 = liquid consistency

Question 33

Fecal consituents

Answer 33

solid waste in it, particles

Question 34

Abdomen

Answer 34

INSPECTION AUSCULTATION PERCUSSION PALPATION

Question 35

Stool collection

Answer 35

does not have to be sterile

Question 36

Occult blood test

Answer 36

red meat = false positive often ordered for 3 different occurrences

Question 37

NG tubes

Answer 37

Decompression  keeping things OUT of the stomach Enteral feeding or medication Administration Lavage = taking things out gavage = putting things in

Question 38

With fiber

Answer 38

must include fluid intake

Question 39

NG tube to

Answer 39

low wall suction