Bowel Elimination

Question 1

The small intestine hooks to the large intestine at the:

Answer 1

cecum

Question 2

Main cause of rectal bleeding?

Answer 2

Hemorroids

Question 3

Defecation:

Answer 3

bowel movement

Question 4

A reflex affecting internal anal sphincter:

Answer 4

involuntary

Question 5

Control comes from the external anal sphincter:

Answer 5

Voluntary

Question 6

Act of defecation:

Answer 6

deep breath
contract abdominal muscles
contract pelvic floor muscles

Question 7

Newborns and Infants:

Answer 7

meconium- 1st fecal material (black, tarry, odorless, sticky)

Question 8

Toddlers:

Answer 8

begin to have some control between 18 or 24 months

Question 9

School Age:

Answer 9

constipation may become an issue

Question 10

Aging Adult:

Answer 10

Old people are obsessed with bowel movements = may become laxative dependent

Question 11

Normal amount of fiber per day:

Answer 11

20-35 grams

Question 12

Gas producing foods:

Answer 12

onions
cauliflower
beans
cabbage

Question 13

Laxative causing foods:

Answer 13

bran
prunes
figs
chocolate
alcohol

Question 14

Constipation causing foods:

Answer 14

cheese
pasta
eggs
lean meats

Question 15

Peristalsis:

Answer 15

involuntary constriction and relaxation of the muscles of the intestine, creating wavelike movements that push the contents of the canal forward

Question 16

Pregnancy:

Answer 16

as the fetus grows, pressure is exerted on the rectum, impairing passage of feces.

Question 17

Surgery:

Answer 17

paralytic ileus, anesthesia blocks stimulation of muscles.

Question 18

Paralytic Ileus:

Answer 18

(stoppage of peristalsis which lasts 24-48 hours) early activity and frequent assessment of bowel sounds are important during this time

Question 19

Non-modiflabe

Answer 19

cannot change

Question 20

Modiflabe

Answer 20

can change

Question 21

Non-modiflabe

Answer 21

age
race
family history

Question 22

Modiflabe

Answer 22

smoking
poor diet
lack of exercise

Question 23

Symptoms of colorectal cancer:

Answer 23

change in bowel habits
feeling of incomplete evacuation
rectal bleeding or blood in stool
abdominal pain
unintentional weight loss

Question 24

Flatus:

Answer 24

gas- adult forms 7-10 liters per day

Question 25

Diarrhea:

Answer 25

characterized by an abnormal frequency and fluidity of fecal evacuations

Question 26

How to prevent excessive flatulence:

Answer 26

limit carbonated drinks don't use straws limit chewing gum avoid gas forming foods

Question 27

Cause of diarrhea:

Answer 27

``` stress medications allergies colon diseases antibiotics iron food intolerance surgery ```

Question 28

Why do you need to make sure a patient is clean and dry after cleaning stool?

Answer 28

because stool is very acidic and can cause skin breakdown

Question 29

Constipation:

Answer 29

having infrequent or difficult bowel movements

Question 30

Causes of constipation:

Answer 30

``` low fiber low fluid intake change in routine chronic use of laxative diseases/disorders neurological disorders decreased activity irregular toileting habits lack of privacy ```

Question 31

Main cause of constipation:

Answer 31

feces stays in the colon too long and all the water is reabsorbed.

Question 32

Fecal Impaction:

Answer 32

collection of hardened feces in the rectum

Question 33

Symptoms of fecal impaction:

Answer 33

anorexia distended abdomen nausea and vomiting

Question 34

Causes of C. Diff:

Answer 34

antibiotics surgery chemotherapy acquired from healthcare workers

Question 35

Diagnostics for C.Diff:

Answer 35

enzyme linked immunoassay (ELIZA)

Question 36

With C.Diff you must wash your hands with:

Answer 36

soap and water

Question 37

With Subjective History, review of factors influencing elimination:

Answer 37

``` use of aids diet medications exercise fluid stress ```

Question 38

Why do you need to chart intake/output?

Answer 38

because the patient is loosing fluid

Question 39

Collection of stool specimen procedure:

Answer 39

``` void first defecate into containers do not place toilet paper in container free pf barium and edema solution use gloves ```

Question 40

Occult blood testing:

Answer 40

checks for hidden blood in the stool

Question 41

Occult blood test requires:

Answer 41

3 different specimens on 3 different days

Question 42

Privacy:

Answer 42

alone if possible and safe

Question 43

Timing:

Answer 43

after meals

Question 44

Nutrition and Fluid:

Answer 44

fiber and water

Question 45

Exercise:

Answer 45

early ambulation, bedside exercises

Question 46

Positioning:

Answer 46

sitting, commode extension

Question 47

If you can't fix constipation naturally what do you do?

Answer 47

move to the pharmacologic methods

Question 48

Suppository:

Answer 48

solid which melts at room temperature and patient holds.

Question 49

Removal of impaction:

Answer 49

digital removal

Question 50

Rectal Catheter:

Answer 50

flatus and distention relief

Question 51

Can fleet enemas be delegated?

Answer 51

yes, they can be delegated

Question 52

Hypertonic Enema:

Answer 52

``` draws water into the colon works in 5-10 minutes contains 90-120 mL of fluid adverse effect=retention of sodium example: fleet enema ```

Question 53

Are enemas a sterile procedure?

Answer 53

no, they are not considered a sterile procedure.

Question 54

How do you give a big enema?

Answer 54

give it slowly

Question 55

Hypotonic enema:

Answer 55

distends colon, stimulates peristalsis and softens feces takes 15-20 minutes to work contains 500- 1000 mL of tap water adverse effect: fluid, electrolyte imbalance, water intoxication contraindicated: CHF, renal conditions example: tap water

Question 56

Isotonic enema:

Answer 56

distends colon, stimulates peristalsis and softens feces takes 15-20 minutes to work contains 500-1000 mL of saline adverse effect- possible sodium retention

Question 57

Soapsuds enema:

Answer 57

irritates mucosa, distends colon works in 10-15 minutes contains 500-1000 mL of water irritates and may damage colonic mucosa

Question 58

Oil enema:

Answer 58

lubricates the feces and colonic mucosa works in 1/2 to 3 hours contains 90-120 mL of oil

Question 59

How to administer an enema:

Answer 59

``` explain procedure wash hands, don gloves provide privacy lubricate about 2.5-3 inches prime the tubing assist patient into Left Lateral Sims position ask patient to take a deep breath inset the enema tube (3-inches) ```

Question 60

When removing fecal impaction:

Answer 60

may cause vagal stimulation and always check cardiac status. (use xylocaine because it is painful)

Question 61

If the bowel diversion is on the left side:

Answer 61

the stool is solid

Question 62

If the bowel diversion is on the right side:

Answer 62

the stool is liquid