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Flashcards in bowel elimination ch.47 Deck (16)
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1

regular elimination of bowel waste products

is essential for normal body functioning

2

alterations are early signs

problems in the gastrointestinal tract or other body systems

3

scientific knowledge base

mouth
esophagus
small intestine
large intestine
anus
defecaction

4

factors influencing bowel elimination

- age
- diet
- fluid intake
- physical acitivty
- psychological factors
- personal habits
- positon during defecation
- pain
- pregnancy
- surgery and anesthesia
- medications
- diagnostic test

5

common bowel elimination problems

- constipation
- diarrhea
- incontinence
- flatulence
- hemorrhoids

6

bowel diversions and other procesures

ostomies
iieoanal pouch anastomosis

7

nursing process: assessment

through pt. eyes
nursing history

physical assessment
- mouth
- abdomen
- lab texts
- fecal specimens
- diagnostic exminations

8

nursing diagnosis

some diagnoses that apply to pt. with elimination problems include:
- bowel incontinence
- constipation
- risk for constipation
- diarrhea
- lack of knowledge of dietary regime

9

planning

Goals and outcomes:
- incorporate elimination habits or routines
- reinforce routines that promote health
- consider preexisting concersn

setting priorities
- patients often have multiple diagnoses

teamwork and collaboration

10

cathartics vs laxatives

cathartics have stroner and more rapid effect on the intestines than laxatives

11

enemas

cleansing enemas
- tap water
- normal saline
- hypertonic solutions
- soapsuds

oil retention
other types of enemas: carminative and kayexalate

12

enema admin

- sterile technique unnecessary
- wear gloves
- explain the procedure, positioning, precautions to avoid discomfort, and length of time necessary to retain the solution before defecation

13

digital removal of stool

- use if enemas fail to remove an impaction
- last resort in manging severe constipation

14

inserting and maintaining a nasogastric tube

categories of nasogastric (NG) tubes
- fine-or small-bore for medication administration and enteral feedings
- large- bore (12 french and above) for gastric decompression or removal of gastric secretions

clean technique
maninting comfort: assessment for inflammation
maintain patency

15

continuin and restorative care

- care of ostomies
- irrigating a colostomy
- puching ostomies
- nutritional considerations
- psychological considerations
- bowel training
- maintenance of proper fluid and food intake
- promotion of regular exercise
- managment of the pt. with fecal incontinence of diarrhea
- maintenace of skin integrity

16

safety guidelines for nursing skills

- instruct pt. who self administer enemas to use the side-lying position
- if pt. has cardiac disease or is taking cardiac or hypertensive medication, obtain a pulse rate, because manipulation of rectal tissue stimulates the vagus nerve and sometimes causes a sudden decline in pulse rate