Chapter 35

Question 0

Large intestine

Answer 0

Lower GI tract. Length 5-6 cm. primary organ of bowel elimination

Question 1

Contraction that propels food through the length of the GI tract

Answer 1

Peristalsis

Question 2

Surgical creation of a stoma

Answer 2

Ostomy

Question 3

Having fewer than three BMs per week, more than 25% of which are hard and require straining

Answer 3

Constipation

Question 4

Preventing flatulence

Answer 4

Limit sodas
No straw or chewing gum
Avoid foods such as cabbage, beans, onions and cawliflower

Question 5

Constipation caused by

Answer 5

Irregular bowel habits 
Chronic illnesses such as Parkinson's, MS, RA, depression, eating disorders, bowel dx
Low fiber diet
Low fluid intake 
Stress
Mobility
Environmental factors
Lack of privacy 
Neuro conditions

Question 6

What foods slow parastalsis

Answer 6

Low fiber foods such as
Pasta 
White rice
White bread
Cheese

Question 7

What is the adequate fluid intake

Answer 7

1.5-2 liters daily

Question 8

Physiological factors that cause acceleration of digestion and parastalsis

Answer 8

Stress
Anxiety
Fear
All these initiate parasympathetic impulses

Question 9

What slow parastatals

Answer 9

Emotional depression

Question 10

Which drugs depress parastalsis

Answer 10

Opiates and snticholinergics

Question 11

Drugs that contain iron sometimes turns stools

Answer 11

Black

Question 12

Slowing or halting parastalsis

Answer 12

General anesthesia

Question 13

Causes of diarrhea

Answer 13

Infection
Inflammation
Food intolerance

Question 14

Inability to control passage of feces

Answer 14

Fecal incontinence

Question 15

What results in hemorrhoids

Answer 15

Pregnancy
CHF
Chronic liver failure

Question 16

Blood in stool

Answer 16

Melena

Question 17

Measures msc amts of blood in the feces

Answer 17

Fecal occult blood test or guaiac
You repeat three times
If positive follow up with a sigmoidoscopy or colonoscopy
Avoid eating red meats 3 days before testing
Stop taking aspirin or any NSAIDs for 7 days before test because could produce false negative test
Vitamin c and citrus fruits and juices stopped 3 days before

Question 18

Stepwise progression of laxatives

Answer 18

Bulk forming laxatives
Stool softener and osmotic stimulants
Suppositories/enemas if all else unsuccessful

Question 19

Most common anti diarrheal agents

Answer 19

Loperamide or diphenoxalate with atropine

Question 20

If infection causative factor for diarrhea

Answer 20

Antibiotic is given

Question 21

If inflammation is cause

Answer 21

Give steroids

Question 22

Temporary cessation of peristalsis

Answer 22

Ileus

Question 23

Single lumen tube with holes near tip

Answer 23

Levin tube

Question 24

Tube with two lumina and preferable for stomach decompression

Answer 24

Salem tube Blue pigtail is the air vent Never use for irrigation Ng tube is clean technique

Question 25

Most common use of an enema

Answer 25

Temporary relief of constipation

Question 26

Lower GI bleeding

Answer 26

Bright red bleeding

Question 27

Symptoms of fecal impaction

Answer 27

Anorexia Distended abdomen N/v

Question 28

Patient teaching for diarrhea

Answer 28

``` Eat foods containing pot and sodium Avoid caffeine Decrease fiber Limit fatty foods Avoid hot, cold or spicy foods ``` Treatment Rehydration is key

Question 29

Patient teaching for constipation

Answer 29

``` Increase fiber Whole grains, raw fruit and veggies 8-10 glasses of water Prune juice Warm/ hot liquids ``` Treatment Laxatives Enemas Mess

Question 30

``` Distends colon Stimulates parastalsis Softens feces 15-20 mins to work Contains 500-1000 tap water Adverse effects - fluid and electro balance and water intoxification Do not use in CHF and renal conditions ``` Is hyper or hypotonic

Answer 30

Hypotonic enemas

Question 31

Fleets enema Works in 5-10 mins 90-120 ml of fluid Adverse effect retention of sodium

Answer 31

Hypertonic

Question 32

Enema lubricate 2-5 2.5-3 inches

Answer 32

2.5 to 3 inches

Question 33

Administering enema

Answer 33

Put patient in left lateral sims position | Insert 3-4 inches as patient takes deep breath

Question 34

Ostomy in | right or left lower quadrant

Answer 34

Right lower quadrant

Question 35

Causes of diarrhea

Answer 35

``` Stress Meds like abx and iron Allergies Food intolerance Asian Americans are more likely to be lactose intolerant Colon dx Surgery ```

Question 36

Causes of constipation

Answer 36

``` Low fiber or fluid intake Decreased activity Irregular toilet habits Change in routine Lack of privacy Chronic use of laxative Diseases/disorders Neuro disorders ```

Question 37

Accumulation of hardened fecal material in the rectum or sigmoid colon

Answer 37

Fecal impaction

Question 38

Symptoms of fecal impaction

Answer 38

Anorexia Distended abdomen N/V

Question 39

``` Impaction with overflow Changes in neural innervation Prolapsed rectum Extreme debilitation Cognitive impairment ```

Answer 39

Bowel incontinence

Question 40

Blood in the stool

Answer 40

Melena

Question 41

Drugs that act to promote bowel evacuation

Answer 41

Laxatives

Question 42

Procedure involving introduction of a solution into the rectum for cleansing or therapeutic purposes

Answer 42

Enema

Question 43

What can result in stimulation of the vagus nerve

Answer 43

Bradycardia | Hypotension