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NUR 333: > Constipation and Diarrhea > Flashcards

Constipation and Diarrhea Flashcards

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1
Q

factors that influence bowel elimination

A
  • age
  • diet
  • fluid intake
  • physical activity
  • psychological factors
  • personal habits
  • positioning during elimination
  • pain
  • pregnancy
  • surgery and anesthesia
  • medication
  • diagnostic tests
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2
Q

older adult care focuses

A
  • trouble chewing
  • esophageal emptying slows
  • impaired absorption
  • weakened sphincters
  • decreased
    – HCl, absorption of vitamins, peristalsis, sensation to defecate, lipase which aids in digestion
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3
Q

common bowel elimination problems

A
  • constipation
  • impaction
  • diarrhea
  • bowel incontinence
  • flatulence
  • hemorrhoids
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4
Q

constipation

A

having fewer than 3 bowel movements a week
- a symptom not diseases
- need to think about it in relation to pts normal

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5
Q

symptoms of constipation

A
  • infrequent BMs
  • discomfort
  • hard dry stool that are difficult to pass
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6
Q

causes of constipation

A
  • irregular bowel habits
  • improper diet –> fiber
  • reduced fluid intake
  • lack of exercise
  • stress
  • certain meds
  • advanced age
  • ignoring the urge to defecate
  • GI disorders
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7
Q

older adults and constipation

A
  • lack of muscle tone (bowels and abdomen)
  • slowed peristalsis
  • lack of exercise
  • inadequate fluid intake
  • too many diary products
  • lack of fiber
  • meds
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8
Q

complications of constipation

A
  • hemorrhoids
  • anal fissure
  • fecal impaction
  • rectal prolapse
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9
Q

constipation prevention

A
  • include plenty of high fiber foods
  • drink plenty of water
  • stay active
  • manage stress
  • don’t ignore urge to go
  • create a schedule
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10
Q

types of laxatives

A
  • bulk forming (pulls bulk like fiber into stool)
  • emollient or wetting (pulls water into GI)
  • osmotic (stimulate urge)
  • stimulant cathartics (stimulate urge)
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11
Q

what do laxatives and cathartics do

A

initiate or facilitate stool passage
- stimulate need to defecate
- not only a stool softener

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12
Q

implementation of cathartics and laxatives

A
  • PO or rectal (suppository or enema)
  • short term action
  • may be used to cleanse the bowels for dx test, procedure, surgery
  • potentially harmful so do not overuse
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13
Q

enemas

A
  • verify order
  • gather equipment
  • position
  • pt teaching
  • admin of enema
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14
Q

things to know when admin an enema

A
  • cramping/pain: slow rate by lowering height of bed
  • abdomen rigid: stop procedure
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15
Q

what to document of enema

A
  • medication
  • how much was instilled
  • measure color, amount, consistency
  • how pt tolerated
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16
Q

enema precaution/complications

A
  • fluid, electrolyte imbalance
  • tissue trauma
  • vagal nerve stimulation
  • abdominal pain/cramping
  • pain
  • perforation
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17
Q

impaction

A

hardened feces that remain in the rectum when there is an inability to expel usually from unrelieved constipation
- if unresolved, can result in intestinal obstruction

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18
Q

ind most at risk for impaction

A
  • debilitation
  • confused
  • unconscious
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19
Q

impaction symptoms

A
  • inability to pass stool for several days despite repeated urge to defecate
  • continuous oozing of liquid stool
  • loss of appetite
  • n/v
  • abdominal distention
  • cramping
  • rectal pain
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20
Q

digital removal of stool

A
  • assess
  • digital removal of stool using finger to break up fecal mass and remove in sections
    painful and there are risks involved
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21
Q

diarrhea

A

loose watery bowel movements that can happen frequently and w urgency

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22
Q

causes of diarrhea

A
  • foodborne pathogens
  • food intolerances or allergies
  • surgery
  • diagnostic testing
  • enteral feeding
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23
Q

common complications of diarrhea

A

skin irritation
dehydration
nutritional concerns

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24
Q

antidiarrheal agents

A
  • decrease intestinal muscle tone to slow passage of feces
  • body absorbs more water
    need to determine cause before admin
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25
examples of antidiarrheal agents
- loperamide - diphenoxylate w atropine - some have opiates but use caution bc bowel forming
26
nursing care for diarrhea
- identify the problem - provide soft and digestible food (prevents further irritation of lining) - maintain fluid and electrolyte balance - prevent the spread --> hand hygiene
27
nursing interventions for fecal incontinence and diarrhea
- meticulous skin care - prevent and monitor for dehydration - fecal management systems (only used for severe cases and often would check w health care provider first)
28
nursing intervention: maintenance of skin integrity
- meticulous skin care - frequent checks - apply skin barrier - consult wound
29
C. diff
a health care associated infection caused by a spore producing bacteria - can live on surface for up to 72 hrs - leads to severe diarrhea * always wash hands *
30
most at risk for c. diff
- antibiotics - elderly - immunocompromised - long term care facilities - GI procedure - previously had c. diff
31
complication of c diff
- dehydration - kidney failure - toxic megacolon - bowel perforation - death
32
prevention of c diff
- wash hands w soap and water - avoid unnecessary use of abx - clean surfaces w bleach - place in Contact D (or spore isolation)
33
diagnosis of c. diff
- hospital protocols - stool sample (PCR)
34
treatment of c diff
- plenty of fluids - good nutrition - abx - surgery - fecal impaction - probiotics
35
bowel incontinence
inability to control passage of feces and gas from anus
36
causes of bowel incontinence
- muscle of nerve damage - any physical condition that impairs the anal sphincter function - constipation or diarrhea - large volumes of stools - surgery - rectal prolapse
37
risk factors for bowel incontinence
- age - female - nerve damage - dementia - physical disability
38
complications for bowel incontinence
- body image disturbances - skin irritation *ensure that they know we are doing everything we can to stop this from happening to them*
39
treatment of bowel incontinence
- anti diarrheal - bulk laxatives
40
prevention of bowel incontinence
- reduce constipation - control diarrhea - avoid straining
41
flatulence
gas - either mouth or rectum
42
symptoms of flatulence
- abdominal distension - cramping - bloating - pain
43
causes of flatulence
- constipation - food intolerance - GI distress - stress
44
nursing care for flatulence
- avoid foods that cause gas - eat small more frequent meals - eat and drink slowly
45
tips to reduce bloating (image)
- eat insoluble fibers - avoid straws - avoid lying down after eating - limit carb intake - limit carbonated drinks - drink water - exercise daily - eat slowly and mindfully
46
hemorrhoids
dilated or engorged veins lining the rectum - purple discoloration that can harden
47
cause of hemorrhoids
inc venous pressure from straining - pregnancy - disease like heart or liver failure
48
types of hemorrhoids
- internal: found in anal cavity, may be inflamed or distended - external: clear visible protrusion of skin out of anus
49
treatment of hemorrhoids
- proper diet, fluids - inc activity - ice - warm sitz bath
50
colon cancer risk factors and warning signs
- african american - high intake of red/processed meat, low fiber - obesity - 50+ - lack of exercise - alc - tobacco - fam hx - hx of inflammatory bowel diseases
51
screenings for colon cancer
- flex sig, scan q 5 years - colonoscopy q 10 years - stool sample, less often used *** recheck w ppt****
52
assessment of pt bowel hx
- usual elimination pattern - description of stool - how does ind defecate - dietary and fluid intake - hx of GI disorders or surgeries - med hx - emotional state - activity/mobility
53
fecal characteristics
- amount - color - odor - consistency - frequency - shape - constituents
54
physical assessments for GI issues
- mouth - abdomen - rectum
55
lab tests for GI problems general info
- no blood for GI (if blood detected in stool, we would want H&H) - know how to collect and send to lab immediately
56
types of lab GI lab tests
- fecal occult blood test - culture and sensitivity - DNA - fats - WBC - ova and parasites
57
fecal occult blood test
- check for hidden blood - ordered to detect cancer or evaluate possible cause of unexplained anemia - stoop sample should be from 2 different areas - often ordered for 3 different occurences - be aware of false positives
58
nursing problems associated w bowel elimination
- constipation - chronic functional constipation - risk for constipation - diarrhea - risk for electrolyte imbalance - deficient fluid volume or risk for - dysfunctional gastrointestinal mobility or risk for - bowel incontinence - nausea - risk for impaired skin integrity - disturbed body image - deficient knowledge
59
goal for bowel incontinence
pt will have normal bowel elimination pattern - how long will it take pt to achieve goal
60
outcome for bowel incontinence
what will pt demonstrate? - consistent bowel elimination - consistent consistency - does not have incontinence
61
implementation of health promotion
- promote normal defecation - regular exercise - well balanced diet
62
inserting NG tube
- decompression of stomach to keep things out - enteral feeding or medication - administration - lavage
63
assessment of NG tube
- abdominal - respiratory - nose - skin - suction
64
nursing care of NG tube
- verify HCP orders - assessment - verify placement - know hoe to hook suction - admin feeding and meds (and if meds is acceptable) - recording i and o
65
bowel training info
- pts with chronic constipation of incontinence - set up daily routine - requires time patience consistency
66
bowel training program
- assessment and documentation - choosing pt centered time - offer fluids to stimulate defecation around normal times - assist commode - provide privacy - normal exercise regimen
67
diet considerations
- recommended well balanced diet with whole grains, legumes, fresh fruit, veggies - fiber intake varies/ind (inc fiber then inc fluids)
68
older adult considerations
- encourage screening - adequate fiber and fluid intake - regular exercise program - older adults are less able to compensate from fluid loss from diarrhea

NUR 333: (10 decks)

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