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Fecal Elimination Power Point Flashcards

1
Q

True or False:

ostomy’s closer to the stomach fecal matter have less smell and less liquid

A

True

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2
Q

True or False:

Ostomy’s closer to the rectum fecal matter has greater smell and is more formed

A

True

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3
Q

The function of this organ absorbs water and nutrients

A

small intestine

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4
Q

The function of this organ excretes waste, reabsorbs water and electrolytes, and stores and mixes food with secreations

A

Large intestine (colon)

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5
Q

The function of this organ forms and secretes bile that is essential for breakdown of fats

A

Liver

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6
Q

Constipation is more common in this age group because of the use of OTC, decreased activity level/ fluid and fiber intake

A

Older adult

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7
Q

Define meconium

A

the first fecal material passed by the newborn up to 24 hours after birth

Dark
Green
Tarry
Odorless
Sticky

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8
Q

What affects peristalsis?

A

Activity
Medications
Anesthesia
Obstructions
Adhesions
Diet

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9
Q

Describe a normal finding of the GI after surgery

A

no bowel sounds after 24 hours
hypoactive bowel without n/v/d

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10
Q

What is the treatment for a pt who has had GI surgery?

A

ambulation

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11
Q

True or false: the intestine are highly vascular - bleeding more easily and absorbing things more easily

A

true

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12
Q

Iron supplements and Pepto-Bismol both turn poop which color

A

black

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13
Q

Which medications affect gastric motility

A

opioids
antihistamines
antidepressants

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14
Q

Describe what normal feces looks like for the adult

A

o brown
o firmed, soft, semi-solid, moist
o cylindrical (contour of the rectum) ~2.5 cm / 1 inch in diameter
o odor will vary with diet
o will also vary with food ingested and persons own bacterial flora
o Constituent [made up of]: small amounts of undigested roughage, sloughed dead bacterial and epithelial cells, fat, protein
o Dried constituent of digested juices like bile pigments and inorganic matter

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15
Q

The recommended daily fiber is what for people 50 years and younger

A

men: 38 grams
women: 28 grams

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16
Q

The recommended daily fiber is what for people 50 years and older

A

men: 30 grams
women: 21 grams

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17
Q

What are gas producing foods?

A

cabbage
onion
cauliflower
bananas
apples

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18
Q

What are laxative producing foods?

A

bran
prunes
figs
chocolate
alcohol

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19
Q

What are constipation producing foods?

A

cheese
pasta
eggs
lean meat

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20
Q

when is it best to listen to bowel sounds

A

between meals
peristalsis is more active

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21
Q

Describe abnormal feces

A

clay or white (lack of bile/ pancreatic or liver diseases)
black or tarry (from drugs like iron or bleeding from upper GI [small intestine or stomach]
red (bleeding from lower GI)
Pale (malabsorption of fats)
orange or green (intestinal infection)
hard / dry (dehydration decreased intestinal motility from lack of fiber, lack of activity, laxative abuse)
diarrhea (increased motility due to bacteria in the colon)
narrow pencil shaped or string like (obstruction of the rectum)
pungent odor (infection of blood)
pus/ parasites/ blood/ large quantities of fat

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22
Q

What is the therapeutic response for docusate sodium (colace) and docusate calcium (Surfak)

A

lowering the surface tension of fecal material
allowing water into the stool
resulting in soft fecal mass

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23
Q

What should the nurse teach families and the pt about docusate sodium (colace) and docusate calcium (Surfak)?

A

drink a glass of water (or fluid juice / milk) with the medication
effectiveness of the medication is 1-3 days
DO NOT take within 2 hours of other laxatives especially mineral oil (docusate sodium (colace) and docusate calcium (Surfak) may increase the absorption of mineral oil since it absorbs water)
Discuss other forms of bowel regulation like increasing fluid, fiber, and activity.

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24
Q

The longer the poop is in the GI the harder and __________ it is.

A

dryer

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25
In older adults who have fecal impaction may show signs of delirium, which is a sudden change in
mental status
26
List factors that affect elimination
diet (fiber/ water) positioning privacy medications activity (stimulates peristalsis) defecation habits (do NOT ignore urge)
27
What is the purpose of soluble fiber and where is it found?
Purpose - helps with diarrhea Dissolves in water
28
What is the purpose of insoluble fiber and where is it found?
mixes with stool apples have high fiber but also found in the skin of fruits and vegetables
29
Describe fecal impaction
mass or collection of hardened feces in the folds of the rectum seeps fecal liquid no normal stool
30
A method to help a pt with fecal impaction is digital desimpaction. What are the risks in doing this?
**vagal nerve stimulation** bleeding fissures perforation [hole developed through the wall of a body organ]
31
A pt with hypothyroidism and an slowed down metabolism can have which sx that effects elimination?
constipation
32
A pt with hyperthyroidism can have with sx that effects elimination ?
diarrhea
33
Can fiber be digested
no
34
If the vagal nerve is stimulated during fecal desimpaction, what can happed to the pt?
They can pass out
35
Describe diarrhea
passage of liquid feces AND increased frequency of defecation gets rid of bacteria that is NOT supposed to be there pt will be dehydrated *increased bowel sounds*
36
A healthy daily fluid intake is how many mL
2000 - 3000
37
Define gastrocolic reflex
defecating after breakfast
38
Define ileus
this is caused when a pt has surgery where handling the intestines is necessary. There will be 24-48 hours of bowel stoppage of intestinal movement
39
This is another way to treat fecal impaction
oil enema 2-4 hours later cleansing enema suppository or stool softener
40
A nurse can teach a pt how to control bowel incontinence by teaching them
modify their diet (water / fiber) eating at a regular schedule so that they eliminate at a regular schedule weight loss surgery
41
When palpating the abdomen, what will flatulence feel like
soft
42
If there is blood in the stool caused by hemorrhoids, what is the characteristics and why?
The rectum is a highly vascular area, hemorrhoids are dilated veins that have ruptured and cause bleeding bright red bleeding / stringy bleeding due to proximity of rectum
43
This medication induces defecation (big guns)
cathartics
44
Describe how a cathartic works and provide example medications
may cause cramps has a strong emptying effect **castor oil** **cascara** **bisacodyl** *(frequent use can cause electrolyte imbalances // and reliance on medication)*
45
Describe how laxatives work and provide example medications
produce a soft or liquid stool may be rapid acting or takes time *(frequent use can cause chronic constipation)* bulk forming - psyllium stool softener - docusate MOM - milk of magnesium **MiraLAX**
46
Magnesium laxatives are contraindicated for pts with
renal insufficiency or ESRD
47
Describe constipation
under 3 BM a week hard dry stool that is difficult to eliminate painful BM
48
List contraindications for enemas
pts who have: appendicitis thrombocytopenia [slow blood clotting / bruising easy] neutropenia [low neutrophils due to infection] diverticulosis [small pouches that bulge out of colon]
49
What is the purpose of enemas
remove feces in constipation and fecal impaction
50
What are the commonly used enemas
cleansing retention carminative return flow
51
What is the purpose of a cleansing enema
to remove feces - prevent the escape of feces during surgery - prepare the intestine for visualization (colonoscopy) or x ray - remove feces due to constipation or impaction
52
Fleet enemas (hypertonic solution) could be contraindicated to pts with this condition
renal failure
53
More than one fleet enema (hypertonic solution) in _____ hours can be harmful
24 hours
54
What is the purpose of retention enemas
induces oil or medication to the rectum and sigmoid colon
55
How long should be retained for this long `
1-3 hours
56
Antibiotic enemas are used to treat
infections locally
57
Anthelmintic enemas are used to treat
worms and intestinal parasites
58
Nutritive enemas are used to
administer fluids and nutrients to to the rectum
59
What is the purpose of a carminative enema and how much fluid is instilled
primary purpose - to expel flatus 60-80 mL of fluid
60
What is the purpose of a return flow enema and how much fluid is instilled
primary purpose - stimulate peristalsis secondary purpose - expel flatus 100 - 200 mL alternating 5-6 times
61
Purpose of hypertonic solution for an enema and example
draws in **enter** water in colon fleet enema
62
Purpose of hypotonic solution for an enema and example
stimulates peristalsis / softens feces tap water
63
This is the safest type of solution for an enema and an example is
Isotonic **safe** Normal saline stimulates peristalsis / softens feces
64
Purpose of soapsuds solution for an enema and example
pure soap irritates mucosa / distends colon
65
Purpose of oil solution for an enema and example
lubricates feces and mucosa mineral oil
66
What temperature should the solution for enema be?
warm
67
What is a stoma?
Opening created by an ostomy
68
What kind of emotional support does the pt need when they have an ostomy
the nurse needs to know that the pt has accepted it and can look at it because they will be changing it at home
69
A risk to ostomies or digestive enzymes is
skin irritation
70
Describe stools that come from a colostomy
solid
71
Describe stools that come from an ilieostomy
generally fluid
72
When does bowel diversion ostomies begin to work?
they begin to function 4-5 days post op
73
When does bowel diversion ostomies begin to work?
they begin to function 4-5 days post op
74
**What are cruciferous [spouty greeny vegetables of the cabbage family] vegetables**
Arugula. Bok choy. **Broccoli.** **Brussels sprouts.** **Cabbage.** **Cauliflower.** **Collard greens.**
75
In a bowel diversion ostomy, an ileostomy can make a pt deficient in what nutrients and why
Vit B12 (biotin) Iron Mg Folic Acid H2O NA+ because there is no colon to absorb these vitamins into the blood stream
76
Dietary considerations **to avoid gas** for a bowel diversion is which foods
**Broccoli.** **Brussels sprouts.** **Cabbage.** **Cauliflower.** **Collard greens.** carbonated drinks alcohol
77
Dietary considerations **to avoid odor** for bowel diversion is which foods
onions broccoli or sprouty vegetables asparagus eggs fish
78
Describe a normal stoma
pink / red may bleed when touched due to being highly vascular
79
How can a pt care for a stoma
asses the skin for irritation each time the appliance is changed treat any irritation immediately keep skin clean by washing off excretion and drying the skin thoroughly colostomy irrigation
80
What are the different types of stool samples
fecal occult blood (guaiac) ova / parasites culture
81
What is the goal of bowel training
establish a normal defecation pattern
82
A pt plan for bowel training would include
fluid fiber exercise hot drinks
83
How long should a bowel training routine be maintained
2-3 weeks *need to be consistent*
84
List other methods used with bowel training
cathartic suppositories *positioning is key* prompt the response to urges physical positioning
85
What is the purpose of a fecal incontinence pouch
to get the pt to stop pooping due to rectal damage
86
What are the nursing responsibilities for a fecal incontinence pouch other than assessing the skin
Changing the bag every 72 hours (sooner if there is leakage) Maintain the drainage system Explain the process and support the pt`
87
What are the goals for pts with fecal elimination problems
maintain or restore bowel elimination pattern maintain or regain normal stool consistency Prevent risks like F&E imbalance, skin breakdown, abdominal distension, and pain
88
How can the nurse promote healthy defecation
giving the pt **privacy** **timing** - the pt needs to defecate when they have the urge. ambulating and bathing should not interfere with their normal defecation pattern/ defecation routine **Nutrition and fluids**
89
How can the nurse teach the pt how to establish a healthy defecation pattern
regular exercise high fiber foods (vegetables, whole grains, fruits) Fluid intake should be 2000-3000 mL /day Do NOT ignore the urge to defecate All the pt time to defecate - preferably around the same time everyday avoid OTC to treat constipation and diarrhea
90
Describe insoluble fiber
increases peristalsis and increases bulk
91
Describe soluble fiber
dissolves in water to form gel-like material to help lower cholesterol and glucose levels
92
How can the nurse teach a pt to manage diarrhea
drink 8+ glasses of water daily/ or even electrolyte fluids Eat foods with Na+ or K+ (meat vegetables fuits) Increase fiber (rice, oatmeal, potatoes) Avoid caffeine and alcohol Limit insoluble fiber (whole wheat / whole grain cereals) limit fatty foods discontinue meds for diarrhea
93
If a pt has been having diarrhea and it is stopped, how can they reestablish normal GI flora
By eating fermented dairy products like yogurt or buttermilk
94
A pt needs to monitor this if they have diarrhea
hypovolemia dehydration
95
A pt should seek a PCP right away if they have the following
weakness dizziness loose / persistent stools for more than 48 hours

EPCC Nursing Foundations (43 decks)

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