38 Bowel Elimination Flashcards
part of the GI that digests protein and carbs
Small intestines
digestive juices fr liver + pancreas enter the ___
small intestines thru opening in duodenum
small intestines is responsible for…
digestion of food + absorption of nutrients into bloodstream
controls the mvmt of chyme fr stomach to sm.intestines
pyloric sphincter
connection bw ileum (sm.intstn) + lrg intestines
ileocecal or ileocolic valve
which colon contains feces?
sigmoid colon (comes after descending colon)
large intestines are responsible for…
absorption of water, formation of feces, expulsion of feces
bacteria in the large intestines act on food residue to produce…
vitamin K + some B complex
nervous system + effects on GI mvmt
autonimic NS- innervates muscles of colon
parasympathetic- stim mvmt
sympathetic- inhibits mvmt
nervous system on defecation
parasymph- intrinsic anal sphincter relaxes, colon contracts, allows fecal mass to enter the rectum
symph- motor impulses
feces vs stool
stool is when feces is expelled out of the body
fecal impaction
prolonged retention or an accum of fecal material that forms a hardened mass in the rectum
Black stool may be caused by
- upper GI bleeding like peptic ulcers
- iron salts fr oxidation of iron
- bismuth subsalicylate
opiods causes medication-induced constipation
enteric neurons control major body functions like bowel control
- opiod-binding receptors are found in enteric neurons in GI tract
- binding interrupts peristalsis
- slow mvmt of stool> incr absorption of h20>
meds that cause constipation
- opioids
- antacids w Al, FeS
- anticholinergic
- inhaled anesthesia for surgery (does NOT apply to local or regional anesthetics)
meds that cause diarrhea
- antibiotics like amoxicillin
- antacids w Magnesium
- metmorfin (for diabetes)
- broad-spectrum antibiotics can cause C.diff to multiply
signs of intestinal obstruction
- distention (inflation)
- potrusion (projection)
- visible waves of peristalsis on the abdomen (usually not visible except in v thin patients)
- hypo(late), hyper(early/partial), absent bowel sounds
HYPOactive bowel sounds
sign of abdominal surgery ot LATE bowel obstruction
HYPERactive bowel sounds
- diarrhea
- gastroenteritis
- early/partial bowel obstruction
Absent bowel sounds (2 mins+)
- peritonitis
- paralytic ileus
- prolonged mobility
Guaiac Fecal Occult Blood Test
[gFOBT]
chemical test that detects the enzyme peroxidase in hemoglobin molecules when blood is present in stool sample
false positives in gFOBT readings may be caused by
- salycate of 325mg+
- nonsteroidal antiinflammatory
- steroids
- iron
- anticoagulants
false negative in gFOBT readings even when blood is present may be caused by
ingestion of vitamin C
Collecting stool samples
asepsis technique, don gloves
- void first
- defecate into container
- avoid contact w soaps, detergents disinfectants, or toilet paper
- notify nurse when specimen is available
- use 2 clean tongue blades
- send to lab immediately or refrigerate
Endoscopy
direct visualization of body organs or cavities
-long, flexible used w fiberoptic tube that transmits light into organs + returns image
Endoscopy is useful for detecting…
- integrity of mucosa, bld vssls, organ parts
- inflammatory, ulcerative, + infectious diseases
- benign/malignant neoplasms
- lesions of esophageal, gastric, intestinal mucosa
3 types of Endoscopy
1 esophagogastroduodenoscopy [EGD] 2 colonoscopy (lrg intstn: anus to ileocecal valve) 3 sigmoidoscopy (sigmoid colon, rectum, anal canal)
Barium Enema
series of radiographs that examine the large intestine after rectal instillation of Barium sulfate
-do not use if hx of ulcerative colitis or active GI bleeding
Abdominal Ultrasound
uses ultrasound waves to visualize organs via small transducer placed against skin
____ must be performed before studies involving Barium
abdominal ultrasound
-retained barium might compromise study
which endoscopy will let you view the distal small bowel?
colonoscopy
which endoscopy will let you view the duodenum?
esophagogastroduodenoscopy
fecal impaction
most often caused by constipation
-prevents passage of normal stools
sign of fecal impaction
liquid fecal seepage w no passage of normal feces
-small amt of liquid may pass around the impacted mass
high risk for fecal impaction
- frequent use of stimulant laxative
- immobile
- spinal cord injury
- parkinson’s
- diabetes mellitus
- malignancies
- chronic kidney disease
Ileostomy
allows LIQUID fecal content fr ileum of SMALL INTESTINE be eliminated thru stoma
Colostomy
permits FORMED FECES in colon to exit thru stoma
Urostomy
stoma attaches to the tubes that transport urine away from the bladder.
Stoma appearance
NORMAL: dark pink to red, moist, protrude 0.5-1in
- pale>anemia
- dark, purple, blue>ischemia
- minimal bleeding is normal, contact provide if bleeding persist
- flush stoma>erosion
J Pouch
type of bowel diversion that does NOT require a stoma.
-aka restorative prctocolectomy ileal pouch-anal anastomosis [IPAA]
J pouch or IPAA are best for patients w…
inflammatory bowel disease or ulceritive colitis
J pouch or IPAA involves the removal of ______ + ____ but leaves the ____ intact
removal of colon + rectum
leaves the anus intact
