Bowel Flashcards
When performing the Valsalva Maneuver what are possible complications?
Patients with cardiovascular disease, glaucoma, increased ICP or new surgical wound are at risk for dysrythmias and elevated BP.
What is intrinsic factor essential for?
In the stomach it is essential for absorption of Vitamin B12
Unless there is a medical contraindication, how much fluid should an adult drink daily?
1100-1400 mLs of fluid
Common Bowel elimination problems
Constipation, impaction, diarrhea, incontinence, and hemorrhoids.
2 drugs that can cause GI bleeding
Aspirin and NSAIDS
How do opioids (narcotics) effect the GI system?
Slow peristalsis and segmental contractions resulting in constipation.
What patients are most at risk for impaction?
Patients that are debilitated, confused or unconscious. They are dehydrated or too weak or unaware of the need to defecate.
What happens with impaction? Signs and symptoms?
Continuous oozing of diarrhea stool. the liquid portion of feces located higher in the colon seeps around the impacted mass. Patient may also lose appetite, have nausea and/or vomiting, abdominal distention and cramping, and rectal pain.
Types of dignostic tests that visualize the GI structures
Endoscopy and colonoscopy
Define diarrhea
Increased number of stools and the passage of liquid, unformed feces associated with disorders affecting digestion, absorption and secretion.
2 Major complications of diarrhea
- Contamination and risk of ulceration (skin breakdown)
2. Fluid and electrolyte or acid-base imbalance.
Causes of diarrhea
Antibiotic use, patients receiving enteral feeding, food allergies and intolerance, surgery and diagnostic tests, foodbourne pathogens and C.diff.
How does a patient acquire C.diff?
- From a healthcare workers hands or direct contact with environmental surfaces that are contaminated.
- Results from factors that cause an overgrowth of C. difficile - Antibiotic use or invasive bowel procedures that disrupt the normal flora of the bowel.
Define fecal incontinence.
It is the inability to control passage of feces and gas from the anus caused by physical conditions that impair anal sphincter function or control.
Define flatulence.
It is a gas accumulation n the lumen of the intestine: strtches and distends ( a common cause of abdominal fullness, pain and cramping).
Hemorroid causes
Increased venous pressure from straining at defecation, pregnancy, heart failure, and chronic liver disease.
What would the consistency of stool look like in an ileostomy and a colostomy of the ascending colon?
It bypasses the entire large intestine and as a result stools are frequent and liquid.
What would the consistency of the stool look like in a colostomy of the transverse colon?
More solid and formed.
What would the consistency of the stool look like in a sigmoid colostomy?
Near normal stool.
Stoma
An artificial opening in the abdominal wall constructed from the ends of the intestine. Can be permanent or temporary.
Ileostomy
Surgical opening in the ileum.
Colostomy
Surgical opening in the colon.
Loop Colostomy
Usually temporary- performed from a medical emergency. Usually constructed in the transverse colon with 2 openings inside 1 stoma. The proximal end drains stool and the distal portion drains mucus.
End Colostomy
Permanent procedure performed when rectum is removed for colorectal cancer. Proximal end forms stoma and distal end is sewn closed or removed. May be temporary with treatment of diverticulitis with a hartmans pouch.
Double Barrel Colostomy
Bowel is surgically cut and both ends are brought through the abdomen. The proximal end remains active and drains feces. Distal end leads to inactive intestine and is left in tact. This can be reversed once the intestinal injury has healed.
Ileoanal Pouch Anastomosis
Surgeon removes colon and creates a pouch from the end of the small intestine and attaches the pouch to the patients anus. Patient remains continent. Procedure necessary for treatment of ulcerative colitis or familial polyps.
