Bowel Elimation Flashcards
Where does the go tract go
Mouth to anus
Role of the bowel in maintaining normal function
The food that the body is not able to disgest is excreted
Bacteria and toxins fro, the gi are excreted
Manufactures vitamin k and b
What assessment to identify mechanisms of altered elimination
History of Gi tract and elimination
Physical assessments
Abdomen
Ova and parasite and stool sample
Decal occult stool
Focused assessment
Normal bowel elimination pattern
Need any help to have bowel movement
Recent change in bowel elimination
Issues with bowel Elimination
Bowel diversion
Inspect
Auscultate
Palpate
Percuss
Characteristics of the stool
Anus and rectum
Disgnostic test
What assessments tech
Fecal occult: to test for blood, fat, meat fibers, bile etc
Ova and parasites
Developmental considerations
Infant: the muscles are not developed as much so decreased control.
Toddlers day time bowel control at 2-3 yes old and 30 months
Adolescent: increased secretion of gastric acid and accelerated growth of large intestines
Older adults: decreased peristalsis and relaxation of sphincter = decreased urge
Breast milk stool vs formula stool
Breast milk: watery and yellow brown
Formula stool: pasty and brown
Risk factors for alterations of elimination
Daily pattern
Food and fluid
Activity and muscle tome: bed rest patients , decreased activities
Lifestyle
Diagnostic studues
Surgery and anesthesia
Pregnancy
Lifestyle and psychological
Pathological conditions
What medication cause constipation
Opioid so give stool softener
Antacids with aluminum
Antidepressants
Calcium supplements
Diarrhea inducing medication
Anti acid with magnesium,
Antibiotics
Metformin
What’s important to note about laxative
Causes weakening of the bowels
Development of chronic comstipation
It’s never a solution
Most common causes of constipation
Depression
Pregnancy
Colon cancer
Stress and eating disorder
Hypothyroidism
Large amounts of diary products
Diseases of the colon and rectum
Inadequate intake if water and fiber
Injury of spinal
Constipation
BM less than 3 times a week
Constipation is associated with
Pain from hemorrhoids
Disruption of regular diet
Inadequate activity
Neurological conditions
Medicine: opioid, iron pill and antidepressants
Resisting the urge to have a bowel movement
Overuse of laxatives
Diarrhea
Loose, watery stool that occur more frequent than usual
Most common causes of diarrhea
Stomach flu
Uremia or hyperthyroidism
Food and lactose intolerance
Vital or bacterial infection
Contaminated food or water
Autoimmune disease (lupus and chron)
Nervous system disorders
What’s are associated disorders affecting diarrhea
Disgestion
Absorption
Secretion
Clostridium difficle
Hospital acquired infectious diarrhea
Antibiotic usage that disrupts the normal gi tract bacteria flora
C diff precautions
Wash hands only
What are some evidenced based interventions
Promote regular bowel habits
Administer laxative or antidiarrheal administer enemas, rectal suppositories, rectal catheter and digital removal of stool
Promoting regular bowel habits
Timing encouraging the pastimes to stay on regular timing
Positioning to sit upright
Provide privacy
Exercise: promote gi mobility
Comfort measurements
Nutrition: high fiber intake
High fiber intake
25-38 g
How can you provide comfort measures for your patient for bowel elimination
Encouraging proper diet
Admin medications
Applying ointment etc
Administering laxatives and antidiarrheals
Stool softeners
Patient and family teaching
Nursing care
Stimulant: sena,bisacodyl
Osmotic polyethylene and antidiarrheals forming psyllium-lactulose magnesium citrate
Laxative. It hardens the stool and pulls it through and becomes soft so it can be excreted
To promote elimination of stool
Enema
Suppository
Oral intestinal lovage
Digital removal of stool
What’s one thing you have to check before giving suppositories
Check the blood pressure
Patient education: prevent diarrhea
Teach about nutrition
Education on anti diarrhea med
Education on food safety
Medication
Prevent constipation
High fiber foods: bread, fruits, veg and whole grains
Adequate fluid: 2,000-3,000 ml
Exercise
What data are you goi h to gain before admission
Physical assessment
Urine and stool characteristics
Measure urine output and bowel movements
Assess for pain associated to elimination
Role of nurse in caring for patient with altercation of urinary elimination
Focused pelvic and perineal care
Focused abdominal and rectal care pre and post gi procedures
Education
Document
Facilitate independent self care
What are we documenting
Initial assessment findings
Changes in status during shift change
Response to test and procedure
Change in weight
Intake and output or skin integrity
Patient response to nursing interventions
What are you educating the family and patient on
Newly diagnosed elimination problem
Ordered test and procedure
Effective infection control
Urinary catheter care
Hat are we teaching the patient
Hydration
Hygiene
Skin care
Medications
Maintain voiding pattern
Knowing and facilitating bowel patterns
Assisting with urination and bowel movement as needed
Uriemte and have BM when u feel the urge to do so
Self catherizatiim
Name some support strategies for patients and family with chronic altercation in elimination
Bowel training program
Set routine time for bowel movement 20-40 min after meal
Monitor bowel movement : frequency, consistency, shape and volume
Ensure privacy
Fluid intake of : 2,000-3,000 ml
Foods that promote regular bowel movement
Use digital removal:
What is the right time to set bowel movements program
20-40 min after meal
Digital removal of poop
Insert lubricated finger into anus
Name some high fiber fiber foods that promote BM
Bran
Grains whole
Dried peas
Fresh fruit and vegetables
What color BM IS bad
Black
What are strategies to manage care of a colostomy or ileostomy
Community resources are available for assistance
Encourage patients to eat foods that are high in fiber
Avoid foods that might cause diarrhea or flatus
Drink 1.8 liters of water per day
Teach about med
Odor control
Inspect stoma
Resume normal activity and sexual relations
What foods to avoid with colostomy to prevent blockage
High in fiber
With skin
Seeds
Shells
Inspecting stoma
Make sure the stoma site is clean and dry
Size is 6-8 inches
Relationship to maintain elimination
Reno = urination
Urine and bowel elimination is essential for fluid and electrolytes balance
There is an emotional toll for patients with bowel dysfunction. Depression and body image problems
Reproduction may be ffedted
Infection control
Emotional and psychological effects of elimination
Despair
Anxiety
Fear: of infection
Shame and incontinence
Mood swings
Assessment
Inspect the abdomen: symmetry, contour distention, protrusion, peristalsis
Inspect anus and retum
Auscultate in 4 quadrants
Palpate
Nursing diagnosis constipation
Constipation related to
Limited fluid intake, low fiber diet, lack of activity, medication, laxative overuse, stress, depression, lack of privacy, fear of pain, ignoring urge to defecate
Nursing diagnosis for diarrhea
Related to
Anxiety
Stews
Chemo
Radiation
Laxative abuse
Med side effect
Tube feedings
Planning patient goal for constipation
Stool is out and normal frequency
Express relief from discomfort
Identify measures to prevent or treat constipation
Planning patient goal for diarrhea
Explain cause of
1500-2000 ml per day
Maintain good skin turgor, usual weight and skin integrity to reveal area
Report less diarrhea and relief from cramps
Defecate formed, soft stool every day to every third day
Implementation constipation
Obtain normal BM pattern
Assess for laxative and enema use
Review diary habits, eating schedule and liquid intake
Assess activity level and administer med
Implementation diarrhea
With the patient daily and note increased weight
Keep rooms odor free
Antidiarrheals drug s needed
Avoid stimulants such as caffeine
Record I and o
Fecal diversion
Creation of ileostomy or colostomy
Ileostomy
Opening between skin and small intestine
Colostomy
Opening between ski and colon
Dietary considerations for ileostomy or colostomy
Avoid food that causes gas:
Avoid foods that causes odors
Avoid food that cause stoma blockage
Eat foods that help controls diarrhea and are natural intestinal deodorizers
Foods that produce ga and and odor
Apples
Asparagus
Beer
Cucumbers
Dairy products
Dried peas, beans, and lentils Eggs
Fatty foods
Fish
Garlic
Melons
Foods that cause stoma blockage
Bean sprouts
Cabbage
Celery
Coconut
Corn
Dried fruit
Mushrooms
Nuts
Peas
Pineapple
Popcorn
Seeds
Skins from fruits and vegetables
Foods that are natural deodorizers
Buttermilk
Parsley
Yoghurt
Why do we irrigate a colostomy
To train the bowel to empty at the same time each day
Osteomyelitis appliance bag why?
Protects the skin
Control odor
How many days after surgery we get colostomy bag
2-5
When do we drain the ostomy bag
1/3 is full
What to include in documentation
Bowel or urinary habits
Assessment findings
Nursing and possible medical diagnosis
Lab and procedural test
Nursing and med interventions
Teaching
Family support system
Legal practice’s NEGLIGENCE
Protect the patient from falling to prevent secondary to delirium for uti or incontinence
Protect patient from pressure injuries
Keeping patient clean
Monitor lab test and results and urine output to prevent dehydration
Provide hygiene and catheter care
Administer prescribed diets and medication
Advocate for the shortest time with catheter
HIPPA
Protect the patient information
Fraud
Information shared with patient is accurate and appropriate
Assault and battery
Obtain patient consent
