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Foundations 3 > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

Newborn/ Infant stool considerations

A

Meconium
Stool color dependent upon type of milk ingested
Frequent and multiple bowel movements a day

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2
Q

Toddler stool

A

Duodenocolic reflex

Toilet training after 22 months

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3
Q

School age stool

A

Bowel function reaches adult standard

Peer pressure may contribute to constipation

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4
Q

Adult/ Older stool

A

Bowel movement frequency decreases, GI motility slows

Increased fluid and fiber in diet

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5
Q

Normal Feces

A 
Frequency: 1-2x a day and 1 every 2-3 day 
Color: Brown 
Consistency: Soft, formed 
Shape: Cylindrical 
Amount: 100/300 g/d 
Odor: aromatic, pungent
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6
Q

Abnormal Feces

A 
Frequency: depends on usual pattern 
Guideline: > 3/d and <1 every 3 days 
Consistency: Hard, loose liquid, high mucus content 
Shape: Narrow, pencil thin 
Amount:<100 g/d or >300 g/d 
Odor: foul, objectionable
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7
Q

Functions of the Intestines: Peristalsis& segmentation

A

Alternating contraction and relaxation of intestinal smooth muscle
Propels the intestinal contents along the entire length of the small and large intestines

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8
Q

What stimulates peristalsis?

A

walls of intestine

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9
Q

Absorption

A

Nutrient and electrolytes in duodenum and jejunum

Vitamins, iron, and fluid in ileum

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10
Q

Valsulva Maneuver

A
  • Take a deep breath against a closed glottis
  • Contract the abdominal muscles
  • Contract pelvic floor muscles
  • It drops HR and blood pressure
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11
Q

Nutrion impact on elimination

A 
Soluble fiber (increases GI transit time)
Oat bran, barley, and nuts
Insoluble fiber (decreases GI transit time)
Whole grains, fresh fruits and vegetables
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12
Q

Which fiber type promotes loose stools?

A

Insoluble

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13
Q

Food intolerances

A

Lactose

Gluten

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14
Q

Fluid impact on elimination

A

75% of feces is water

  • If body is alcking water it will take from feces
  • Increased GI motility= loose stools
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15
Q

Exercise impact on elimination

A

Move less, defecate less

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16
Q

Lifestyle and ignoring urge to defecate

A
  • Emotional extremes
  • Changing daily routine
  • Ignoring the urge leads to the urge weakening over time
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17
Q

Pregnancy

A

Iron supplements + growing fetus = constipation

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18
Q

Opioids cause

A

constipation

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19
Q

ABX cause

A

diarhea

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20
Q

To examine the lower GI tract with a camera, what must be out of the lower GI tract?

A

Stool

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21
Q

When the colon is diverted through a stoma

A

Colostomy

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22
Q

When the ileum is diverted through a stoma

A

ileostomy

-No large intestine, potential issue with loss of fluid and electrolytes

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23
Q

Pouches can be created surgically to give the patient control over when a bowel movement occurs

A
  • Kock pouch

- J-pouch

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24
Q

Normal stoma findings

A

red pink, beefy

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25
Q

Abnromal stoma findings

A

bluish tint, drainage around it

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26
Q

Fecal Collection

A

Pouch connected to a stoma

The part that covers a stoma is called an appliance

27
Q

When should the pouch be emptied?

A

When it becomes 1/4 full

28
Q

What do you rinse the pouch with after emptying it?

A

Clean warm tap water

- 60 ml syringe

29
Q

What if fecal contents leak around where the pouch is attached to the skin?

A

Entire bag must be removed and replaced

30
Q

Abd inspection Normal

A

Normal Findings:
Symmetric
Slightly rounded

31
Q

Ab inspection abnormal

A

Malnutrition? Hollow or scaphoid

Obstruction? Distended

32
Q

Normal auscultation

A

Heard within 5-15 seconds

33
Q

Abnormal auscultation

A

More frequent than 5 seconds? Hyperactive

34
Q

How long do you listen to confirm absent?

A

Listen to each quadrant 1-2 mins

35
Q

Constipation

A

Common GI issue

Patients experience bloating, fullness, an urge to defecate without an ability to pass stool, malaise, loss of appetite, nausea, vomiting, and abdominal distention.

Dependent upon a person’s baseline functioning
Less frequent
Harder stool
Persistent for at least 12 weeks in a year’s time

36
Q

What is important in determining if its constipation?

A

Ask about the patient’s normal routine

37
Q

Fecal impaction

A

Usually, the result of untreated and unrelieved constipation

Several days of constipation followed by an involuntary loose bowel movement that does not relieve feeling of bloating or fullness

Similar symptoms to constipation

38
Q

How is fecal impaction diagnosed?

A

Digital rectal exam

39
Q

Diarhea

A
  • Loose and more frequent stools
  • increased gastric motility
  • hyperactive bowel sounds
40
Q

Causes of diarhea

A 
Medications, medical conditions, emotional changes
Symptoms: Cramping
Nausea
Burning sensation
Anal inflammation
Bleeding and breakdown
41
Q

Neurological injury, spinal cord injury, or altered mental status can lead to…..

A

fecal incontinence

42
Q

Gas or flatulence is caused by

A

bacterial activity in the large intestine

43
Q

What food increases flatulence

A

Introduce a person gradually into new diet high in fiber

44
Q

An obstruction or tumor can lead to

A

distension

-requires a follow-up and investigation

45
Q

What type of bowel activity could lead to an order for a stool specimen and culture?

A

Diarrhea

-Altered color

46
Q

Stool specimen and culture

A

-collected by the nurse
Educate patient to avoid mixing urine with sample
Have urinal or a second bedpan nearby

47
Q

Fecal occult blood test

A

A type of test that detects the presence of blood
-More common now for this test to be sent to the lab to be performed from a regular stool specimen rather than a bedside procedure

48
Q

Recommended screening tool for colorectal cancer

Blood in stool may indicate cancer or polyps in the colon or rectum

A

Fecal occult blood test

49
Q

XRay considerations

A

A radiopaque substance is swallowed or instilled in the rectum and then imaging is performed as it proceeds through the GI tract

Detects abnormalities in the large and small bowel

50
Q

What is done before the test?

A

clear the bowels with laxatives or enemas

51
Q

What is done after the test?

A
  • Barium can harden stool and cause constipation or an impaction, increase fluids and administer a laxative
  • Barium cam make the stool appear chalky or white
52
Q

EGD

A

upper gi test

53
Q

Lower GI tests

A

-Sigmoidoscopy
Colorectal cancer screening every 5 years

Colonoscopy

  • Colorectal cancer screening every 10 years
  • If high risk though, screening can be every 5 years
  • Colonoscopy used more often for screening since its visualizes the entire colon
54
Q

What is used in both procedures?

A

A flexible fiber-optic instrument to visualize certain parts of the GI tract
-Tests are used for diagnosis and treatment

55
Q

What is done before lower GI tests?

A

Bowel- preparation: use of laxative solution to clear the bowels of stool

56
Q

What is done after lower Gi tests?

A

Monitor for bleeding or dull abdominal pain

57
Q

Tx for diarrhea

A

-Antidiarrheals
Loperamide
Bismuth subsalicylate

58
Q

Medications that treat the cause of diarhea

A

Loperamide and Bismuth subsalicylate (peptmo bismal)

59
Q

Fecal microbiota transplant

A

Used for persistent clostridium difficile infection

Healthy stool from a human donor placed in GI tract

90% effective in reducing infection rate

60
Q

Bowel training

A

Used for individuals with a neurological impairment

Routine developed around a specific time of day to achieve a soft stool consistency

Modified for individuals with partial sphincter control

Can utilize pelvic floor exercises, abdominal massage, and biofeedback

61
Q

Enema indication

A

Promote bowel movement

Clear bowel area before a procedure

62
Q

Types of enema demonstrated

A

Small-volume: Mineral oil and steroids
Large-volume: tap water or saline
Return-flow: removes flatus

63
Q

NG tubes indications

A

Gastric decompression, gastric lavage, or gastric feeding

64
Q

Placement must be confirmed using?

A

Radiographic confirmation is the gold standard

Foundations 3 (5 decks)

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