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Nursing Fundamentals > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

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1
Q

Structures of the Small intestine:

A

the duodenum, jejunum & ileum

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2
Q

Structures of the Large intestine:

A

cecum, colon, rectum & anus

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3
Q

Structures of the colon

A

Ascending, transverse & descending & sigmoid colon

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4
Q

Function of the intestines

A

Motility

Absorption

Defecation

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5
Q

A forced expiration against a closed glottis, may be used when needed to initiate a bowel movement.

A

The Valsalva maneuver

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6
Q

Two types of motility:

A

Segmentation

Peristalsis

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7
Q

Daily fiber needs for a woman

A

24-25 grams

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8
Q

Daily fiber needs for a man

A

35-38 grams

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9
Q

Length of small intestine

A

20ft long

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10
Q

Length of large intestine

A

6ft long

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11
Q

The anus has how many sphincters?

A

Two

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12
Q

What type of response does the internal anal sphincter have?

A

Involuntary

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13
Q

What type of response does the external anal sphincter have?

A

Voluntary

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14
Q

A sphincter muscle valve that separates the small intestine and the large intestine

A

Ileocecal valve

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15
Q

Type of people that have problems with gut transit

A

Older adults

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16
Q

Intestinal motility is controlled by

A

The autonomic nervous system

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17
Q

Absorption takes place in the

A

Small intestine

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18
Q

Motility that propels/ pushes feces through

A

peristalsis

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19
Q

Contraction of intestinal circular smooth muscles that mixes chyme is called

A

Segmentation

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20
Q

Process of digestion, in which food, gastric acid and pepsin are turned from mush into a semi-digested acidic liquid called

A

Chyme

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21
Q

Contracting (pinching) and relaxing of intestinal muscles

A

Segmentation

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22
Q

Autonomic nervous system innervation:

A

Sympathetic

Parasympathetic

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23
Q

Sympathetic-

A

Slows down

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24
Q

Parasympathetic-

A

Speeds up

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25
Q

Partially digested food (chyme), empties from the stomach to the _________ for __________

A

Small intestine for absorption

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26
Q

Where most nutrients an electrolyte absorption occurs

A

Duodenum & jejunum

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27
Q

Absorbs some vitamins, iron & fluids.

A

Ileum

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28
Q

Final absorption of nutrients especially fluid & electrolytes

A

Large Intestine

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29
Q

The process begins when peristalsis propels feces into the rectum causing rectal distention.

A

Defecation

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30
Q

___________________ are stimulated causing contraction of the descending & sigmoid colon, rectum, anus & the relaxation of the internal & external sphincter

A

Parasympathetic nerve fibers

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31
Q

The external anal sphincter can remain closed until the person decides

A

To defecate

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32
Q

Speed of passage affects __________

A

Absorption. The slower the better.

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33
Q

Normal feces consist of ___% water & ___% solids

A

75% water & 25% solids

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34
Q

Solids within normal feces includes:

A

Bacteria, undigested fiber, fat, inorganic matter & some protein

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35
Q

The major undigested fiber of feces

A

Cellulose

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36
Q

The color in feces comes from

A

Bilirubin

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37
Q

Bilirubin comes from

A

The liver

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38
Q

White stool has low

A

Bilirubin caused by gallbladder condition

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39
Q

Feces has an aromatic, pungent odor due to

A

Bacterial breakdown of proteins

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40
Q

Yellow or green feces is an indicator of

A

A virus

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41
Q

Normal feces color should be

A

Yellowish brown

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42
Q

Factors affecting elimination

A

Nutrition- fiber gives bulk, ( fruits, vegetables &grains)

Food intolerances

Fluid intake- 2000ml per day

Activity & exercise-promotes muscle tone & peristalsis

Body position

Ignoring the Urge to Defecate

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43
Q

Best body position for elimination

A

Sitting or squatting

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44
Q

Ignoring the urge to defecate can lead to

A

Constipation

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45
Q

Steatorrhea

A

Greasy stool

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46
Q

Lifestyle factors affecting elimination

A

Individual pattern any changes in ADLS or emotions such as stress or traveler’s diarrhea or constipation

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47
Q

Pregnancy factors affecting elimination

A

Hormonal changes, fetus, iron supplements can cause constipation or frequent smaller stools

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48
Q

Medication factors affecting elimination

A

Can cause constipation or diarrhea
Ex. antibiotics cause diarrhea
Narcotics constipation

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49
Q

Diagnostic procedure factors affecting elimination

A

Barium is binding and can cause problems with elimination

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50
Q

Patients should start on a _____ diet right after surgery

A

light diet

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51
Q

An inflammation of the peritoneum that is usually due to a bacterial or fungal infection.

A

Peritonitis

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52
Q

A silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen

A

Peritoneum

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53
Q

A stoma through the small intestine

A

ileostomy

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54
Q

A stoma through the colon

A

Colonostomy

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55
Q

The portion of the intestine that is brought through the abdominal wall

A

Stoma

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56
Q

Reasons for fecal diversion

A

Colitis, Trauma, chronic disease or diverticulitis

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57
Q

Proper position of a stoma

A

Above the skin or level with skin (flat)

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58
Q

Ostomy at end descending colon may not need

A

A bag because they have more control

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59
Q

Patients with a ileostomy may not have

A

a large intestine

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60
Q

Patients with an ileostomy have liquidly stool which causes

A

fluid and electrolyte imbalances

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61
Q

Two stomas on ab wall

A

Double barrel colostomy

62
Q

Double barrel colostomy:

Stoma that evacuates stool

A

Proximal stoma

63
Q

Double barrel colostomy:

Stoma that evacuates mucus

A

Distal stoma

64
Q

Double barrel colostomy:

Stoma that does not need a bag

A

Distal stoma

65
Q

Double barrel colostomy:

Stoma that needs a bag

A

Proximal stoma

66
Q

Can a double barrel colostomy be reversed?

A

Yes

67
Q

Reason for double barrel colostomy

A

Tumor removal

68
Q

Loop of bowel with two openings

A

Loop colostomy

69
Q

Temporary colostomy where a pin is used to keep a loop of bowel above the skin, then removed after a couple of weeks

A

Loop colostomy

70
Q

Is a loop colostomy permanent?

A

No it is temporary

71
Q

Internal pouch where a catheter is needed for bowel elimination

A

Koch pouch or “K pouch”

72
Q

Patient with this kind of pouch does not have a rectum or anus (possibly because of disease)

A

K Pouch

73
Q

Is a Koch pouch permanent?

A

Yes

74
Q

Type of pouch needed to be drained 4-5 times a day and patient does not feel fullness

A

Koch pouch

75
Q

Type of internal pouch where the patient can feel pressure and fullness

A

J pouch

76
Q

Type of pouch where the patient has an anus but no rectum or large intestine

A

J pouch

77
Q

Type of pouch where a valve at the anus is opened to go

A

J pouch

78
Q

Type of pouch where the patient has kidneys but no bladder

A

Ileal conduit

79
Q

Type of pouch where the ureters are attached to the ileum to drain urine

A

Ileal conduit

80
Q

Is the ileal conduit a sterile system?

A

Yes

81
Q

Continent ileostomy

A

Kock pouch

82
Q

Ileoanal reservoir

A

J pouch

83
Q

Type of altered bowel function that can lead to impaction

A

Constipation

84
Q

Type of altered bowel function that is very dry at the end

A

Slow transit constipation

85
Q

Antibiotics disrupt gut flora for

A

3 months

86
Q

Shoes should be bleached after leaving this patient’s room

A

C-Diff

87
Q

This type of problem is a risk for cardiac patients with constipation

A

Vasovagal problem

88
Q

CDAD a type of antibiotic associated diarrhea

A

Clostridium Difficile Associated Diarrhea

89
Q

Constipation problem caused by poor nursing

A

Impaction

90
Q

Best body position for manual disimpaction

A

Left side lying

91
Q

Stool that is green in color and very contagious

A

C-diff

92
Q

Flatulence is caused by

A

Foods or talking too much

93
Q

Excessive amounts of gas, liquids, or intestinal contents

A

Abdominal distention

94
Q

An intestinal blockage without an actual physical obstruction

A

Paralytic ileus

95
Q

Blockage that can occur 72 hours after abdominal surgery

A

Paralytic ileus

96
Q

Risks for altered bowel function

A

Patients who are immobile, poor fluid or diet, or on pain meds

97
Q

How to assess for abdomen

A

Look for contour, listen, and palpate

98
Q

Pain after palpating

A

rebound pain

99
Q

Measure of abdominal girth is

A

doc ordered and done first thing in the morning

100
Q

Exam to look for hardened stool, hemorrhoid’s, or bleeding

A

Perirectal exam

101
Q

Abrasion or tearing of skin

A

Excoriation

102
Q

Diagnostic tests

Stool culture must not be contaminated with

A

Urine or toilet paper

103
Q

Diagnostic tests

Preliminary results within __ hr

A

24 hours

104
Q

Diagnostic tests

Final results given after __ hr

A

48 hours

105
Q

Diagnostic tests

Length of time needed to know if antibiotics are needed

A

48 hours

106
Q

Hidden blood in stool

A

Occult blood

107
Q

Diagnostic tests

Stool for ova or parasites must be

A

Warm and go direct to lab

108
Q

Diagnostic tests

For salmonella, shigella, or c-diff

A

stool culture

109
Q

FOBT

A

Fecal Occult Blood Test

110
Q

A procedure that uses a guaiac paper slide test to detect fecal occult blood.

A

Hemoccult test

111
Q

When is the hemoccult test done?

A

Samples are taken from three bowel movements on three different days

112
Q

Guaiac test paper turns this color if there is blood present in stool

A

Blue

113
Q

Things that can cause a false positive in FOBT testing and should be stopped at least 3 days prior to testing

A

ASA (aspirin), Nsaids, steroids, and rare meats

114
Q

This can inhibit color reaction and cause a false negative in FOBT testing

A

250mg/day of Vit C

115
Q

Radiologic exam of the upper GI

A

UGI

116
Q

Radiologic exam where the radiologist follows barium from the esophagus through the ileum.

A

GI with small bowel

117
Q

Type of enema needed for visualization of the lower tract

A

Barium

118
Q

Patients may need this to pass the barium out of body

A

Laxatives

119
Q

These two radiologic tests are sometimes done together

A

GI with small bowel and barium enema

120
Q

Type of exams done under conscious sedation

A

Endoscopic Examinations

121
Q

20 minutes exam done with a flex scope through the mouth up to the duodenum, gas discomfort is expected after

A

EGD - Esophagogastroduodenoscopy

122
Q

Type of diagnostic test done under complete sedation

A

colonscopy

123
Q

Type of diagnostic test that visualizes the colon to ileocecal valve. Prep is done the day before

A

Colonoscopy

124
Q

Diagnostic tests to visualize the sigmoid colon & rectum

A

Sigmoidoscopy

125
Q

Type of diagnostic tests where the patient is conscious but may be given valium and enema prior

A

Sigmoidoscopy

126
Q

Helps to reestablish normal bowel movements in persons who suffer from constipation, diarrhea, incontinence, or irregularity

A

Bowel training

127
Q

Fluids needed for health

A

1500 – 2000 ml a day

128
Q

Saline laxative that contains Magnesium

A

Milk of magnesia

129
Q

Medication that can be habit forming and cause electrolyte imbalance

A

Laxatives

130
Q

Medication given when there is slow bowel motility- contra indicated when viral or bacterial agents cause diarrhea

A

Antidiarrheal

131
Q

Type of medication given to patients with colitis or Chron’s

A

Antidiarrheal

132
Q

Simethicone

A

Antiflatulence-gas relief ( no eating for 20 minutes)

133
Q

When healthy feces is transplanted in a sick patient to treat c.diff

A

FMT - Fecal Microbiota Transplant

134
Q

It is the cleansing of a portion of the large bowel by the insertion of fluid rectally.

A

Enema

135
Q

Small volume enema that draws water into the colon to promote peristalsis

A

Hypertonic (fleet)

136
Q

Small volume enema using mineral oil- good for fecal impaction and softens stool

A

Oil Retention

137
Q

Time it takes for small volume enema to act

A

5-10 minutes

138
Q

Large volume enemas can only be given ___ times due to risk of electrolyte imbalance

A

Three times

139
Q

Procedure for large volume enema

A

750-1000ml, can be tap water, soapsuds or saline.
Luke warm – 105-110 degrees F
Pt. Must be on LT side with knees flexed
Prime tubing- no air
Container – 18 in. above anus
Lubricate 2-3 in of tubing & insert tip in rectum ( adult 3-4 in) towards the umbilicus.
Run slowly- helps prevent cramping & allows for retention
Have client hold as long as possible
Cleansing enemas can only repeat 3x.

140
Q

Type of enema used to treat flatus (gas)

A

Return-flow Enema ( Harris Flush)

141
Q

This is 10 inches long and used for gas relief

A

Rectal tube

142
Q

A bag used with adhesive to collect a sample

A

Fecal collection during incontinence

143
Q

Involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid. Used during overdoses

A

Gastric lavage

144
Q

Is the introduction of nourishment into the stomach by means of a tube passed through the nose or mouth

A

Gastric gavage or feeding

145
Q

Draining the stomach contents

A

Gastric decompression

146
Q

A double-lumen nasogastric tube used for suction and irrigation of the stomach

A

Salem sump

147
Q

If there is no drainage coming from a Salem sump this should be done

A

Move tube to unblock or get doc ordered irrigation

148
Q

intermittent suction is done to prevent

A

trauma

149
Q

Suction set to suction every ___

A

60 sec

150
Q

NG should not be used when there is

A

nausea or vomiting present

151
Q

Nursing Considerations for NG tube

A

Maintaining suction
Maintaining patency
Ensuring accurate placement

152
Q

Tube where end tip is weighted

A

Nasointestinal tube

Nursing Fundamentals (19 decks)

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