Bowel Elimination Flashcards by El S

Cathartic

Laxative

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Occult blood

Not obvious blood

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Valsalva maneuver

Strain

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What are the 3 F’s of bowel movement

FLUIDS
FIBER
FHYSICAL ACTIVITY

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Functions of the digestion tract

Breakdown food
Absorb nutrients
Eliminate

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What is the function of bowel elimination

To excrete/eliminate wast products of digestion

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Small intestine job

To absorbs nutrients and electrolytes

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Large intestine job

Main function is elimination!
Absorbs H20 and electrolytes

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Physiology of defecation

Pooping
Peristaltic waves move feces to rectum every 3-12 minutes
Sensory nerves in rectum are stimulated
Sphincters relax and feces moves through the anal canal and expelled through anus

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Rate of passage of bowel contents

food stimulates peristalsis
Occurs in 1-2 days

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Pooping patterns through life

Babies take about 2-10 BM’s a day
Pregnant women are more prone to constipation due to pressure on abdominal organs and iron supplements

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Describe Meconium poop

Black and brown
The babies first poop
Is dark due to material from amniotic fluid

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Describe Breast-fed poop

Yellow and fatty

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How much fluid and fiber should you be consuming

At keast 2000-3000 mL per day
Fiber stimulates peristalsis,
softens stool

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Factors that affect constipation

Busy schedule, immobility, medications such as opioids/iron sulfate/laxatives
Chronic worriers, pain, surgery

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Nursing history Assessment for Bowel Assessment

Find out the patients normal pattern of bowel movement ( how often )
Usual feces description ( soft, mushy, hard)
Recent changes
Past problems eliminating
Presence of an ostomy
Factors that may be affecting pooping pattern

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Physical Examination for bowel movment

Includes:
Examination of the abdomen, rectum and anus
Ausculation-> Palpation
Inspect feces for color, consistency, shape, amount, odor and abnormalities
Review data collected from any tests done

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Where would you start when escalating bowel sounds

Right lower quadrant because it gives you the most noise

Normal bowel sounds
Hypo-active sounds
Hyper-active sounds

5-30 bowel sounds
less than 5 per minute
more than 30 per minute

General key characteristics of feces

color, consistency, shape, amount, odor, constituents

Normal bowel movement description

75% water, 35% solid
Soft but formed
100-400 gm/day
light to dark brown in color
Looks like a sausage or snake, smooth and soft

Tarry brown stool aka Melena

Blood in upper GI tract

Dark or bright red color stool

Blood from lower GI tract

Streaking of blood on toilet tissue

Lower rectal or anal bleeding

Light gray or clay colored stool

gall bladder disease

How would you obtain a stool specimen

Void first, not mixing stool with urine Defecate into required container No toilet paper in sample Wear gloves and use tong to put 1 inch of stool in container, if liquid then 15-30 mL

Guiac stool for blood

Smear poop on paper applicator, our drops on it If color change= signs of blood present

Describe flatulence

Excessive gas in the stomach and intestines Causes abdominal extension and pain Can occur due to surgery, foods or opioids

What is diarreah

Passage of liquid feces with increased frequency May be acute or chronic Causes cramps and increased bowel sounds

Nursing interventions of Diarrhea

Encourage intake of fluids that contain electrolytes Administer anti-diarrheal medications Keep skin dry and clean: can use zinc oxide as a moisture barrier

What are some predisposing factors to constipation

Insufficient fiber & fluid intake Chronic use of laxatives Medications Age, increased risk in older age Inactivity or mobility

Nursing interventions for constipation

Encourage activity, increased fluids, dietary fiber avoid long term use of laxatives respons to urge to poop, dont hold it in review medications administer stool softeners

What are complications to constipation

Hypertension Fecal impaction Hemorrhoids Fissures Megacolon

What is fecal impaction

Mass or collection of hardened feces Passage of liquid fecal seepage

Signs and symptoms of fecal impaction

Seepage of liquid stool Rectal pain Abdominal distention

Nursing interventions for fecal impaction

Digital dis-impaction:removing poop with lubricated fingers Encourage activity, fiber, liquids Ascertain laxative usage Administer stool softness

What are hemorrhoids

Dilated engorged veins increased pressure when straining internal or external itching and pain

When dealing with hemorrhoids, what procedures should you avoid doing

Rectal temps, enemas or dis-impactions

What is bowel incontinence

Loss of voluntary ability to control fecal and gaseous discharges More common in stroke and paralysis patients

What are some nursing measures in bowel incontinence

Establishing toileting schedule Maintaining skin integrity

What are some ways to promote bowel eliminations

Privacy, squatting position, bedpan position, laxatives, anti-diarrheal agents, enemas, have a bowel routine

Ostomy

Opening made to allow passage of urine or stool Piece of intestine brought out onto the clients abdomen

Stoma

Mouth like opening in the abdominal wall to drain urine or stool

General Nursing intervenions on Bowel Movements

Teaching about medications and how they can effect bowel movement Decrease any flatulence Administer Enemas