Bowel Elimination Flashcards
Cathartic
Laxative
Occult blood
Not obvious blood
Valsalva maneuver
Strain
What are the 3 F’s of bowel movement
FLUIDS
FIBER
FHYSICAL ACTIVITY
Functions of the digestion tract
Breakdown food
Absorb nutrients
Eliminate
What is the function of bowel elimination
To excrete/eliminate wast products of digestion
Small intestine job
To absorbs nutrients and electrolytes
Large intestine job
Main function is elimination!
Absorbs H20 and electrolytes
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
Rate of passage of bowel contents
food stimulates peristalsis
Occurs in 1-2 days
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
Describe Meconium poop
Black and brown
The babies first poop
Is dark due to material from amniotic fluid
Describe Breast-fed poop
Yellow and fatty
How much fluid and fiber should you be consuming
At keast 2000-3000 mL per day
Fiber stimulates peristalsis,
softens stool
Factors that affect constipation
Busy schedule, immobility, medications such as opioids/iron sulfate/laxatives
Chronic worriers, pain, surgery
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
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
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
