Bowel Elimination Flashcards
what is elimination
removal, clearance or separation of matter
what is bowel elimination
removal or excretion of waste product of the intestines from the body
what is the gi tract responsible for
removal of digestive waste in the form of stool
what is the process of bowel elimination
fecal matter reaches rectum
stretch receptors initiate contraction of sigmoid colon/rectal muscles
internal anal sphincter relaxes
sensory impulse causes voluntary “bearing down”
external sphincter relaxes
what are some variables influencing bowel elimination
developmental considerations
daily patterns
food and fluid
activity and muscle tone
lifestyle
psychological variables
pathologic conditions
medications
diagnostic studies
surgery and anesthesia
how to promote regular defecation/daily patterns
provide privacy
assist w/ positioning
consider timing
food and fluid
encourage exercise
managing flatulence
what are some constipating foods
cheese
eggs
lean meats
pasta
what are some foods with laxative effetcs
greasy foods
alcohol
coffee
caffeine
chocolate
bran
what are some gas producing foods
beans
cabbage
onions
what does physical activity stimulate
peristalsis
what does a sedentary lifestyle cause
constipation
what is diarrhea caused by
food poisoning
ecoli
malabsorption
what is constipation caused by
bowel obstruction
tumors
adhesions from scar tissue
hernias
what is the effect of aspirin and anticoagulants on stool
pink to red to black stool
what is the effect of iron salts on stool
black stool
can cause constipation
what is the effect of bismuth subsalicylate on stool
used to treat diarrhea can also cause black stools
what is the effect of antacids on stool
white discoloration or speckling in stool
can cause constipation
slows peristalsis
what is the effect of antibiotics on stool
green/gray color
can cause cdiff
what is the effect of opioids on stool
can cause constipation
slows peristalsis
what do diagnostic studies affect in pt
normal patterns
what do surgery and anesthesia inhibit
peristalsis
what is a risk after abd surgy
paralytic ileus
what are some common bowel elimination problems/alterations
diarrhea
constipation/fecal impaction
bowel incontinence
bowel diversions
what is a bowel diversion
an ostomy
Enemas may be needed
Causes include nervous system problems, dysfunctional motility
Avoid straining
constipation
Caused by infections, contaminated food, medications, or changes in diet
Monitor fluid and electrolyte balance
Having loose stools often more than 3 or more in one day
Monitor for skin breakdown
diarrhea
Monitor for skin breakdown
Inability to control the discharge of feces and flatulence
bowel incontinence
Monitor for skin breakdown
Done for cancer, ulcerations, trauma or inadequate blood supply
Tarry stools are warning sign
bowel diversion
how to manage a pt w/ diarrhea
teach hand hygiene
Educate about foods that cause diarrhea
Monitor stool output and color/consistency
Monitor fluid balance
Monitor electrolyte levels
Monitor skin integrity
Medications
how to manage a pt w/ constipation
increase high fiber foods
Increase fluid intake
Increase activity/exercise
Provide Privacy
Allow time
Assist patient to comfortable position
Do not ignore urge
Avoid straining
enemas
how to manage a pt w. bowel incontinence
Absorbent products
External fecal collection
Internal fecal collection
Bowel training
Monitor for skin breakdown
what are some common diagnostic studies done
direct visualization
indirect visualization
labs
what are some examples of direct visualization studies
Esophagogastroduodenoscopy
Colonoscopy
Sigmoidoscopy
Wireless capsule endoscopy
what are some diagnostic tests done
Upper gastrointestinal (UGI)
Small bowel series
Barium enema
Abdominal ultrasound
Magnetic resonance imaging (MRI)
abd ct scan
what lab studies are done
occult blood
stool culture
in an occult blood study what are they looking for
hidden blood in stool
in a stool culture what are they looking for
bacteria in stool
what are the types of ostomies
Sigmoid colostomy
Descending colostomy
Transverse colostomy
Ascending colostomy
Ileostomy
what are some characteristics of a sigmoid colostomy
bowel is not working
more solid
more common
what is a characteristic of a descending colostomy
bowel is not working
what are some characteristics of a transverse colostomy
usually temporary
crohn’s disease
cancer
can have it reverse
what are some characteristics of an ascending colostomy
liquid stool
leakage
what are some characteristics of an ileostomy
in small intestines
liquidy
what color is a stoma supposed to be
dark pink
if a stoma is pale pink what does that indicate
anemia
if a stoma is blue what does that indicate
o2 difficiency
how do you take care of an ostomy
Keep the patient as free of odors as possible; empty the appliance frequently.
Inspect the patient’s stoma regularly.
Note the size, which should stabilize within 6 to 8 weeks.
Keep the skin around the stoma site clean and dry.
Measure the patient’s fluid intake and output.
Explain each aspect of care to the patient and self-care role.
Encourage patient to care for and look at ostomy
when do you empty a liquidy stoma appliance
when it is 1/3 full
when do you empty a solid stoma appliance
when it is 1/2 full
what is some pt teaching for colostomies
explain reason for bowel diversion and rationale for treatment
demonstrate self care behaviors that effectively manage the ostomy
describe follow-up care and existing support resources
report where supplies may be obtained in community
verbalize related fears and concerns
demonstrate positive body image
