Bowel Elimination Flashcards
Factors that influence bowel elimination
age
diet
fluid intake
physical activity
pain
pregnancy
psych
personal habits
position during defecation
Dx tests
meds
surgery
OA care
trouble chewing
slow esophageal emptying
impaired absorption
weakened sphincters
What GI functions decrease in OA?
hydrochloride acid
peristalsis
absorption of vitamins
sensation to defecate
lipase to aid in fat digestion
Constipation
symptom not disease
less than 3 BM in a week
Constipation SX
infrequent BM
discomfort
hard/dry stool
Causes of constipation
irregular bowel habits
improper diet (too much dairy)
dehydration
lack of exercise
stress
meds
older age
ignoring urge
GI disorders
Complications of constipation
hemorrhoids
anal tissue damage
fecal impaction
rectal prolapse
Laxatives and Cathartics
bulk forming (taken consistently)
emollient/wetting
osmotic (mag supps)
stimulant cathartics (urge need to go)
Are laxatives long or short term action?
short term
What position should you put a patient in for an enema?
left lateral sims
When should you stop an enema?
if the abdomen is rigid
cramping or pain
Impaction
unrelieved constipation and irritability to expel hardened stool in rectum
Risk factors for impaction
deabilitated
confused
unconscious
How to diagnose impaction
digital rectum exam
Sx of impaction
inability to pass stool despite urge
continuous oozing of liquid stool
loss of appetite
N/V
abdominal distention
cramping
rectal pain
Treatment for impaction
digital removal
assess need
nurse uses finger to break up and remove stool (last resort)
Diarrhea
loose watery stool
Causes of diarrhea
food borne pathogens
food intolerances, allergies
surgery
Dx tests
enteral feeding
Complications of diarrhea
dehydration ***
skin irritation
nutritional concerns
Antidiarrheal agents
decrease intestinal muscle tone and slows passage of feces
body absorbs more water
What kind of medication should be used in caution for diarrhea?
opioids
What electrolyte levels are lower with dehydration?
sodium- hyponatremia
potassium-hypokalemia
C diff
most common HAI-diarrhea
spore forming bacteria
Hand hygiene for C diff
soap and water
bleach wipes
Risk factors for C diff
elderly
antibiotic use
immunocompromised
GI procedure
long term care facility
Hx C diff
Complications of C diff
dehydration
kidney failure
toxic mega colon
bowel perforation
Contact precaution for C diff
Contact D
How is C diff diagnosed?
stool sample
Treatment for C diff
fluids
nutrition
antibiotics
surgery
fecal implantation
probiotics
Bowel incontinence
inability to control passage of feces and gas from anus
Nursing care for incontinence
frequent rounding
perineal care
call light
scheduled voiding times
Teaching points for incontinence
limit fluids before bed
pelvic floor muscle exercises
voiding schedule
bowel training
void before bed
What fluids promote urination or BM?
caffeine
soda
coffee
Prune juice
Causes of bowel incontinence
nerve or muscle damage
impairment of fecal sphincter
constipation, diarrhea
large volume stool
surgery
rectal prolapse
Risk factors for bowel incontinence
older age
female
nerve damage
dementia
decreased physical ability
Complications of bowel incontinence
body image disturbance
skin irritation/ breakdown
Treatment for bowel incontinence
antidiarrheals
bulk laxatives
Prevention of bowel incontinence
reduce constipation
control diarrhea
avoid straining long term
Flatulence
gas
burp or fart
SX of flatulence
abdominal distinction
cramping
bloating
Causes of flatulence
constipation
Food intolerance
GI diseases
stress
Food with insoluble fiber
cauliflower
potatoes
green beans
encourage!
Limiting carb intake foods
whole wheat
bran
oats
nuts
encourage!
Hemorrhoids
dilated or engorged veins in lining of rectum
internal or external
Causes of hemorrhoids
increased venous pressure from straining
Treatment for hemorrhoids
excision for external
diet and fluids
exercise
warm sitz bath
surgery but high risk
ice pack
Colon cancer
2 leading cause of cancer in men and women
Risk factors for colon cancer
family history
>50 years
AA race
increased intake of red meat
decrease fiber intake
obesity
lack of exercise (sedentary)
alcohol, tobacco use
Hx of inflammatory bowel disease
When should you start screening for colon cancer?
50 years
Lab test for stool
if blood in stool - H and H
specimens
culture and sensitivity
DNA, fats, WBC
OVA and parasites
Fecal occult blood test (FOBT)
ordered to detect cancer and evaluate unexplained diarrhea
stool sample from 2 places, 3 occurrences
Purpose of NG tube
decompress stomach
enteral feeding
meds
Nursing care for NG tube
verify order
verify placement with x-ray or residual
hook up to low wall suction (80-120)
administer food with meds
record I and O
When is bowel training appropriate?
chronic constipation or fecal incontinence
set up daily routine
What can habitual use of laxatives cause?
chronic constipation
What is a drink that has a laxative effect?
coffee
alcohol
What are the only kinds of laxative that can be taken long term, daily?
bulk forming
