Bowel Elimination

Question 1

Normal Adult Stool is

Answer 1

-Excreted painlessly
-Comes out brown, soft, moist, cylindrically shaped and aromatic
-Normal amount secreted varies with individuals diet but range is usually between 100-400g/day = several times/day to 2-3 times/week

Question 2

Proper Positioning

Answer 2

-Sitting, leaning forward and exert Intra-abdominal pressure and contract thigh muscles

Question 3

Position: Valsalva Manoeuvre

Answer 3

-Where you contract the abdominal muscles and diaphragm while maintaining forced expiration against a closed airway is not recommended
-It increases intrathoracic pressure which can cause immediate tachycardia followed by reflex bradycardia and lead to cardiac arrest in individuals with cardiac disease

Question 4

Defecation Reflex

Answer 4

-Individual needs to respond to this reflex
-The longer we suppress this urge the harder the stool becomes as it sits in the vowel and rectum which could lead to constipation

Question 5

Stool Characteristics: Normal

Answer 5

Colour: brown (adult), yellow (infant)
Consistency: formed, soft, semisolid, moist
Shape: cylindrical (2.5cm) in diameter
Amount: Varies with diet 100-400g/day
Odour: Aromatic (affected by ingested food and patients on bacterial flora)
Constituents: small amount of undigested roughage, sloughed dead bacteria and epithelial cells, fat, protein, dried constituents of digestive juices

Question 6

Stool Characteristics Abnormal: Clay or White

Answer 6

-absence of bile pigment (bile obstruction)
-diagnostic study using barium

Question 7

Stool Characteristics Abnormal: Black/Tarry

Answer 7

-medication/supplement (Eg iron)
-bleeding from upper GI tract (Eg stomach, small intestines)
-diet high in red meat and dark green vegetables

Question 8

Stool Characteristics Abnormal: Red

Answer 8

-bleeding from lower GI tract (Eg rectum)
-some foods (Eg beets)

Question 9

Stool Characteristics Abnormal: Pale

Answer 9

-malabsorption of fats
-diet high in milk and milk products and low in meat

Question 10

Stool Characteristics Abnormal: Orange or green

Answer 10

-intestinal infection

Question 11

Stool Characteristics Abnormal: Hard/dry

Answer 11

-Dehydration
-Decreased intestinal motility secondary to lack of fibre in diet
-Lack of exercise
-Emotional upset
-Laxative abuse

Question 12

Stool Characteristics Abnormal: Loose, Watery

Answer 12

-Increased intestinal motility (Eg irritation of bowel by bacteria)

Question 13

Stool Characteristics Abnormal: Narrow, pencil shaped or stringlike

Answer 13

-Obstructive condition of the rectum

Question 14

Stool Characteristics Abnormal: Pungent

Answer 14

-Infection; blood

Question 15

Stool Characteristics Abnormal: Constituents

Answer 15

-Pus (bacterial infection)
-Mucous (inflammatory condition)
-Blood (gastrointestinal bleeding)
-Large quantities of fat (malabsorption
-Foreign object
-Parasites (infects caused primarily from fecal contamination)

Question 16

Factors Affecting Defecation

Answer 16

-Development
-Diet
-Fluid intake
-Physical activity
-Psychology
-Defecation habits
-Medications
-Diagnostic procedures
-Anesthesia and surgery
-Pathological conditions
-Pain
-Positioning

Question 17

Developmental Changes

Answer 17

-Occur to defection throughout the lifespan
-Newborn: first stool passed is called meconium (dark green, tarry, odourless, sticky)
-Infants: breastfed infants have frequent light yellow to golden sift liquid stools whereas formula have dark yellow, tan fever which is more formed, stools become less frequent and more formed as solid foods are introduced
-Toddlers: control of defecation usually occurs between 1-2 years of age
-School age children: bowel habits are like adults, some may delay defecation due to an activity such as play
-Older adults: Constipation may result due to reduced activity levels, inadequate fluid and fibre intake and muscle weakness

Question 18

Diet

Answer 18

-diet and regular eating patterns are critical to healthy bowel movements
-fibre plays an important role in providing bulk and water retention within the feces
-Low residue/low fibre foods such as rice, eggs, and lean meats can impair the defecation reflex and move slower through the system therefore requiring increased fluid intake
-Lactose intolerance can also impact = lactose acts as an osmotic laxative