Bowel Elimination Flashcards
Normal Adult Stool is
-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
Proper Positioning
-Sitting, leaning forward and exert Intra-abdominal pressure and contract thigh muscles
Position: Valsalva Manoeuvre
-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
Defecation Reflex
-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
Stool Characteristics: Normal
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
Stool Characteristics Abnormal: Clay or White
-absence of bile pigment (bile obstruction)
-diagnostic study using barium
Stool Characteristics Abnormal: Black/Tarry
-medication/supplement (Eg iron)
-bleeding from upper GI tract (Eg stomach, small intestines)
-diet high in red meat and dark green vegetables
Stool Characteristics Abnormal: Red
-bleeding from lower GI tract (Eg rectum)
-some foods (Eg beets)
Stool Characteristics Abnormal: Pale
-malabsorption of fats
-diet high in milk and milk products and low in meat
Stool Characteristics Abnormal: Orange or green
-intestinal infection
Stool Characteristics Abnormal: Hard/dry
-Dehydration
-Decreased intestinal motility secondary to lack of fibre in diet
-Lack of exercise
-Emotional upset
-Laxative abuse
Stool Characteristics Abnormal: Loose, Watery
-Increased intestinal motility (Eg irritation of bowel by bacteria)
Stool Characteristics Abnormal: Narrow, pencil shaped or stringlike
-Obstructive condition of the rectum
Stool Characteristics Abnormal: Pungent
-Infection; blood
Stool Characteristics Abnormal: Constituents
-Pus (bacterial infection)
-Mucous (inflammatory condition)
-Blood (gastrointestinal bleeding)
-Large quantities of fat (malabsorption
-Foreign object
-Parasites (infects caused primarily from fecal contamination)
Factors Affecting Defecation
-Development
-Diet
-Fluid intake
-Physical activity
-Psychology
-Defecation habits
-Medications
-Diagnostic procedures
-Anesthesia and surgery
-Pathological conditions
-Pain
-Positioning
Developmental Changes
-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
Diet
-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
