Bowel Elimination Flashcards
What are the 2 ways of Diagnostic tests of the GI system?
- Visualization of the GI tract
- Stool specimen collection
What are the 2 ways of visualizations of the GI tract?
- DIRECT visualization:
- Endoscopy
- Panendoscopy
- Sigmoidoscopy - INDIRECT visualization:
1) UGI: Pt. swallow barium and they’d take images as they swallow. May do a small bowel follow-thru and test can be done with a CONTRAST liquid if no danger of aspiration!
2) LGI (Barium Enema, “BE”). Done with a Contrast liquid to see if bowel may have a PERFORATION!
3) X-ray, CT, MRI, Ultrasound
What are the 4 stool specimen types??
- Culture
- O&P (Ova and Parasites)
- FOBT (Fecal Occult BLOOD Test)
- Guaiac (checking for blood in the stool)
- Hemoccult slide
- Colocare
What are the 10 nursing interventions that facilitate a normal urinary elimination?
- Urinal AND Bedpan use
- Bladder irrigation
- Lifestyle changes
- Bladder training
- Bladder scanning
- Catheterization
- External (Condom & Purewick)
- Internal
- Catheter care
- Medications!
What are the interventions for urinary issues?
- Health Promotion (4):
1) Patient education
2) PROmote normal urination
3) PROmote complete bladder emptying
4) PREvent infections - Acute Care Setting (5):
1) Catheterization- Larger number = the larger the diameter
- Indwelling catheter has balloons to help keep it stay for long time period
- Simple urethral catheter is when u just put it in, drain urine, and take it out
- Risks: Infection (CAUTI) & Trauma to the bladder and urethra
2) Suprapubic catheter
3) Texas/Condom catheter
4) Urinary Diversions
5) Meds
- Continuing/Restorative Setting:
1) Lifestyle changes
2) ** PELVIC FLOOR MUSCLE TRAINING (KEGEL)
3) Bladder training
4) TOILETING SCHEDULE
5) *** INTERMITTENT CATHETERIZATION FOR CHRONIC RETENTION
6) Incontinence-Associated Dermatitis prevention
Do you put someone who has a CHRONIC INCONTINENCE (Incomplete bladder emptying) on an INDWELLING CATHETER?!!!
NOOOO
you do NOT put someone with chronic INCONTINENCE an indwelling catheter
When do you do Intermittent Catheterization?
For CHRONIC RETENTION
What are the Nursing interventions to facilitate BOWEL elimination process?
- Lifestyle changes
- Enema
- Meds
- RECTAL tube (when someone is in the ICU, if they have loose stools, this can help maintain it)
- Bowel training
- Diversions & ostomies
- Nasogastric decompression
What is fecal impaction?
What are the S/S of it? What would you may require? And what should you rule out?
When a person is unable to pass a significant volume stool
1) Signs & Symptoms:
1. Liquid stool in small amnts. (cramping pushes liquid around BM mass)
2. Frequent urge without BM
3. A/N/V (anorexia, nausea, vomiting)
4. Abd. distention & cramping
5. Digital exam: can feel large hard mass
2) May require NGT placement
3) Rule out GI obstruction
What are the fecal impaction Removal procedure?
NEED DOCTOR’S ORDER!!!
1. Oil retention enema; allow to sit in for awhile until it softens
2. SSE (soap studs) and NS (saline) can be used also
3. Digital removal: break the stool up using your gloved and lubricated finger
- WATCH FOR VAGAL RESPONSE!!!!!!!!!!!!!!!!!
What are the 5 TYPES OF LAXATIVES??
1) OSMOTIC/SALINE:
1. Lactulose
2. MOM/ Magnesium Hydroxide
3. Fleet Phospho-Soda –> ORAL AND ENEMA
2) Contact/Stimulant/Irritation:
1. Bisacodyl –> ORAL AND SUPPOSITORIES
2. Senna tablets
3. CASTOR OIL!!
3) Bulk Forming (Fiber) –> Mix the powder at BEDSIDE so they’ll still be liquid, AND follow with another GLASS OF WATER:
1. Psylium
2. Methyl-cellulose
4) EMOLLIENTS (Lubricants) –> Draws water into stools so it softens stools:
1. Stool softeners: Docusate Sodium
2. Mineral Oil!!! –> will absorb FAT SOLUBLE VITAMINS, SO DON’T TAKE REGULARLY!!!
5) Bowel Prep/ evacuant:
1. Poly-ethylene glycol / electrolyte: CoLYTE & GoLYTE!
