Bowel Elimination Flashcards

1
Q

how does age affect bowl movements

A

decreased motility
increased meds which can lead to constipation and diarrhea
decreased diet and fluid intake
decreased activity and exercise
increased meds
laxative abuse
sphincter abnormalities

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2
Q

what do we want fiber intake at

A

25-30g

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3
Q

what do we want fluid intake at

A

2-3L

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4
Q

how does activity and exercise promote bowel movements

A

promotes GI motility
gives good muscle tone
helps maintain bowel function

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5
Q

what meds cause constipation

A

narcotics

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6
Q

what meds cause diarrhea

A

antibiotics and opiods

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7
Q

stress can casue

A

constipation and diarrhea

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8
Q

how does surgery and anestihics affect bowel

A

stops peristalsis which could lead to small bowel obstruction

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9
Q

what is some diagnostic test that can affect bowels

A

contrast because it hardens

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10
Q

cystic fibrosis

A

fatty foul stools

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11
Q

diabetes

A

neuropathies

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12
Q

what does knowing If the patient is passing gas tell us

A

the bowels are moving

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13
Q

what do we want to asses when inspecting the anus

A

hemrooids

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14
Q

what do we want to know about the stool

A

color, consistency, amount

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15
Q

statoid

A

fatty

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16
Q

black stool could mean

A

iron

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17
Q

steadorrea

A

odor
- cystic fibrosis
pancreatic disease

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18
Q

how much do we need for culture and sensitivity

A

1 inch or 15-30mL

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19
Q

what is guaiac

A

occult blood
- blood that cannot be seen

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20
Q

before we perform an occult blood test what do we want to limit the patients diet to

A

no red meet

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21
Q

examples of direct visualization

A

colonoscopy, sigmoidoscopy, wireless capsulse

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22
Q

indirect visulaization

A

barium enema, barium swallow, CT, ultrasound

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23
Q

when doing an occult blood what color is positive

A

blue

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24
Q

what color is an upper GI bleed

A

black and dark, coffee grounds, tarry

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25
Q

what is a lower GI bleed look like

A

bright red

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26
Q

when doing a scope of the colon what side do we want them on

A

left lateral

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27
Q

when we have someone who is going through barium what do we want to give them

A

fluids and laxatives because barium hardens

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28
Q

constipation

A

dry hard stool that is hard to pass

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29
Q

impaction

A

hard immovable object

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30
Q

what is a tell tale sign that the impaction is higher up in GI

A

fluid water from rectum because only liquid is able to get around impaction

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31
Q

if you go to assess for impaction and you don’t feel anything in the rectum do they still have an impaction

A

yes it can be higher up

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32
Q

diarrhea

A

moving too fast through GI, water is not absorbed

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33
Q

incontintence

A

not aware and has no control

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34
Q

flatulence

A

gas

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35
Q

hemorrhoids

A

distended vein in rectum
bright red bleeding

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36
Q

small bowel obstruction can be caused by

A

surgery and anesthetics

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37
Q

small bowel obstructions stop

A

peristalsis

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38
Q

3 things we need to do to treat constipation

A

fluid, fiber, stool softener

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39
Q

is colace a laxitive

A

no

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40
Q

what does colace do

A

absorbs water and makes it easier to pass

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41
Q

what is a bulk forming (Metamucil)

A

bulks up stool which puts pressure on the wall which creates peristalsis

42
Q

3 other laxatives

A

lubricant, stimulant, saline osmotic

43
Q

lubricant

A

mineral oil

44
Q

stimulant

A

dulcolax

45
Q

saline osmotic

A

MOM

46
Q

laxative

A

irritates the bowel lining to get peristalsis

47
Q

is impaction moveable

A

NO

48
Q

who do we not do a digital disimpaction on

A

cardiac patient

49
Q

how do we do a digital disimpaction

A

left side lying
rectum only
double glove
lubricant

50
Q

enema

A

liquid through tube into bowel

51
Q

what temp do we want the enema

A

room temp

52
Q

if a patient complains of cramping during an enema what do we do

A

stop

53
Q

how do we have the patient laying during an enema

A

left side lying

54
Q

what do we do to the bed during an enema

A

pad the bed

55
Q

tap water enema amount

A

500-100mL

56
Q

what does a tap water enema do

A

distends the intestine, increases peristalsis, softens stool

57
Q

normal saline enema amount

A

500-100mL

58
Q

what does normal saline enema do

A

distends the intestine, increases peristalsis, softens stool

59
Q

soap suds enema amount

A

500-100mL

60
Q

what does soap subs enema do

A

distends the intestine, irritates intentional mucosa, softens stool

61
Q

fleets hypertonic enema amount

A

70-130mL

62
Q

what does a fleets hypertonic enema do

A

distends intestine, irritates intestinal mucosa

63
Q

what do we use lactulose for

A

acute alcohol consumption where there is increase amonia
this decreases the ammonia

64
Q

what is kaexelate used for

A

in patients with high potassium this works in the bowel to absorb excess potassium

65
Q

oil retention enema amount

A

150-200mL

66
Q

what does a oil retention enema do

A

lubricates stool and intestinal mucosa

67
Q

what do we assess for after an enema

A

perforation

68
Q

how does a patient present with an perforation

A

back pain, acute abdominal pain, rectal pain and bleeding, fever

69
Q

if the impaction is at the end of the bowel what do we need to check for

A

if the bowel is getting blood
at the end of the bowel we have decreased capillary flow so if we have any pressure on the capillaries we could cause the bowel to die

70
Q

bowel perforation is often

A

fatal

71
Q

if a patient has a bowel perforation how do they die

A

peritonitis/sepsis

72
Q

what are the two causes of bowel perforation

A

impaction and enema

73
Q

what comes first constipation or impaction

A

constipation

74
Q

what is the first step in the treatment of diarrhea

A

STOOL CULTURE

75
Q

why is a stool culture the first step in treating diarrhea

A

because if it is bacteria causing this we do not want to stop the diarrhea

76
Q

drugs that decrease GI motility

A

atropine, Imodium, paregoric, lomotil

77
Q

absorbants

A

kaopectate

78
Q

antimicrobial

A

pesto bismol

79
Q

if we are doing something around the anus what are we watching for

A

vitals

80
Q

bowel training programs

A

pelvic floor muscle training
diet (increase fiber)

81
Q

when are rectal tubes appropriate

A

when it is liquid

82
Q

what is includes in skin protection for fecal incontinence

A

peri wash
peri ointment

83
Q

sigmoid colostomy

A

formed bowel

84
Q

descending colostomy

A

formed soft

85
Q

transverse colostomy

A

pasty

86
Q

ascending colostomy

A

liquid

87
Q

ileostomy

A

total liquid

88
Q

how long after surgery will the stoma return to normal

A

6-8 weeks

89
Q

what color do we want the stoma

A

red

90
Q

what color is bad for a stoma

A

pink/grey

91
Q

why do we want the wafer to fit snuggly around the stoma

A

to protect the surrounding skin from enzymes in the feces

92
Q

how often do we change the wafer

A

few days

93
Q

what should we teach about diet to a patient with a stoma bag

A

increase fiber (grains, oats, vegetables)
decrease gas causing ingredients (beans, alcohol, beer, cabbage, brussule sprots)

94
Q

what is one food that is very cleansing

A

yogurt

95
Q

what are risk factors for colorectal cancer

A

smoking, genetics, red meet

96
Q

who is colorectal cancer most common in

A

men and AA

97
Q

leading symptom for colorectal cancer

A

ribbon like stool because of the diameter of the bowel is changed

98
Q

is there warning signs for colorectal cancers

A

often there is none

99
Q

what are some warning signs for colorectal cancer

A

changes in bowel habits
blood in stool
constant need to evacuate bowel
weakness and fatigue
cramping or abdominal pain
unintended weight loss

100
Q

what is the recommendation for colonscopy

A

every 10 years at age of 45

101
Q

if someone is high risk how often do we perform colonoscopy’s

A

every 5 years