Bowel Elimination Flashcards by Lani Manners

how does age affect bowl movements

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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what do we want fiber intake at

25-30g

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what do we want fluid intake at

2-3L

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how does activity and exercise promote bowel movements

promotes GI motility
gives good muscle tone
helps maintain bowel function

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what meds cause constipation

narcotics

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what meds cause diarrhea

antibiotics and opiods

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stress can casue

constipation and diarrhea

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how does surgery and anestihics affect bowel

stops peristalsis which could lead to small bowel obstruction

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what is some diagnostic test that can affect bowels

contrast because it hardens

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cystic fibrosis

fatty foul stools

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diabetes

neuropathies

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what does knowing If the patient is passing gas tell us

the bowels are moving

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what do we want to asses when inspecting the anus

hemrooids

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what do we want to know about the stool

color, consistency, amount

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statoid

fatty

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black stool could mean

iron

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steadorrea

odor
- cystic fibrosis
pancreatic disease

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how much do we need for culture and sensitivity

1 inch or 15-30mL

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what is guaiac

occult blood
- blood that cannot be seen

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

no red meet

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examples of direct visualization

colonoscopy, sigmoidoscopy, wireless capsulse

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indirect visulaization

barium enema, barium swallow, CT, ultrasound

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when doing an occult blood what color is positive

blue

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what color is an upper GI bleed

black and dark, coffee grounds, tarry

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what is a lower GI bleed look like

bright red

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

left lateral

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

fluids and laxatives because barium hardens

constipation

dry hard stool that is hard to pass

impaction

hard immovable object

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

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

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

yes it can be higher up

diarrhea

moving too fast through GI, water is not absorbed

incontintence

not aware and has no control

flatulence

gas

hemorrhoids

distended vein in rectum bright red bleeding

small bowel obstruction can be caused by

surgery and anesthetics

small bowel obstructions stop

peristalsis

3 things we need to do to treat constipation

fluid, fiber, stool softener

is colace a laxitive

what does colace do

absorbs water and makes it easier to pass

what is a bulk forming (Metamucil)

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

3 other laxatives

lubricant, stimulant, saline osmotic

lubricant

mineral oil

stimulant

dulcolax

saline osmotic

MOM

laxative

irritates the bowel lining to get peristalsis

is impaction moveable

who do we not do a digital disimpaction on

cardiac patient

how do we do a digital disimpaction

left side lying rectum only double glove lubricant

enema

liquid through tube into bowel

what temp do we want the enema

room temp

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

stop

how do we have the patient laying during an enema

left side lying

what do we do to the bed during an enema

pad the bed

tap water enema amount

500-100mL

what does a tap water enema do

distends the intestine, increases peristalsis, softens stool

normal saline enema amount

500-100mL

what does normal saline enema do

distends the intestine, increases peristalsis, softens stool

soap suds enema amount

500-100mL

what does soap subs enema do

distends the intestine, irritates intentional mucosa, softens stool

fleets hypertonic enema amount

70-130mL

what does a fleets hypertonic enema do

distends intestine, irritates intestinal mucosa

what do we use lactulose for

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

what is kaexelate used for

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

oil retention enema amount

150-200mL

what does a oil retention enema do

lubricates stool and intestinal mucosa

what do we assess for after an enema

perforation

how does a patient present with an perforation

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

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

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

bowel perforation is often

fatal

if a patient has a bowel perforation how do they die

peritonitis/sepsis

what are the two causes of bowel perforation

impaction and enema

what comes first constipation or impaction

constipation

what is the first step in the treatment of diarrhea

STOOL CULTURE

why is a stool culture the first step in treating diarrhea

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

drugs that decrease GI motility

atropine, Imodium, paregoric, lomotil

absorbants

kaopectate

antimicrobial

pesto bismol

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

vitals

bowel training programs

pelvic floor muscle training diet (increase fiber)

when are rectal tubes appropriate

when it is liquid

what is includes in skin protection for fecal incontinence

peri wash peri ointment

sigmoid colostomy

formed bowel

descending colostomy

formed soft

transverse colostomy

pasty

ascending colostomy

liquid

ileostomy

total liquid

how long after surgery will the stoma return to normal

6-8 weeks

what color do we want the stoma

red

what color is bad for a stoma

pink/grey

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

to protect the surrounding skin from enzymes in the feces

how often do we change the wafer

few days

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

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

what is one food that is very cleansing

yogurt

what are risk factors for colorectal cancer

smoking, genetics, red meet

who is colorectal cancer most common in

men and AA

leading symptom for colorectal cancer

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

is there warning signs for colorectal cancers

often there is none

what are some warning signs for colorectal cancer

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

what is the recommendation for colonscopy

every 10 years at age of 45

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

every 5 years