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Theory Unit 5 > Bowel elimination > Flashcards

Bowel elimination Flashcards

1
Q

Patient assessment of bowel elimination

A

When was your last BM?

What is a normal BM pattern for the client?

Are they experiencing or have a history of bowel problems?

What is there daily fluid intake? And is it adequate?

What is their activity status?

Are they under a lot of stress?

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2
Q

Terms you can use for bowel elimination

A

Defecate
Bowel movement – BM
Passing stool

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3
Q

Feces

A

Are in the intestinal track

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4
Q

Stool

A

Is the term used once passed or eliminated?

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5
Q

Fecal color characteristics

A

Brown
Bloody – blood streaks
Black – meds – blood – food
Gray or whitish – digestive enzymes

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6
Q

Bright blood in stool

A

Means coming from the lower part of the intestinal track

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7
Q

Dark blood in the stool

A

Means the blood is more than likely coming from the upper part of the intestinal track

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8
Q

Medication’s that can influence the appearance of stool

A

Anticoagulants – pink, red, black

Iron – black, tarry stools

Antacids – white discoloration, or speckling in the stool

Antibiotics - green, gray

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9
Q

Stool characteristics

A

Volume Dash amount, more fiber, more volume

Odor – related to food they eat

Consistency – soft, semi solid, formed, easy to pass

Shape – not ribbon like

Constituents Dash waste, things we don’t need, don’t want to see fat, blood, pus, or mucus

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10
Q

What is Steatorrhea

A

Fat in stools

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11
Q

Factors affecting bowel elimination

A

Age peristalsis slows with age,
Fluid intake
Physical activity
Psychosocial factors
Personal habits
Positioning
Pain
Pregnancy
Surgery and anesthesia
Medication

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12
Q

breast-fed could result in yellow seedy, looking stools, formula, fed, could result in rusty brown stools

A
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13
Q

Diet and increase in fiber, increases volume, lactose, foods that cause constipation, or dairy and pasta

A
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14
Q

Cystic fibrosis

A

Affects the ducts of the pancreas and gallbladder lacking enzymes, and causes bulky , fatty stools

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15
Q

Salmonella

A

Loose stools, and is caused by foodborne

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16
Q

E. coli

A

It is a normal bacteria that lives in your stool, but When your body acquires too much it becomes dangerous, food borne from poor hand, hygiene, sanitation’s, and cleaning methods

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17
Q

What may be one of the first symptoms of disease?

A

Changes in stool characteristics and frequency of passing stools

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18
Q

Warning, signs of colon cancer

A

Changes in bowel elimination pattern

Blood in stools

Rectal or abdominal pain

Change in the characteristics of the stool

Sensation of incomplete emptying after a bowel movement

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19
Q

Diagnostic tests

A

Fecal occult blood testing

Stool culture usually looking for parasites, pathogens, eggs, etc.

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20
Q

Steps for a fecal occult blood test

A

Explain the procedure to the

Ask the client to collect a specimen in the toilet receptacle, bedpan, or bedside commode

Don gloves

With a wooden applicator, place small amount of stool on the window of the test card

Follow the facilities procedure for handling apply a label to the card and send them to the laboratory for processing

Alternately, you can place a couple of drops of developer on the opposite side of the card. A blue color indicates the stool is positive for blood.

Remove gloves and perform hand hygiene

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21
Q

Steps for obtaining a stool culture looking for parasites ova

A

Explain the procedure to the client

Ask the client to collect a specimen in the toilet receptacle, bedpan, commode

Don gloves

With a wooden tongue, depressor transfer the stool to a specimen container

Label to the container with clients, identifying information. Be sure information is correct.

Perform hand hygiene

Transport the specimen to the laboratory 

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22
Q

Endoscopy

A

A radio logical diagnostic test, where a tube is placed into your mouth and goes down to your stomach

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23
Q

Colonoscopy

A

 A radio logical, and diagnostic test done where a scope goes through the colon and up into the intestinal track

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24
Q

Endoscopy and colonoscopy and EGD’s use what kind of tube

A

 Fiber optic to examine G.I. track

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25
Barium swallow – enema, radiological, diagnostic test
Patients can have nothing by mouth NPO Hey, use of a contrast medium for an x-ray visualization. The contrast is Chucky and thick. Once the diagnostic test is finished, all of the barium must get out of the body
26
Constipation
Decreased peristalsis in the G.I. track Passage of dry, hard stools Decreasing frequency
27
Things that may cause constipation
Change in diet Exercise Medication Environmental factors
28
Impaction
Retention of a hardened fecal mass in the rectum, resulting from prolonged constipation
29
Symptoms of infection
Small amounts of fluid may go around the mass and liquid fecal seepage with no passage of normal feces
30
Steps of palpating the bowel
Auscultate Palpate Percuss Listen for one minute, if you hear nothing listen for another five minutes, if you still hear nothing contact provider
31
Treatment for an impaction
Digital removal of stool Must obtain vital signs prior
32
Diarrhea
Passage of excessively liquid unformed stool May experience cramping, nausea and vomiting, blood in stool Large amounts of fluid and electrolyte maybe lost Cold fluids and rich foods should be avoided Patient may be put on a brat diet – bananas, rice, applesauce, toast
33
Bowel incontinence ******
Loss of anal sphincter control Inability to control BM passage May be due to many factors, such as – 
34
Flatulence
Excessive formation of gases in the stomach or intestines, causing cramping, discomfort, distention Movement will ease
35
Hemorrhoids
Dilated or engorged veins lining the rectum that can be internal or external
36
What causes hemorrhoids?
Straining, obesity, liver, problems, or heart problems You can avoid hemorrhoids by changes in your diet fiber, and fluid movement
37
Nausea
The sense of wanting to vomit
38
Vomiting
Emesis do not leave patient, look at emesis and assess do oral care after Change any soiled clothes or linens If vomiting patient has had abdomen surgery, check incision site
39
Rectocele
A condition where the wall between the rectum and vagina weakens
40
Risk factors for a rectocele
Genetics Childbirt Aging Obesity
41
Expected findings of a rectocele
Soft bulge of tissue in the vagina that might protrude through the vaginal opening Difficulty having bowel movement Sense of rectal fullness A feeling that the rectum has not completely emptied
42
How to diagnose a rectocele
Pelvic MRI X-ray Ultrasound
43
Patient centered care of a rectocele
Prevent constipation Vaginal pessary Kegel exercises Surgical repairs, mesh, or tape Avoid heavy, lifting Control coughing Avoid weight gain
44
Bowel diversions
Ileostomy and colostomy
45
Ileostomy
a surgical operation in which a piece of the ileum is diverted to an artificial opening in the abdominal wall. A stoma is created with the small intestine versus the colon
46
Stools with bowel diversions
More liquid stools that the diversion is placed higher in the intestinal track, more solid stools as you move down the track
47
When to empty bowel diversion bags
When they are 1/3 to a half full
48
When assessing ileostomies or colostomy , always assess the stoma, the color should be red, pink, moist
49
Digestive enzymes will break down skin
50
An ileostomy is more constant liquid stools and can’t be regulated versus a colostomy has firmer stools and is more regulated
51
Promoting regular bowel elimination
Timing Positioning Privacy Nutrition Exercise
52
Positioning for bowel elimination
Provide elevated toilet seat and defecating Place head of bed at 30 to 45° when using bedpan Provide moistened, hand, wipes, or washcloths for use after toileting
53
Timing for bowel elimination
Assist patient to the toilet an hour after meals Teach patient the importance of not postponing, the urge to defecate
54
Privacy for bowel elimination
Curtains closed when using commode in bed pan Door closed and have cold light in reach when using bedpan or commode
55
Nutrition for bowel elimination
Provide fluid intake of 1500 ML‘s to 2000 ML‘s daily High fiber, such as fruits, veggies, whole greens Bran and fluids are more effective than medication for promoting regular BMs
56
Exercise for bowel elimination
Assist with range of motion, exercise to upper and lower extremities five reps each once a day Ambulate in hall, assisted by one using walker twice daily
57
Considerations with surgery and anesthesia
Stop ASA – aspirin, anticoagulants, and possibly other medication’s before surgery to prevent G.I. bleeding Peristalsis may be inhibited or ceased postop leading to paralytic ileus Opioids, often cause constipation may need to be taking a stool softener
58
What is a paralytic ileus?
A functional motor paralysis of the digestive track
59
Bowel medication’s
Cathartics-help to move BM Laxatives help to move BM Stool softeners help to move BM Enemas constipation Suppositories constipation Antidiarrheals diarrhea
60
What do cathartics in laxatives do?
Promote emptying of the intestinal track Cathartics exert a stronger affect on the intestines than laxatives
61
Stool softeners
Soften the fecal matter Cocasset sodium
62
Least invasive to most invasive
Nutritional Metamucil Stool softeners Laxatives Cathartics
63
What is the most common cause of chronic constipation?
Habitual use of laxatives
64
If patient is having abdominal pain, they should not be given a laxative. It could increase the pain.
65
Anti-diarrheal medication’s
Inhibits peristalsis – slows it down Opiates Lodi mill Kaolin pectin Kaopectaid Pepto-Bismol has aspirin in it
66
Enemas position in left Sims position
Promotes defecation by stimulating peristalsis A solution is instilled into the large intestine sigmoid colon through the rectum Administration of enemas are not a sterile procedure the colon contains bacteria Use aseptic technique
67
Cleansing enema’s purpose
Relieve constipation, and or impaction Cleanse the bowel prior to surgery or diagnostic test Promote visualization of the intestinal track for an x-ray or endoscopy Help establish regular bowel function during belt training program
68
Types of cleansing enema’s
Tap, water enema – they are hypo tonic. They have no pulling power. Normal saline – safest 500 to 1000 ML’s into the sigmoid colon Soapsuds enema – irritates the lining to create peristalsis. They are harsh and could cause inflammation to the bowel. Hypertonic solution fleets enema Oil retention is a mineral lubricant
69
Administering a cleansing enema
Temp of 105 to 110° not too cold or too hot Towards the belly button Use gloves Average amount of solution is 750 to 1000 ML‘s Place and Sims position Insert lubricated tip 3 to 4 inches for adults into the rectum Direct tubing towards the umbilicus Hold tubing constantly Instruct to take deep Open clamp and allow solution to enter slowly Elevate solution bag or container 12 to 18 inches Lower container or clamp if cramping or fluid escapes around tube After administering all solution clamp and remove, have toilet paper ready or waterproof pad under patient Encourage patient to hold as long as possible
70
After patient has expelled enema
Observe, feces and solution Inspect color, consistency, amount of stool and fluid passed Assess complaints of pain, cramping, abdominal rigidity, or distention Document results
71
Suppositories
Are con or oval shaped for ease of insertion into the body cavity, and designed to melt at body temperature Lubricate with water soluble lubricant Insert past internal and external think they’re approximately 4 inches Internal and external sphincter against rectal wall 
72
Geriatric considerations
Constipation is common Use of over-the-counter laxatives Unable to recognize urge to defecate Impaired mobility
73
Diverticulosis
A condition in which small sacs or pouches form in the colon
74
Diverticulitis
An inflamed pouch, or sac in the colon that is the result of stool, becoming trapped
75
Irritable bowel syndrome – IBS
A gastrointestinal condition, characterized by abdominal pain and changes to bowel elimination patterns that can include diarrhea and or constipation
76
Crohn’s disease
A chronic disease that causes inflammation in the G.I. track, but commonly affects the small intestine
77
What is a J-pouch?
A J-pouch is an internal pouched formed with the ileum. It is an internal reservoir that connects to the anus, after removal of the rectum and colon. 
78
Dysuria
Pain or discomfort with urination, often due to infection or injury 

Theory Unit 5 (2 decks)

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