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Nursing fundamentals > bowel elimination > Flashcards

bowel elimination Flashcards

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1
Q

What are hemorrhoids?

A

when the veins in the anal canal become abnormally distended

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2
Q

When is the rectum empty?

A

Immediatly before and after defecation

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3
Q

how much Chyme enters the large intestines daily?

A

1500 mL

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4
Q

how much water is absorbed in the large intestines?

A

800-1000 mL a day

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5
Q

how often does peristalsis take place?

mass sweeps?

A

every 3-12 minutes

one to 4 times in 24 hours

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6
Q

how much food is normally excreted in stool withing 24 hours?

A

about one third to one half

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7
Q

if someone has a heart condition, what should they be concerned about during defacation?

A

Bearing down too much can decrease blood flood to the atria and ventricles,

called the valasalva maneuver

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8
Q

what is an average count of BMs in a day for breast fed infants?

Bottle fed?

After they are one year old?

A

2-10

1 or 2

1 or 2

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9
Q

when does toddler bowel training become possible? when does it usually happen?

A

18-24 months

30 months

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10
Q

how much fluid is needed to facilitate good BM

A

2000-3000 mL

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11
Q

what are some constipating foods?

A

cheese, lean meat, eggs, pasta

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12
Q

what are some foods that have a laxative effect?

A

fruits and veggies, bran, chocolate, alcohol, coffee

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13
Q

what are some gas producing foods?

A

onions, cabbage, beans, cauliflower

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14
Q

what color would you expect to see the stool if a pt was taking aspirin or anticoagulants?

Iron salts?

antacids?

antibiotics?

A

pink to red to black stools

black

white discoloration or speckling in stool

green-grey color

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15
Q

what causes mechanical obstructions?

what are some?

A

pressure on the intestinal walls

tumors, stenosis, adhesions, hernias, and strictures

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16
Q

what causes functional obstructions?

what are some?

A

inability of the intestinal musculature to move the contents through the bowel

muscular systrophy, Parkinson’s, diabetes, and manipulation of the bowel during surgery

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17
Q

what is it called when the bowels stop moving because they were manipulated during surgery?

what considerations have to be made?

A

paralytic ileus

food and fluids are withheld for 24-28 hours

18
Q

what influences the volume of stool?

what is normal?

special considerations?

A

the amount, type, and nature of the diet

varies

more roughage = more stool

consisant large diarrheal stools suggest problem with in small bowel or proximal colon

small frequent stools with urgeny suggest a disorder of the left colon or rectum

19
Q

what is the normal color for stool?

what can influence this?

A 
infant = yellow to bronw
adult = brown
red meat and spinach = black 
absence of bile = white or clay colored
medications 
bleeding (high in the tract is black low is fresh blood)
standing too long darkens the stool
20
Q

what is the normal odor of stool?

what can alter this?

A

pungent

affected by foods that are ingested
pH value (normal is neutral or slightly alkaline)
excessive putrefacation
presence of blood in stool

21
Q

what is the normal consistency of stool?

what can effect this?

A

soft, semi solid and formed

food and fluid intake, and gastric motility

less time in = more liquid

longer time in = harder

22
Q

what is the normal shape of stool and what can influence this ?

A

tubular, around 1 inch diameter

a obstruction can produce narrower stool, pencil shaped

rapid peristalisis thins stool

increased time in can result in a hard, marble like mass

23
Q

what are the normal constituents of stool?

what can alter this?

A

bile, intestinal secretions, epithelial cells, bacteria, inorganic material, seeds, meat fibers, fat

internal bleeding, infetion, inflammation, and other pathological conditions

24
Q

What foods can trigger a false positive for fecal occult blood?

what medications?

What can produce a false negative

A

red meat, liver, kidneys, fish, tomatoes, cauliflower, horseradish, turnips, melon, bananas, and soybeans.

salicylate of more than 325 mg, steroids, iron, anticoagulants

Vitamin C can produce a false negative even in the presence of bleeding

25
Q

what is a common symptom of pinworms?

A

perianal itching

26
Q

how should diagnostic tests be scheduled? give an example?

A

from least invasive to most invasive

fecal occult blood, barium studies, then endoscopic examinations

27
Q

What is the name of a bulk forming laxative?

How does it work?

onset time?

Contraindications?

A

Metamucil

causes stool to absorb water and swell

within 24 hours

can interfere with calcium and iron and some meds
dont give to peoplewho are bedridden or have intestinal strictures
can be expensive

28
Q

what is the name of a stool softener?

how does it work?

advantage

contraindications”?

A

Colace

agents with detergent that allow water and fat to penetrate and lubricate stool

Recommended for those who must refrain from straining

lubricant can interfere with fat soluable absorption

29
Q

What is the name of an emollient?

how does it work

advantages

contraindications?

A

mineral oil

lubricates the intestinal tract and stops colonic absorption of water

effective within 8 hours

can interfere with fat soluable absorbtion and can be aspirated

30
Q

what is the name of a stimulant laxative?

how does it work?

advantages?

contraindications?

A

Dulcolax

promotes peristalsis by irritating the intestinal mucosa or stimulating nerve endings

works faster than bulking agents

most abused
causes lazy bowel syndrome
can affect vitamin D and calcium absorption 
not recommended for elderly
alters electrolyte transport
31
Q

what is the name of a saline-osmotic laxative?

How does it work?

advantages?

contraindications?

A

MOM

draws water into intestines and stimulates peristalsis

used when rapid clearing is desired

no elderly
can produce dehydration
not recommended in patients with kidney disease or heart failure

32
Q

what category does Paregoric belong to?

how does it work?

what are some cautions?

A

antidiarrheal, works on the smooth muscle

increases smooth muscle tone
decreases GI motility
Diminishes GI secretions

may be addictive ( opium)
May cause drowsiness and lightheadedness
discontinue after diarrhea subsides

33
Q

how does Diphenoxylate and atropine work against diarrhea? (lomotil)

what are some cautions?

A

slows gastric motility through local effect on GI wall

is chemically related to morphine, can be addictive in high doses
can cause drowsiness

34
Q

How does loperimide work against diarrhea?

advantages?

cautions?

A

inhibits peristalsis via direct effect on GI wall

not addictive, works longer than Lomotil

may cause drowsiness
must be discontinued of no improvemtn in 48 hours with acute cases

35
Q

How doe Kaolin-pectin (Kaopectate) work to stop diarrhea?

what is an advantage?

cautions?

A

absorbs and soothes

Nondrowsy

can interfere with oral medications absorption and nutrient absorption

36
Q

How does Bismuth-subsalicylate (Pepto) work to stop diarrhea?

advantages?

Cautions?

A

decreases GI secretions and has a antimicrobial action against bacterial and viral pathogens

no drowsiness

contains salicylate so check with physician before giving to children or administering asprin
may decrease absorption of medications

37
Q

For a tap water enema ( hypotonic)

How much?

How does it work?

Onset?

adverse effects?

A

500-1000mL

distends intestines, increases peristalsis, softens stool

15 mins

fluid and electrolye imbalances and water intoxication

38
Q

For a Normal Saline enema (isotonic)

How much?

How does it work?

Onset?

adverse effects?

A

500-1000 mL

distends intestines, increases peristalsis, softens stool.

15 mins

fluid and electrolyte imbalances, sodium retention

39
Q

For a soap enema

How much?

How does it work?

Onset?

adverse effects?

A

500-1000mL (concentrate is 3-5mL/1000mL)

Distends intestines, irritates the intestinal mucosa, softens stool

10-15 minutes

rectal mucosa irritation or damage

40
Q

For a hypertonic enemea

How much?

How does it work?

Onset?

adverse effects?

A

70-130 mL

distends intestines, irritates intestinal mucosa

5-10 minutes

sodium retention

41
Q

For an oil enema

How much?

How does it work?

Onset?

adverse effects?

A

150-200 mL

lubricates stool and intestinal mucosa

30 mins

none

42
Q

What are the types of retention enemas and what are they for?

A

oil retention - lubrication

carminiative - expel flatus (milk and molassas enema)

Medicated - absorb mediation through the rectal mucosa

Anthelmintic - destroy pathogens

Nursing fundamentals (22 decks)

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