Bowel Elimination Flashcards
Constipation is…
a symptom, not a disease
Constipation =
having fewer than 3 bowel movements a week**
Position
very important for some, need to be in specific position to defecate
Slowed peristalsis
less fluid in BM, harder
Hemorrhoids
swollen veins
Bulk Forming
daily
Methylcellulose (Citrucel)
Pysllium (Metamucil)
Polycarbophil (Fibercon)
Emollient or Wetting
Docusate Sodium (Colace, Doss)
stool softeners
Osmotic
Saline- based
Magnesium Citrate
Magnesium Hydroxide (Milk of Magnesia)
Sodium Phosphate (Fleet Phospho-Soda)
Polyethylene Glycol (Miralax)
Lactulose
Stimulant Cathartics
Bisacodyl (Dulcolax)
Senna (Ex-Lax, Senokot)
stimulate movement of colon
Left lateral sims side
enema side
- try to hold it in as long as they can
Slow the enema rate
by lowering the bag
- pt may c/o cramping
Enema precautions and complications
- fluid and electrolyte imbalances
- tissue trauma
- vagal nerve stimulation (fainting)
- pain
- perforation
- abd pain/cramping
Impaction ->
can lead to intestinal obstruction if stool is not removed
Individuals most at risk for impaction
- debilitated (spinal cord injury)
- confused
- unconscious
Impaction s/s
- continuous oozing of liquid stool
- loss of appetite
- n/v
- abd distention
- cramping
- rectal pain
Digital removal of stool
- lubrication
- use finger to break up fecal mass and remove it in sections
- very painful
- risks involved
Enteral feeding can cause…
diarrhea, means they are not tolerating it
Antidiarrheal agents
- decrease intestinal muscle tone to slow down the passage of feces
- body absorbs more water
- must determine cause of diarrhea to figure out if they need medicine
- loperamide or diphenoxylate w/ atropine
Fecal management system
need HCP order
- can be effective, can be left in for too long
C-diff at risk population
- abx pts
- elderly
- immunocompromised
- long term care facilities
- GI procedure
- previous had c-diff
C-diff complications
- dehydration
- kidney failure
- toxic megacolon
- bowel perforation
- death
C-diff prevention
wash hand w/ soap and water
clean with BLEACH
Treatment of C-diff
Plenty of fluids & good nutrition
Antibiotics
Surgery
Fecal implantation
Probiotics
Causes of bowel incontinence
- Muscle or nerve damage
- Any physical condition that impairs the anal sphincter function
- Constipation or diarrhea
- Large volume of stools
- Surgery
- Rectal prolapse
Risk factors of bowel incontinence
Age
Female
Nerve Damage
Dementia
Physical disability
Bowel incontinence tx
Anti-diarrheals
Bulk laxatives
Prevention of bowel incontinence
Reduce constipation
Control diarrhea
Avoid straining
Flatulence prevention
- avoid foods that cause gas
- eat small, more frequent meals
- eat and drink slowly
- eat more insoluble fiber
Foods that cause flatulence
- beans
- broccoli
- turnips
- brussel sprouts
- carbonated drinks
- straws
Hemorrhoids definition
dilated or engorged veins in lining of rectum
- external or internal
- increased venous pressure from straining
- pregnancy, sitting on toilet, liver disease, heart failure
Colon cancer risk factors and warning signs
- Race: African Americans
- Diet: High intake of red meat or processed meats, low fiber
- Obesity
- 50+
- Lack physical activity
- Alcohol, tobacco use
- Family history
- History of inflammatory bowel disease
Bristol stool chart
type 1 = pebbles
type 4 = smooth sausage
type 7 = liquid consistency
Fecal consituents
solid waste in it, particles
Abdomen
INSPECTION
AUSCULTATION
PERCUSSION
PALPATION
Stool collection
does not have to be sterile
Occult blood test
red meat = false positive
often ordered for 3 different occurrences
NG tubes
Decompression keeping things OUT of the stomach
Enteral feeding or medication
Administration
Lavage = taking things out
gavage = putting things in
With fiber
must include fluid intake
NG tube to
low wall suction
