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Foundations > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

Functions of GI Tract

A
  1. Prepare food for absorption & use
  2. Absorb nutrients and fluid
  3. Temporary storage of waste
  4. Electrolyte balancing
  5. Remove secretions [gallbladder, pancreas]
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2
Q

GI Tract Parts

A
  1. Mouth
  2. Esophagus
  3. Stomach
  4. Small Intestine (Duodenum, Jejunum, Ileum)
  5. Large Intestine
  6. Anus
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3
Q

Mouth: Function and Essential Elements

A

Function: mechanical and chemical breakdown

Essential Elements: Saliva, teeth, tongue, swallowing

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4
Q

Esophagus: Function and Essential Elements

A

Function: to stomach, airway protection

Essential Elements: 2 sphincters- upper and lower prevent reflux

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5
Q

Stomach: Function and Essential Elements

A

Function: storage, mixing, emptying

Essential Elements: HCL, pepsin (protein breakdown), mucous (protection, intrinsic factor (B12)

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6
Q

Small Intestine: Function and Essential Elements

A

Function: digestion and absorption of most nutrients
Essential Elements:
1. Duodenum (10”) processes chyme
2. Jejunum (8”) absorbs carbs, protein
3. Ileum (12”) absorbs H2O, fat, salts, vitamins, iron

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7
Q

Alterations in Small Intestine

A
  1. malabsorption
  2. nutrient deficiency
  3. electrolyte imbalance
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8
Q

Large Intestine: Function and Essential Elements

A 
Function: organ of elimination
Essential Elements: 
1. Absorption of H2O depends on SPEED
2. Bicarb exchanged for chloride, K+ excreted
3. Essential bacteria
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9
Q

Anus: function and Essential Elements

A

Function: Sphincters

Essential Element: CNS Control

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10
Q

Elimination relies on:

A
  1. GI function
  2. CNS Control
  3. Sensation
  4. Moderate Peristalsis
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11
Q

Factors Affecting Elimination

A
  1. Age & Development
  2. Diet
  3. Fluid [1,500-2,000 ml/day for normal stool]
  4. Activity: promotes peristalsis and tone
  5. Psychosocial
  6. Position [bedbound], pain or pregnancy
  7. Surgery, anesthesia causes decrease in peristalsis, ileus
  8. Medications affecting elimination, elimination also affects medications.
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12
Q

Factors Affecting Elimination by Age & Development

A

Infant- small capacity, increase speed, no control
Older adult- low efficiency/motility/sensation
low absorption, protein synthesis, constipation

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13
Q

Factors Affecting Elimination by Diet

A
  • fiber, gas-producing foods increase motility

- lack of enzyme leads to food intolerance (lactose, gluten)

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14
Q

Factors Affecting Elimination by Psychosocial Factors

A

Stress, depression, access
Privacy, cleanliness and impaired ability may lead to ignoring urge, constipation.
Embarrassment may cause delay in seeking help.

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15
Q

Factors Affecting Elimination by Medications

A

Analgesics- opioids slow peristalsis
Include: NSAIDS and ASA (irritation, bleeding, low protective mucous)
Antibiotics- disrupt flora which lead to diarrhea

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16
Q

How Elimination Affects Medication

A

Motility may affect absorption, excretion; which affects timing & effectiveness, side effects

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17
Q

Alterations in Elimination

A
  1. Constipation
  2. Impaction
  3. Diarrhea
  4. Incontinence
  5. Flatulence
  6. Hemorrhoids
  7. Neurogenic Bowel- lack of innervation
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18
Q

Surgical Alterations

A
  1. G-tubes & J-tubes for feeding
  2. Ostomies for elimination
    - name refers to site; ileostomy, colostomy
    - site determines consistency of effluent, nutritional deficiencies likely
    - may be reversed or permanent
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19
Q

Nursing Diagnosis for Elimination

A
  1. Altered Elimination: constipation/Diarrhea
  2. Self-Care deficit
  3. Knowledge deficit
  4. [Risk for or Actual] Fluid/ Electrolyte Imbalance
  5. Pain
  6. Nutrition: less than body requirements r/t altered digestion, elimination, absorption
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20
Q

Nursing Assessment

A
  1. diet and intake
  2. elimination pattern “usual” and new
  3. bowel sounds, palpation & observation
  4. medications
  5. activity
  6. age
  7. appearance of stool:
    - tarry/bright red smear- blood
    - pale/clay- mucous, fatty
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21
Q

Goals for Elimination: Overall

A

Return to normal elimination pattern

-patient reports passing soft, formed stool daily w/o pain

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22
Q

Goals for Elimination: Short Term

A

Short term goals support modifiable factors

  • patient will increase fluid intake to 1,500ml/day
  • patient will walk to end of hall and back 3x today
23
Q

Goals for Altered Patterns

A
  • pt will correctly demonstrate ostomy care by end of week
  • pt will independently perform catheter care after breakfast today
  • pt will choose a nutritionally balanced diet incorporating gluten-free foods from a list
24
Q

Nursing Interventions

A
  1. Promote normal elimination when possible
    - position, privacy, pain management, safety
  2. Advancing diets: clear, soft, regular
  3. Special diets: lactose free, gluten free, high fiber, and fluid restriction
  4. Activity
  5. Medications: laxatives, softeners, fiber, cathartics, anti-diarrheals
  6. Enemas
  7. Ostomy Care
    - assessment, irrigation, change bag, skin care
  8. NG tubes: for decompression, removal of gas/secretions, feeding, taking meds
  9. Bowel Training
  10. Education: Pt and family
    - vagal response [cardiac], fluid restriction, meds, diet, new Dx, post-op, when to call M.D
25
Q

Nursing Evaluation

A
  • was goal met?
  • Goal Met: Patient passed soft formed brown stool w/o pain today. continue with plan of care.
  • Advance education as patient progresses in ability and comfort, general health
26
Q

What could cause alterations in elimination that reflect problems in the GI tract or elsewhere?

A

Neuro, cancer, GI tract problems, liver, kidneys

27
Q

“normal” elimination

A

Different for each person

28
Q

Where does absorption of nurtrients begin?

A

The small intestine

29
Q

Feces- 75%, 25%

A

75% water, 25% solids (bacteria, fiber, fat, inorganic matter, protein)

30
Q

What is the antibiotic for C. Dif?

A

Flagyl. C.Dif is very contagious. example from class- can be transmitted by touching a door knob

31
Q

What is chyme?

A

Undigested food

32
Q

How long does it take for food to reach the large intestine?

A

3 hours

33
Q

Anus spinchters (CNS control)

A

Tells us when to push food out

34
Q

Hyperkalcemia PT

A

Will be given meds (kayexalate) to poop

35
Q

When do new borns usually have a bowl movement?

A

24-28 hours after birth

36
Q

Who usually abuses laxatives?

A

Elderly, eating disorders

37
Q

How much fluid intake is needed for normal stools?

A

1.5-2 liters (changes depending on condition)

38
Q

What age group may ignore an urge to go potty?

A

Toddlers

39
Q

Are caffeinated beverages included in normal fluid intake?

A

no

40
Q

Why would pregnancy affect bowl elimination?

A

Hemorrhoids because of pressure

41
Q

ASA

A

Aspirin

42
Q

What are black tarry stools indicative of?

A

Upper GI issues

43
Q

What are bright red stools indicative of?

A

Lower GI issues

44
Q

What is Imodium?

A

Drug used to treat diarrhea

45
Q

What is a side effect of anesthesia from surgery?

A

Decreased motility

46
Q

Where are G tubes placed?

A

The stomach

47
Q

Where are J tubes?

A

The jejunum

48
Q

Steatorrhea

A

Fatty stools

49
Q

What could mucus in the stools be indicative of?

A

Ulcer colitis, parasites

50
Q

What could pain after a fatty meal be indicative of?

A

Gall bladder inflammation

51
Q

Five F’s

A

Fat, Female, Forties, Flatulent, Fertile

52
Q

What is the overall goal for elimination?

A

To return to normal elimination pattern

53
Q

What sign is used to test for an inflamed appendix?

A

Murpheys sign- rebound tenderness

Foundations (4 decks)

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