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Assessment > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

Functions of the small intestine

A

digestion, absorption of carbs, fat and protein

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2
Q

functions of larger intestine

A

absorption of water, vitamins and minerals

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3
Q

Factors that affect bowel elimination

A 
age
stress
dietary intake
fluid intake
activity 
medications
surgery
anesthesia
pregnancy
pathological conditions
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4
Q

changes in associated with constipation

A

decreased frequency and more water is reabsorbed from he feces. as result the stool that is passed is hard and dry and requires more effort.

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5
Q

changes associated with diarrhea

A

increase in frequency and less water is absorbed

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6
Q

why are bowel diversions performed

A

done for a variety of reasons including, cancer, ulcerations, trauma, or inadequate blood supply. temporarily done to allow healing of distal portion of bowel, permanently done when severe disease or trauma is necrotic and cannot be salvaged

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7
Q

Topics for nursing history

A

Normal bowel pattern
appearance of stool
changes in bowel habits or stool appearance
history of elimination problems
use of bowel elimination aids, including diet, exercise, medication and remedies

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8
Q

physical assessment steps

A
  • inspection, auscultation, percussion and palpation
  • size, shape, contour, sounds
  • tenderness, presence of air or solid, presence of masses
  • inspect the anus for hemorrhoids
  • palpate anus for stool or masses
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9
Q

independent nursing actions to encourage regular eliminations

A
  • privacy
  • allow for uninterrupted time
  • teach to sit or squat, drink at least 1500mL, exercise 3-5 times a week
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10
Q

types of enemas

A

cleansing
retention
return-flow (harris flush)

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11
Q

hypotonic enemas

A

Large volume, leads to rapid evacuation by intestinal distention

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12
Q

isotonic enemas

A

Large volume, leads to rapid evacuation by intestinal distention

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13
Q

hypertonic enemas

A

small volume. attacks water into the colon, causing distention and stimulating peristalsis and dedication. Patient usually retain hypotonic and isotonic longer than hypertonic solutions. hypertonic solutions are more irritating to the mucosa.

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14
Q

Making a patient comfortable while administering an enema

A
  • explain purpose and what to expect
  • always provide privacy
  • reassure the patient you will be immediately available to help to restroom
  • lubricate the time of enema and administer slowly
  • have patient breath slowly through mouth
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15
Q

Interventions to helping a patient adapt psychologically to a bowel diversion

A
  • being willing to talk with patient about his reaction to stoma and concerns about living with an ostomy
  • taking a caring approach when providing stoma care
  • allowing adequate time for the patient to learn about self-care
  • coordinating a visit by a volunteer from the united ostomy association
  • providing information about a community support group of people living with an ostomy or other bowel diversions
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16
Q

Drugs that inhibit evacuation

A
  • antacids
  • iron
  • pain medication
  • antimotility drugs (used to stop diarrhea)
  • anestesia
17
Q

drugs that promote evacuation

A
  • antibiotics

- laxatives

18
Q

normal bowel sounds

A

5-15 gurgles every minute

19
Q

hyperactive bowel sounds

A

very high pitched and more frequent. Occur with small bowel obstructions and inflammatory siocrders and may produce diarrhea

20
Q

hypoactive bowel sounds

A

low pitched, infrequent and quiet. indicates decreased peristalsis which can result in constipation

21
Q

absent bowel sounds

A

nothing for 3-5 minutes. indicate lack of intestinal activity which may occur after abdominal surgery and indicate a paralytic ileus.

22
Q

occult blood

A

hidden in the stool

23
Q

Foods that cause diarrhea

A

spicy, high-fat, greasy snacks or large quantities of raw fruit and vegetables.

24
Q

monitoring interventions for diarrhea

A
  • assess frequency, amount, color and consistency
  • monitor I/O, body right, and vitals to assess hydration. turgor
  • monitor serum electrolyte leves
  • monitor skin integrity
25
Q

BRAT diet

A

for children with diarrhea. Bananas, white rice, applesauce, and toast

26
Q

interventions for short-term constipation

A
  • increase intake of high-fiber foods
  • increase fluid intake
  • increase physical activity
  • provide privacy
  • assist the patient to a seated or squatting position
  • allow the patient to uninterrupted time to use the toilet
  • encourage the patient not to ignore the urge to defecate
  • assess for complications
27
Q

cleansing enemas

A
  • treat severe constipation or impactions
  • clear the colon in preparation for visualization procedures
  • empty the colon when starting a bowel training program
  • clear the colon for surgeries of the lower GI tract and some pelvic surgeries
28
Q

hypotonic enema

A

cleansing. large volume that distends the intestine and leads to rapid evacuation of stool

29
Q

hypertonic enema

A

cleansing small volume. attracts water into the colon causing distention and stimulating peristalsis and defecation

30
Q

retention enemas

A

solution is meant to be reading for prolonged period. small volume

31
Q

oil-retention enema

A

softens stoll and lubricates the rectum. used to press hard stool or before digital removal of stool. 90-120mL

32
Q

carminative enema

A

helps expel flatus and relieve bloating and distention. used after pelvic surgery when peristalsis is slow to return and the client experiences pressure from gas. 60-180mL

33
Q

medicated enemas

A

used to instill antibiotics to treat infections in the rectum or anus or to introduce anthelminthic agents for treatment of intestinal worm and parasites.

34
Q

nutritive enemas

A

for patients who are dehydrated and frail. used in hospice

35
Q

interventions for incontinence

A
  • monitor patter of BM
  • provide bedpan at regular intervals or times
  • change clothing ASAP to prevent skin irritation
  • provide prompt hygiene
  • monitor skin for breakdown
  • review diet, fluid intake, activity level and medicines
  • bowel training program
  • consider containment or indwelling methods to prevent drainage

Assessment (4 decks)

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