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Fundamentals > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

The small intestine hooks to the large intestine at the:

A

cecum

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2
Q

Main cause of rectal bleeding?

A

Hemorroids

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3
Q

Defecation:

A

bowel movement

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4
Q

A reflex affecting internal anal sphincter:

A

involuntary

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5
Q

Control comes from the external anal sphincter:

A

Voluntary

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6
Q

Act of defecation:

A

deep breath
contract abdominal muscles
contract pelvic floor muscles

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7
Q

Newborns and Infants:

A

meconium- 1st fecal material (black, tarry, odorless, sticky)

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8
Q

Toddlers:

A

begin to have some control between 18 or 24 months

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9
Q

School Age:

A

constipation may become an issue

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10
Q

Aging Adult:

A

Old people are obsessed with bowel movements = may become laxative dependent

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11
Q

Normal amount of fiber per day:

A

20-35 grams

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12
Q

Gas producing foods:

A

onions
cauliflower
beans
cabbage

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13
Q

Laxative causing foods:

A 
bran
prunes
figs
chocolate
alcohol
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14
Q

Constipation causing foods:

A

cheese
pasta
eggs
lean meats

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15
Q

Peristalsis:

A

involuntary constriction and relaxation of the muscles of the intestine, creating wavelike movements that push the contents of the canal forward

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16
Q

Pregnancy:

A

as the fetus grows, pressure is exerted on the rectum, impairing passage of feces.

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17
Q

Surgery:

A

paralytic ileus, anesthesia blocks stimulation of muscles.

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18
Q

Paralytic Ileus:

A

(stoppage of peristalsis which lasts 24-48 hours) early activity and frequent assessment of bowel sounds are important during this time

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19
Q

Non-modiflabe

A

cannot change

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20
Q

Modiflabe

A

can change

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21
Q

Non-modiflabe

A

age
race
family history

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22
Q

Modiflabe

A

smoking
poor diet
lack of exercise

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23
Q

Symptoms of colorectal cancer:

A 
change in bowel habits
feeling of incomplete evacuation
rectal bleeding or blood in stool
abdominal pain
unintentional weight loss
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24
Q

Flatus:

A

gas- adult forms 7-10 liters per day

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25
Q

Diarrhea:

A

characterized by an abnormal frequency and fluidity of fecal evacuations

26
Q

How to prevent excessive flatulence:

A

limit carbonated drinks
don’t use straws
limit chewing gum
avoid gas forming foods

27
Q

Cause of diarrhea:

A 
stress
medications
allergies
colon diseases 
antibiotics
iron
food intolerance
surgery
28
Q

Why do you need to make sure a patient is clean and dry after cleaning stool?

A

because stool is very acidic and can cause skin breakdown

29
Q

Constipation:

A

having infrequent or difficult bowel movements

30
Q

Causes of constipation:

A 
low fiber
low fluid intake 
change in routine
chronic use of laxative
diseases/disorders
neurological disorders
decreased activity 
irregular toileting habits 
lack of privacy
31
Q

Main cause of constipation:

A

feces stays in the colon too long and all the water is reabsorbed.

32
Q

Fecal Impaction:

A

collection of hardened feces in the rectum

33
Q

Symptoms of fecal impaction:

A

anorexia
distended abdomen
nausea and vomiting

34
Q

Causes of C. Diff:

A

antibiotics
surgery
chemotherapy
acquired from healthcare workers

35
Q

Diagnostics for C.Diff:

A

enzyme linked immunoassay (ELIZA)

36
Q

With C.Diff you must wash your hands with:

A

soap and water

37
Q

With Subjective History, review of factors influencing elimination:

A 
use of aids
diet
medications
exercise
fluid
stress
38
Q

Why do you need to chart intake/output?

A

because the patient is loosing fluid

39
Q

Collection of stool specimen procedure:

A 
void first
defecate into containers
do not place toilet paper in container 
free pf barium and edema solution
use gloves
40
Q

Occult blood testing:

A

checks for hidden blood in the stool

41
Q

Occult blood test requires:

A

3 different specimens on 3 different days

42
Q

Privacy:

A

alone if possible and safe

43
Q

Timing:

A

after meals

44
Q

Nutrition and Fluid:

A

fiber and water

45
Q

Exercise:

A

early ambulation, bedside exercises

46
Q

Positioning:

A

sitting, commode extension

47
Q

If you can’t fix constipation naturally what do you do?

A

move to the pharmacologic methods

48
Q

Suppository:

A

solid which melts at room temperature and patient holds.

49
Q

Removal of impaction:

A

digital removal

50
Q

Rectal Catheter:

A

flatus and distention relief

51
Q

Can fleet enemas be delegated?

A

yes, they can be delegated

52
Q

Hypertonic Enema:

A 
draws water into the colon
works in 5-10 minutes
contains 90-120 mL of fluid
adverse effect=retention of sodium 
example: fleet enema
53
Q

Are enemas a sterile procedure?

A

no, they are not considered a sterile procedure.

54
Q

How do you give a big enema?

A

give it slowly

55
Q

Hypotonic enema:

A

distends colon, stimulates peristalsis and softens feces
takes 15-20 minutes to work
contains 500- 1000 mL of tap water
adverse effect: fluid, electrolyte imbalance, water intoxication
contraindicated: CHF, renal conditions
example: tap water

56
Q

Isotonic enema:

A

distends colon, stimulates peristalsis and softens feces
takes 15-20 minutes to work
contains 500-1000 mL of saline
adverse effect- possible sodium retention

57
Q

Soapsuds enema:

A

irritates mucosa, distends colon
works in 10-15 minutes
contains 500-1000 mL of water
irritates and may damage colonic mucosa

58
Q

Oil enema:

A

lubricates the feces and colonic mucosa
works in 1/2 to 3 hours
contains 90-120 mL of oil

59
Q

How to administer an enema:

A 
explain procedure
wash hands, don gloves
provide privacy
lubricate about 2.5-3 inches
prime the tubing
assist patient into Left Lateral Sims position
ask patient to take a deep breath
inset the enema tube (3-inches)
60
Q

When removing fecal impaction:

A

may cause vagal stimulation and always check cardiac status. (use xylocaine because it is painful)

61
Q

If the bowel diversion is on the left side:

A

the stool is solid

62
Q

If the bowel diversion is on the right side:

A

the stool is liquid

Fundamentals (12 decks)

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