Bowel Elimination Flashcards
Factors that affect bowel movements
Developmental stage Personal factors -privacy Nutrition Medications Surgical procedures -anesthesia -manipulation of the bowel Pregnancy
Types of laxatives
Stool softeners Osmotic laxatives Lubricant laxatives Stimulant laxatives Bulking agents Chloride channel activators Combo laxatives
Stool softeners
Enable moisture and fat to penetrate stool making is more soft
Osmotic laxative
Draws water into the bowel from surrounding tissue resulting in bowel distention
Lubricant laxative
Coating the stool and GI tract in a thin waterproof layer of lubricant to ease passage
Ex: mineral oil
Stimulant laxatives
Bowel irritants stimulating intense peristalsis Ex: Castor oil Senna Bisacodyl
Bulking agent
Non foods high in fiber
Usually combined with adequate fluids to stimulate urge to evacuate
Safest form of laxative
Chloride channel activators
Increase intentional fluid and motility to help pass stool
Combination laxatives
Laxatives that contain more than one laxative ingredient such as a stimulant and a softner
Types of Ostomies
Colostomies Ileostomies End stomas Loop colostomies Double-barrel colostomy
Colostomy
Ends in the colon
Brings part of colon through abdomen
Double-barrel colostomies
Two separate stomas
Proximal stoma drains feces
Distal stoma drains mucus
Loop colostomy
Section of bowel is brought out and held in place by rod
Anterior wall is incised
Iliostomy
Bring portion of the ilium out of the abdomen Bypasses the larger intestine Liquid drainage 2 pouch types -kock pouch -total colectomy with ileoanal reservoir
Kock pouch
Used in iliostomy
Internal pouch to collect drainage
Must be drained using tube
Ileoanal reserve
Ileostomy pouch that holds feces but allows patient to use toilet per normal
Bowel frequency
Depends on the person
Usually 2-3 per week (for adults)
Bowel colors
White or clay: absence of bile -may indicate bile obstruction or antacid use Light brown -diet high in milk and low in meat Black/ tarry: indicates iron or blood -May indicate upper GI bleeding or large quantities or iron rich foods Red: -bleeding in lower GI -hemorrhoids
Normal quantity of stool
150g/ day
Variations
-quantity varies from 100-400 based on intake
Normal shape of stool
Diameter of rectum
-1 in or 2.5cm
Variations
-narrow or pencil= obstruction, constriction or rapid peristalsis
-small or marble like= linger time in the large intestine
Consistency of stool
Formed, soft, and moist
Variations
-hard= constipation
-watery= diarrhea
Odor
Affected by foods
-strong foul odor may indicate bleeding or infection
Promoting poop
- privacy
- assists with position
- timing
- diet
- exercise
Hypotonic enema
500-1000mL of tap water and soap
Used to promote pooping
Isotonic enema
500-1000mL normal saline
Used to distend colon and promote peristalsis
Hypertonic enema
90-120ml of sodium phosphate
Used to attract water from membranes
Faster acting 5-10 min
Oil enema
90-120mL mineral oil, cottonseed oils or olive oil
Used to soften feces and lubricate rectum
Usually 1-2 hours before a cleansing enema
Soapsuds enema
Pure Castile soap
Irritates intestines and causes peristalsis
Carminative enema
1:2:3 enema or MGW solution
-magnesium, glycerine, water
Provides relief from abdominal distension
How much fiber should you intake daily
25-38 g/day
