Bowel Elimination Flashcards
- Absorb fluid and nutrients
- Temporary storage of feces
- Balancing fluid and electrolyte levels
- Allow elimination of waste and gas
Functions of GI tract
Digestion begins with mastication.
Mouth
Peristalsis moves food into the stomach
Esophagus
Stores food; mixes food, liquid, and digestive juices; moves food into small intestines
Stomach
Duodenum, jejunum, and ileum
Small Intestine
The primary organ of bowel elimination
Large Intestine
Expels feces and flatus from the rectum
Anus
These structures are necessary for the defecation process.
Organ of the GI tract
Physiological factors critical to bowel function and defecation include?
- normal GI tract function,
- sensory awareness of rectal distention and rectal contents,
- voluntary sphincter control, and
- adequate rectal capacity and compliance.
begins with movement in the left colon, moving stool toward the anus.
When stool reaches the rectum, distention causes relaxation of the internal sphincter and awareness of the need to defecate.
At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out.
Normal defecation process
Sometimes people use to assist in stool passage.
This method exerts pressure to expel feces through voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway.
Valsalva maneuver
Increase risk for cardiac dysrhythmias and HTN using a valsalva maneuver
Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound
is painless, resulting in passage of soft, formed stool.
Normal defecation
Approximately 20 feet long
Extends from the stomach to the large intestine
Small Intestine
First 10 inches
Duodenum
About 8 feet long
Jejunum
About 11 feet long
Ileum
where is digestion completed?
Small Intestine
enzymes that function in the small intestine to assist in digestion
bile and pancreatic enzymes
where is vitamins and mineral absorbed?
small intestine
Extends from the ileum to the Anus
Approximately 5 feet long
No Digestion takes place in the large intestine
large intestine
Stores and eliminates undigested waste
Absorbs water, vitamins and minerals
Functions of large intestine
Cecum Appendix Ascending Colon Transverse Colon Descending Colon Sigmoid Colon Rectum Anus
Large Intestine
can give nurses a lot of information; therefore it is important to ask questions related to bowel elimination & monitor this
Fecal Assessment
fecal characteristics
ascending colon
fluid feces
fecal characteristics
between ascending colon and transverse colon
semifluid feces
fecal characteristics
along transverse colon
mushy feces
fecal characteristics
between transverse and descending colon
semi mushy feces
fecal characteristics
descending
semi solid feces
fecal characteristics
below or within sigmoid colon
solid feces
Separate hard lumps like nuts (difficult to pass)
Type 1
Constipation
Sausage shaped but lumpy
Type 2
Like a sausage but with cracks on surface
Type 3
Like sausage or snake, smooth and soft
Type 4
Soft blobs with clear-cut edges and soft
Type 5
Fluffy pieces with ragged edges, a mushy stool
Type 6
Watery, no solid pieces (entirely liquid)
Type 7
is a symptom of something is going on, not a disease
Constipation
Improper diet, reduced fluid intake, lack of exercise, and certain medications causes?
Constipation
infrequent bowel movements (less often than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feces
Signs of constipation
slows the heart rate that may
occurs during straining while defecating, taking rectal temperatures,
completion of enemas, and
digital removal of impacted stool.
Vagal stimulation
is a significant health hazard
Constipation
Health issues that need to prevent constipation and avoid using the Valsalva maneuver.
patients with a history of cardiovascular disease,
diseases causing elevated intraocular pressure (glaucoma),
or increased intracranial pressure
causes problems for the patient with recent abdominal, gynecological, or rectal surgery.
Straining during defecation
Factors Affecting Elimination
Age Fluid intake Psychological factors Position during defecation Pregnancy Medications, laxatives, and cathartics Diet Physical activity Personal habits Pain Surgery and anesthesia Diagnostic tests
A symptom, not a disease; infrequent stool and/or hard, dry, small stools that are difficult to eliminate
Constipation
Results from unrelieved constipation; a collection of hardened feces wedged in the rectum that
a person cannot expel
Impaction
an increase in the number of stools and the passage of liquid, unformed feces
Diarrhea
Inability to control passage of feces and gas to the anus
Incontinence
Accumulation of gas in the intestines causing the walls to stretch
Flatulence
Dilated, engorged veins in the lining of the rectum
Hemorrhoids
What medications that may affect the GI System?
NSAIDS Aspirin Stool Softeners/Laxatives Enemas Narcotics Anticholinergic Agents
How to assess Bowel pattern and habits
What shall we ask?
Physical Assessment
What shall we do?
Last BM, color, consistency, nl frequency, nutritional habits, etc
Auscultate bowel, sounds, inspect & palpate abdomen
Diagnostic Tests for bowel assessment
Stool Specimens Fecal Occult Blood Test (Guaiac Test) Radiographic Test (X-Ray) Contrast Studies Endoscopy Colonoscopy
How and why stool specimen is collected (for Ova and Parasite)
Detects intestinal infections
Series of three stools are usually collected
Specimens are collected with a tongue blade and placed in a container with a preservative
Stool must be examined within 30 minutes of collection
When should the stool be examined?
within 30 minutes of collection
also called super infection
C. Diff. (Clostridium Difficile)
How to prevent C. Diff spread?
Wash hand thoroughly with
soap and water
C. Diff precautions
Contact Precautions
Before the isolation is lifted for patient affected with C. Diff.
48 hours of no diarrhea
