Bowel Elimination

Question 1

Bowel Elimination

Answer 1

• Normal GI tract function
• Sensory awareness
• Sphincter control

Question 2

Normal bowel elimination

Answer 2

a patient is able to have a bowel elimination without a rush to toilet, no excessive straining, no blood loss, no laxative use

Question 3

Normal frequency

Answer 3

daily, 2-3 times a week

Question 4

Normal color and consistency

Answer 4

brown and soft

Question 5

What to ask patient?

Answer 5

whats their normal bowel movement and when was their last bowel movement

Question 6

Factor affecting elimination

Answer 6

Personal habits, not comfortable using public restrooms so hold it for hours.

Question 7

Fiber

Answer 7

absorbs fluid, promotes elimination of softer stool, peristalsis is stimulated.

Question 8

Fiber intake

Answer 8

25g per day for females
38g for males.
About 5 servings a day

Question 9

Less fluid intake develops?

Answer 9

hard stools, constipation

Question 10

Activity level

Answer 10

exercise stimulates peristalsis.

Question 11

Meds

Answer 11

antacids = slows peristalsis resulting in constipation
Antibiotics= loose stool, diarrhea
Iron supplements = causes discoloration of stool (Black stool) can cause constipation

Question 12

Health history

Answer 12

any recent surgeries with general anesthesia = slows bowel motility.

Question 13

Emotional distress

Answer 13

depression = peristalsis decreases, leading to constipation

Question 14

Continence

Answer 14

asking if patient can make it to the bathroom before bowel movement

Question 15

Pain

Answer 15

problem relating to bowel elimination. Pooping should be painless. if pain is present investigate for hemorrhoids.

Question 16

Always ask patient…

Answer 16

if they have changes in bowel movement.

Question 17

Physical Assessment

-Abdomen

Answer 17

look at contour of abdomen, asculatate bowel sounds, assess any tenderness with palpation

Question 18

Physical Assessment

-Stool

Answer 18

always assessing patients stool. look at color, (gray or clay colored= liver problems)
(black or starry= melnia, blood) (streaky blood = infection) consistency : hard, soft, liquid

Question 19

Stool labs:

Occult blood

Answer 19

Guiac or FOBT test : get specimen to get tested to see if blood in stool that you cant see with naked eye

Question 20

Stool labs:

FIT test

Answer 20

another stool lab testing

Question 21

0&P

Answer 21

ova and parasites testing : stool must be fresh and warm, can not be mixed with urine or water.

Question 22

Sigmoidoscopy

Answer 22

direct visualization; every 5 years, start screenings at 50 yo. Visualing anus canal, rectum, and sigmoid canal

Question 23

Colonoscopy

Answer 23

direct visualization; every 10 years; moves up farther in rectum than sigmoidoscopy.

Question 24

EGD

Answer 24

direct visualization; upper GI. looks at esophagus and stomach. Scope is inserted through mouth. Purpose to do tissue biospys

Question 25

KUB

Answer 25

flat plate- basic xray, can detect gall stones, distended bowels

Question 26

Barium swallow/Enema

Answer 26

inserted through rectum or drink barium solution. Remain upright and rotate side to side. PUSH fluids bc barium can cause constipation

Question 27

Computed Tomography (CT)

Answer 27

gives 3 dimensional picture, drink IV liquid. so assess for iodine or shellfish allergies. Creatinum levels needed before. Might feel nausea or warmth, push fluids to flush contrast out of body

Question 28

Magnetic resonance imaging (MRI)

Answer 28

sensitive test, just using resonance. May receive dye but no iodine dye. Assess patient has no metal on body, jewerly, etc

Question 29

Short term constipation

Answer 29

recently developed and resolved quickly, change in lifestyle, change in diet, etc

Question 30

Chronic constipation

Answer 30

develop related to chronic illness, lower level of peristalsis, depress, Parkinson’s, hyperthyroidism, person who frequently uses laxatives

Question 31

CM

Answer 31

• Infrequent stools >3 days
• Difficulty defecating
• Hard feces
• Pain

Question 32

Enemas

Answer 32

instilling/ running fluids into rectum into colon

Question 33

Fecal impaction

Answer 33

stuck feces, hard stool stuck in rectum.

Question 34

CM of fecel impaction

Answer 34

• unable to pass stool
• oozing loose stool
• anorexia
• cramping
• rectal pain

Question 35

Danger of fecel impaction

Answer 35

obstruction - EMERGENCY, needs surgery.
vagal stimulation - get gloves, lubricant, position patient, insert finger into rectum to feel hard stool. notify provider

Question 36

Diarrhea

Answer 36

passage of liquid unformed stool.

Question 37

Dangers of Diarrhea

Answer 37

• fluid volume deficit
• metabolic acidosis
• skin breakdown

Question 38

bowel incontinence

Answer 38

this is the inability to control the passage of feces and gas

Question 39

causes of bowel incontinence

Answer 39

neuromuscular disease or any of the problems that lead to diarrhea

Question 40

2 dangers of bowel incontinence

Answer 40

skin breakdown and social embarrassment

Question 41

3 treatment options for bowel incontinence

Answer 41

protect skin (skin moisture barriers, etc.), find ways to avoid social embarrassment, bowel training

Question 42

hemorrhoids

Answer 42

blood vessels that sense if stool or gas needs to pass can enlarge and become irritated, causing