bowel elimination ch.47

Question 1

regular elimination of bowel waste products

Answer 1

is essential for normal body functioning

Question 2

alterations are early signs

Answer 2

problems in the gastrointestinal tract or other body systems

Question 3

scientific knowledge base

Answer 3

mouth 
esophagus
small intestine
large intestine 
anus 
defecaction

Question 4

factors influencing bowel elimination

Answer 4

• age
• diet
• fluid intake
• physical acitivty
• psychological factors
• personal habits
• positon during defecation
• pain
• pregnancy
• surgery and anesthesia
• medications
• diagnostic test

Question 5

common bowel elimination problems

Answer 5

• constipation
• diarrhea
• incontinence
• flatulence
• hemorrhoids

Question 6

bowel diversions and other procesures

Answer 6

ostomies

iieoanal pouch anastomosis

Question 7

nursing process: assessment

Answer 7

through pt. eyes
nursing history

physical assessment

• mouth
• abdomen
• lab texts
• fecal specimens
• diagnostic exminations

Question 8

nursing diagnosis

Answer 8

some diagnoses that apply to pt. with elimination problems include:

• bowel incontinence
• constipation
• risk for constipation
• diarrhea
• lack of knowledge of dietary regime

Question 9

planning

Answer 9

Goals and outcomes:

• incorporate elimination habits or routines
• reinforce routines that promote health
• consider preexisting concersn

setting priorities
- patients often have multiple diagnoses

teamwork and collaboration

Question 10

cathartics vs laxatives

Answer 10

cathartics have stroner and more rapid effect on the intestines than laxatives

Question 11

enemas

Answer 11

cleansing enemas

• tap water
• normal saline
• hypertonic solutions
• soapsuds

oil retention
other types of enemas: carminative and kayexalate

Question 12

enema admin

Answer 12

• sterile technique unnecessary
• wear gloves
• explain the procedure, positioning, precautions to avoid discomfort, and length of time necessary to retain the solution before defecation

Question 13

digital removal of stool

Answer 13

• use if enemas fail to remove an impaction

- last resort in manging severe constipation

Question 14

inserting and maintaining a nasogastric tube

Answer 14

categories of nasogastric (NG) tubes

• fine-or small-bore for medication administration and enteral feedings
• large- bore (12 french and above) for gastric decompression or removal of gastric secretions

clean technique
maninting comfort: assessment for inflammation
maintain patency

Question 15

continuin and restorative care

Answer 15

• care of ostomies
• irrigating a colostomy
• puching ostomies
• nutritional considerations
• psychological considerations
• bowel training
• maintenance of proper fluid and food intake
• promotion of regular exercise
• managment of the pt. with fecal incontinence of diarrhea
• maintenace of skin integrity

Question 16

safety guidelines for nursing skills

Answer 16

• instruct pt. who self administer enemas to use the side-lying position
• if pt. has cardiac disease or is taking cardiac or hypertensive medication, obtain a pulse rate, because manipulation of rectal tissue stimulates the vagus nerve and sometimes causes a sudden decline in pulse rate