bowel elimination evolve Flashcards
1
Q
Elimination of solid waste products is a normal function of the body and critical to maintaining
A
nutritional status, hydration, and fluid and electrolyte balance
2
Q
bowel elimination may be disrupted by
A
food and fluid intake
various illnesses and diseases
trauma and surgery
medications
immobility
psychological issues
3
Q
The GI system is a series of
A
muscular organs
4
Q
The esophagus is
A
collapsible tube connecting the pharynx to the stomach
5
Q
primary function of the esophagus
A
transport solids and liquids from the mouth, where digestion begins, into the stomach
6
Q
The stomach is located at
A
left upper quadrant of the abdomen
7
Q
The function of the stomach is
A
mix food with digestive juices, causing the chemical and mechanical breakdown of food into chyme before entering the small intestine
8
Q
Chyme is
A
thick fluid mass of partially digested food and gastric secretions that is passed from the stomach to the small intestine
9
Q
The stomach produces and secretes
A
hydrochloric acid, pepsin, intrinsic factor, and mucus
10
Q
hydrochloric acid cause
A
breakdown of the food structures and helps kill harmful bacteria ingested with the foods
11
Q
Pepsin acts to
A
degrade protein
12
Q
Intrinsic factor is needed for
A
the intestines to efficiently absorb vitamin B12
13
Q
Mucus protects
A
stomach lining from damage by gastric acid and enzyme activity
14
Q
The small intestine has _________ _________ _______ functions
A
digestive and absorptive functions
15
Q
The small intestine contain three segments which are
A
duodenum
jejunum
ileum
16
Q
The duodenum has
A
two secretory functions
17
Q
duodenum first secretory function
A
hormones are secreted that trigger the pancreas to release pancreatic juice and bile
18
Q
duodenum secound secretory function
A
protects the intestine by secreting chemicals that neutralize the acidity of the chyme from the stomach before it reaches the jejunum
19
Q
The mid-region of the small intestine is
A
jejunum
20
Q
jejunum, controls
A
carbohydrate and protein absorption
21
Q
The ileum is responsible for
A
absorption of fats, bile salts, and water
22
Q
Contents that remain undigested after passing through the small intestine empty into
A
the cecum in the lower right quadrant of the abdomen
23
Q
The large intestine is
A
the primary organ of bowel elimination
24
Q
The large intestine is composed of
A
cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anus
25
the large intestine is located on
periphery of the abdominal compartment and surrounds the small intestine and other structures
26
Peristalsis is
the mechanism of progressive contraction and relaxation of the walls of the intestine
27
Peristalsis function
forces chyme into the large intestine
28
The colon is made up of
muscular tissue
29
The colon expand and contract to
accommodate and eliminate varying amounts of waste and gas (flatus)
30
The functions of the colon are
absorption, secretion, and elimination
31
Water is absorbed from
indigestible food residue
32
Nutrients and electrolytes, especially sodium and chloride, are absorbed from
digested food that has passed from the small intestine
33
The rectum has folds of tissue that
temporarily hold fecal contents
34
straining of the rectum folds causes
formation of hemorrhoids
35
Hemorrhoids are
swollen and inflamed veins in the anus or lower rectum
36
anal canal help control
bowel continence
37
Defecation is
the final act of digestion
38
in Defecation
solid, semisolid, or liquid waste is expelled by the body is the process of defecation (restroom)
39
the nerves in the rectum are stimulated so
the person becomes aware of the need (urge) to defecate
40
The characteristics of feces vary depending on
diet, illness, medications, and age
41
Diarrhea is
an intestinal disorder that is characterized by an abnormal frequency and fluidity of bowel movements
42
characteristics of diarrhea
Hyperactive bowel sounds, urgency, abdominal pain, and cramping
43
Diarrhea is associated with
disorders that affect digestion, absorption, and secretion in the GI tract
44
Diarrhea is when
Ingested materials pass too quickly through the intestine resulting i decreased time to absorb fluids and nutrients
45
diarrhea causes
allergies or intolerance to food, fluids, or drugs; antibiotic use; cathartic or laxative use; communicable foodborne pathogens; diseases of the colon; diagnostic testing of the lower GI tract; enteral nutrition usage; medications; psychological stress; surgery of the GI tract; and Clostridioides difficile
46
C. difficile
bacterium that causes diarrhea
47
why is c diff dangerous
can lead to life-threatening inflammation of the colon
48
c diff is transmitted by
contact
49
C. diff symptoms
foul-smelling, watery diarrhea three or more times a day for 2 or more days, accompanied by mild abdominal cramping and tenderness
50
Prolonged diarrhea may lead to
nutritional and metabolic disturbances, with resultant fatigue, weakness, malaise, and loss of a substantial amount of fat and muscle tissue
51
Serious fluid and electrolyte losses can cause
nausea, vomiting, headache, confusion, fatigue, restlessness, and muscle weakness and spasms
and risk for skin breakdown
52
Incontinence refers to
loss of voluntary control of fecal and gaseous discharges through the anus.
53
adults older than 65 years of age are more likely to have
constipation
54
Constipation is a complication of
pregnancy and occurs after surgery
55
Constipation is defined as
having infrequent or difficult bowel movements as well as having fewer than three bowel movements per week
56
patients with constipation may experince
e abdominal cramping, pain, pressure, distention, anorexia, and headache.
57
Causes of constipation
Irregular bowel habits, ignoring the urge to defecate, a diet low in fiber or high in animal fats, hemorrhoids, and low fluid intake
58
block nerve impulses to colon causes
change in bowel patterns
59
conditions that slow GI motility or increase water absorption
hypothyroidism, hypercalcemia, or hypokalemia
60
anxiety depression and congnitive impairment causes
change in bowel patterns
61
prologed periods of rest/ no exercise causes
slow GI motility
62
what medication slow colonic action
anticholinergics,
antispasmodics
anticonvulsants,
antidepressants,
antihistamines,
antihypertensives,
antiparkinsonian agents,
bile acid sequestrants
diuretics, antacids,
iron supplements,
calcium supplements,
opioids
63
laxative misuse causes
rebound constipation
64
Older adults may experience slowed peristalsis related to
loss of muscle elasticity
reduced intestinal mucous secretion
low-fiber diet
65
hemorrhoids cause
retention of fecal material and constipation
66
Straining during defecation can
induce elevations in intraocular pressure
increased intracranial pressure
changes in cardiac rhythm
hemorrhoids
67
Valsalva maneuver consists of
bearing down” while holding the breath
68
Valsalva maneuver causes
rise in blood pressure
fall in arterial blood pressure
Dizziness, blurred vision, and fainting can result
69
Impaction refers to
presence of a hard fecal mass in the rectum or colon that the patient is incapable of expelling
70
Impaction is the result of
unresolved constipation
71
Impaction is seen most often in which type of patients
debilitated, confused, or unconscious patients
72
The cardinal sign of impaction is
continuous oozing of liquid stool, with no normal stool
73
impaction causes patient to have
Loss of appetite
nausea
vomiting
distention
cramping
rectal pain
74
Barium used in radiologic examinations contributes to
risk for impaction
75
patient receiving barium for diagnosis or treatment is encouraged to
increase fluids or give laxatives or enemas to ensure the removal of the barium.
76
how to check for impaction
digital examination and palpation of the mass
77
can nurses check for impaction
yes
78
Flatulence is
production of a mixture of gases in the intestine, by-products of the digestive process
79
flatulence mixture is know as
flatus
80
Severe flatulence often is associated with
abdominal distention and severe sharp pain.
81
Flatulence results from
Action of bacteria in chyme passing through the large intestine
swallowed air and gases that diffuse between the bloodstream and the intestine
foods such as cabbage and onions
abdominal surgery, and narcotics
82
walking and rocking may help
relieve pain and promote movement of the gases through the intestines
83
ostomy is
surgically created opening in a GI, urinary, or respiratory organ that is exited onto the skin
84
stoma is
body opening but usually refers to the actual exit point for a GI surgical ostomy, which forms a slight protuberance of mucosa through the skin
85
normal stoma charistirctics
dark pink to red
warm and moist
86
Bowel ostomies are classified as
temporary or permanent and by their anatomic location and technique of stoma construction
87
who needs bowel diversions
patients with conditions that prevent normal passage of feces from the rectum
88
colostomy is surgically created when
portion of the colon (large intestine) or the rectum is removed
89
temporary colostomy is used to
allow the lower portion of the colon to rest or heal
90
Permanent colostomies are placed when
colorectal cancer
the lower digestive tract is removed due to illness or disease
91
Single stomas are created when
one end of the bowel is brought out through an opening onto the anterior abdominal wall
92
transverse colostomy is created in ______ resulting in?
transverse colon/ one or two openings
93
with transverse colostomy appliances
are in place at all times
94
Ascending colostomies in
right side of the abdomen
95
loop colostomy is a
temporary colostomy created in a surgical emergency
right abdomen
96
ileostomy is
surgically created opening in the small intestine
97
Ileostomies may be
temporary or permanent
98
patients with ileostomies have to
wear an appliance continuously and take special precautions to prevent skin breakdown
99
ingestion of _______ ______ diet improves likelihood of normal elimination pattern
high-fiber
100
which type of fiber help keep stool soft
whole grains, fresh fruits, and vegetables
101
recommended amount of daily faiber
20 to 35 g
102
what foods increase colon motility
onions, cauliflower, and beans
103
Food intolerance causes
digestive upset
watery stools
diarrhea
cramps
flatulence
104
Spicy foods produce
diarrhea and flatus in some people
105
what are constipation foods
Cheese, pasta, eggs, and lean meats
106
what foods have laxative effect
Bran, prunes, figs, chocolate, and alcohol
107
Emotional stress affects on digestive process
accelerates the digestive process, and peristalsis is increased
108
Diseases associated with stress include
colitis
Crohn’s disease
ulcers
irritable bowel syndrome
109
Patients with depression may have
slowed peristalsis, resulting in constipation
110
sounds, sights, and odors associated with use of bedpans and bedside commodes, or of shared toilet facilities contribute to
constipation
111
ignoring the urge to defecate causes
constipation and impaction to occur
112
what is the best posture to defecate
squatting
113
Hemorrhoids, rectal surgery, fistulas, and abdominal surgery will cause
patients to suppress the urge to defecate to avoid pain
114
Pregnancy causes
Straining during defecation or the delivery process can result in hemorrhoid formation
115
Prenatal vitamins high in iron increase the risk for
constipation
116
stoppage of peristalsis is called
paralytic ileus
117
paralytic ileus occurs during
surgery due to the anesthesia
118
laxative effect on defecation
ease defecation
119
Types of laxatives include
bulk-forming agents, osmotics, salines, stimulants, and stool softeners
120
Cathartics are
strong laxatives that stimulate evacuation of the bowel by causing a change in GI transit time
121
antibiotics causes
diarrhea
122
Anticholinergic effect?
depress GI motility
123
Opioid analgesics effect?
depress GI motility
124
Histamine antagonists does what
supress secretion of hydrochloric acid
125
Calcium supplements and opioids effect
slow colonic action
126
Iron salts causes
constipation
127
nonsteroidal antiinflammatory drugs (NSAIDs) causes
red or black stools depending on where the bleeding is occurring
128
why does diagnostic tests effect eleminations
patient may be placed on a restricted diet or given cleansing enemas
129
assessment of the GI system include
health history
physical assessment of the abdomen
inspection of the feces
focused diet history
chewing difficulties, medications, illnesses, and food intolerance.
130
Family history is evaluated for
GI cancer, Crohn’s disease, and other GI disturbances with familial links.
131
inspect the patient’s mouth, teeth, tongue, and gums for
sores, dentition, and moisture
132
Poor dentition, mucosal dryness, and mouth sores can cause
pain or make swallowing difficult
133
inspecting abdomen include
contour (shape)
symmetry
bulging, masses, or pulsations
movement
scars, stomas, and lesions
134
auscultation begins in
right lower quadrant and proceeds through each of the remaining quadrants
135
Normal bowel sounds are
irregular, high-pitched, and gurgling and occur every 5 to 15 seconds
136
Hyperactive bowel sounds tend to be
loud, high-pitched, and rushing
137
Hypoactive bowel sounds are
slow and sluggish, with occurrence of fewer than five sounds per minute
138
Absence of sounds of bowel indicaties
obstruction or paralytic ileus
139
Palpation determines
organ size, organ placement, masses, pain, and presence of fluid
140
painful area are palpated
last
141
The abdomen should be
soft, smooth in contour, and pain-free.
142
Laboratory testing can help determine
presence of bleeding, inflammation, or infection
143
stool culture is used along with other tests to detect
parasites in the stool and help determine the cause of diarrhea
144
Stool cultures are ordered if
patient complains of diarrhea for several days or when blood or mucus is noted in loose stools
145
stool sensitivity testing report may identify
causative agent, with appropriate treatment suggestions.
146
fecal occult blood test Tests for
presence of blood in the feces
147
melena is
microscopic (occult blood) or may be easily seen as red blood or black, tar-like stools
148
growths or polyps in the? causes blood to be present
colon
hemorrhoids
anal fissures
intestinal infections
ulcerative colitis
Crohn’s disease
diverticular disease
peptic ulcers
abnormalities of the blood vessels
149
positive FOBT indicates
that blood has been found in the stool
150
The FOBT requires
collection of three small stool samples taken 1 day apart
special diet
151
Foods that affect FOBT are
broccoli, cantaloupe, carrots, cauliflower, cucumbers, fish, grapefruit, horseradish, mushrooms, poultry, radishes, red meat, turnips, and vitamin C–enriched foods and beverages
152
upper GI series (barium swallow) is
radiologic study that defines the anatomy of the upper digestive tract to visualize the esophagus, stomach, and duodenum
153
Upper Gastrointestinal Series find diseases and conditions such as
ulcers, tumors, hiatal hernias, scarring, blockages, and abnormalities of the GI tissues
154
upper GI study risk
radiation exposure
155
before upper gi study you should
stop eating and drinking 4 to 8 hours before test
156
before upper gi study you have to drink
liquid that contains barium
157
barium may cause
constipation and cause the stool to turn gray or white for a few days after the procedure.
158
esophagoscopy is
endoscopic procedure to view the inside of the esophagus
159
gastroscopy is
a procedure to view the inside of the stomach
160
duodenoscopy is
procedure to view the inside of the duodenum
161
esophagoscopy, gastroscopy, duodenoscopy are referred to as
esophagogastroduodenoscopy (EGD).
162
esophagogastroduodenoscopy (EGD)
is when
fiberoptic endoscope, a flexible instrument with a small camera on the end, is passed through the mouth, down the throat, and into the stomach
163
esophagogastroduodenoscopy (EGD)
assists in the diagnosis or clarification of
abnormalities that may have been seen on an x-ray image
164
Upper endoscopies are prescribed for patients with
swallowing difficulties, vomiting, bleeding, gastric reflux, abdominal pain, or chest pain
165
with endoscopies the patient has to stop___ and ____ _ hours before procedure
eating and drinking
8 hours
166
with endosopies the patient recives medications that causes
drowsiness, relaxation, amnesia, and possibly light-headedness
167
after endoscopy patient cannot drive for
12 hours after the procedure
168
Colonoscopy is a procedure performed to visualize
inflamed tissue, ulcers, and abnormal growths
169
Colonoscopy visualize problems in
anus, rectum, and colon
170
Colonoscopy is mainly used to identify
colorectal cancer and diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus, and weight loss
171
with Colonoscopy patient is put on _____ diet for how long?
clear liquid diet for 1 to 3 days
172
before colonoscopy in several hours patient are classified as
NPO
173
Bowel Incontinence symptoms
Sphincter dysfunction, constant dribbling of soft and liquid feces, inability to recognize the urge to defecate, fecal staining of underclothing
174
plan of care to reestablish normal bowel
* Patient will defecate formed stools within 48 hours after colonoscopy.
* Patient will pass soft stools daily during rehabilitation.
* Patient’s episodes of bowel incontinence will decrease within 48 hours after starting a bowel training program.
175
ongoing use of laxatives is associated with
constipation and impaction
predisposition to colorectal cancer
dependency
electrolyte imbalance
176
warm liquid help
stimulate peristalsis and aid in defecation
177
The FOBT is recommended yearly after age
45
178
Sigmoidoscopy and colonoscopy test for
colorectal polyps and early signs of cancer
179
The bedside commode is used most often with
adult patients who can get out of bed but have difficulty with ambulation
180
Early Ambulation stimulates ________ and help_____ _____
peristalsis, maintain function
181
rectal suppository is
drug delivery system that is inserted into the rectum, where it dissolves for medication absorption through the rectal mucosa
182
Types of Enemas
Cleansing enemas
Hypertonic
Isotonic
Oil retention enemas
Medication enemas
Carminative enemas
Return-flow enemas
183
Cleansing, hypertonic, isotonic enma uses
Empty the bowel and remove feces through instillation of fluid.
Primary action: Peristalsis stimulation.
184
Oil retention enemas uses
Lubricate the rectum and colon.
185
Medication enemas uses
Antibiotic or anthelmintic enemas used to treat local infections such as bacteria, worms, and parasites are types of retention enemas.
186
Carminative enemas uses
Provide relief from gastric distention by stimulating peristalsis to improve passage of flatus.
187
Return-flow enemas uses
Provide relief from gastric distention by stimulating peristalsis to improve passage of flatus.
188
enema is
introduction of solutions into the rectum and sigmoid colon via the anus
189
Nasogastric (NG) intubation is necessary when the patient needs
decompression of the GI tract, administration of medication or enteral feedings, compression of internal hemorrhage, or gastric lavage
190
Ostomy appliances are used to
protect skin, collect drainage, and control odor
191
