Bowel Elimination (Exam 2) Flashcards by Isaiah Smith

Older Adults Care Focus

-Trouble chewing
-Esophageal emptying slows
-Impaired absorption
-Weakened sphincters

How well did you know this?

Not at all

Perfectly

Older Adult Decreases

-Hydrochloric acid
-Absorption of Vitamins
-Peristalsis
-Sensation to defecate
-Lipase to aid in fat digestion

How well did you know this?

Not at all

Perfectly

Constipation

-Symptom not a disease

-Having fewer than 3 BM per week

How well did you know this?

Not at all

Perfectly

Consipation: Symptoms

-Infrequent BM’s
-Discomfort
-Hard, dry stools. Hard to pass

How well did you know this?

Not at all

Perfectly

Constipation: Causes

-Irregular bowel habits

-Improper diet

-Reduce fluid intake

-Lake of exercise

-Certain medications

-Age

-Ignoring the urge

How well did you know this?

Not at all

Perfectly

Older Adults and Constipation

-Lack of MT

-Slowed Peristalsis

-Lack of exercise

-No fluid

-Too much dairy

-Lack of fiber

-Medications

How well did you know this?

Not at all

Perfectly

Complications of Constipation

Hemorrhoids
Anal Fissure
Fecal Impaction
Rectal Prolapse

How well did you know this?

Not at all

Perfectly

Constipation prevention

-High fiber foods
-Drink plenty of water
-Stay active
-Manage stress
-Don’t ignore the urge
-Create schedule

How well did you know this?

Not at all

Perfectly

Laxatives and Cathartics

-Other than bulk forming… Do not take these regularly

How well did you know this?

Not at all

Perfectly

Implementation: Cathartics and Laxatives

-Medications that initiate stool passage

-Short Term

-May be used to cleanse bowl

-Potential harmful effects of overuse. Can cause dependance

How well did you know this?

Not at all

Perfectly

Nursing Care: Enema

-Left laterally sim side

-Hold Enema as long as they can

-Later thing we try. Last resort after

How well did you know this?

Not at all

Perfectly

Enema Precautions and Complications

-Fluid and electrolyte imbalance

-Tissue trauma

-Vagal nerve stimulation

-Abdominal pain/cramping

-Pain

-Perforation

How well did you know this?

Not at all

Perfectly

Impaction

Results from unrelieved constipation and the inability to expel the hardened feces rained in the rectum

How well did you know this?

Not at all

Perfectly

If impaction is not resolved it can lead to

Intestiinal Obstruction

How well did you know this?

Not at all

Perfectly

Most at risk for Impaction

-Debilitated

-Confused

-Unconscious

How well did you know this?

Not at all

Perfectly

Impaction Symptoms

-Inability to pass toll for several days despite the urge to defecate

-oozing of liquid stool around

-Loss of appetite

-N/V

-Distention

-Cramping and Rectal Pain

How well did you know this?

Not at all

Perfectly

Impaction Treatment: Digital Removal of Stool

-Assess

-Digital removal

-Nurse uses finger to break up fecal mass and removed it in sections

-Very painful

-Risks involved

How well did you know this?

Not at all

Perfectly

Diarrhea

Loose watery Bowel Movements

How well did you know this?

Not at all

Perfectly

Diarrhea: Causes

Foodborne pathogens

Food intolerances

Surgery

Testing

Enteral Feeding (Not tolerating)

How well did you know this?

Not at all

Perfectly

Diarrhea: Common Complications

-Skin irritation

-Dehydration

-Nutritional Concerns

How well did you know this?

Not at all

Perfectly

Antidiarrheal Agents

-Decrease muscles tone to slow the passage of feces

-Body absorbs more water

-Must determine cause of diarrhea (Sometimes you want diarrhea)

How well did you know this?

Not at all

Perfectly

Nursing Care: Diarrhea

-Identify the problem and eliminate

-Provide soft digestible foods

-Maintain fluid and electrolyte balance

-Prevent spread… Good hand hygiene

How well did you know this?

Not at all

Perfectly

Fecal Management System

Folly Cath for GI tract

Can be affective but can not stay in for long. Can lead to ulcers and erosion

Nursing Interventions: Maintenance of skin integrity

-Meticulous skin care

-Frequent checks

-Apply skin barrier

-Consult with WOCN

C-Diff

-Health care associated infection. -Spore forming and can live for a very long time

C-Diff: Who is at risk

Anitboitics Elderly Immunocompromised Long term care Previously had it

C. Diff: Complications

Dehydration Kidney failure Toxic megacolon Bowel perforation Death

C.Diff Prevention

-Wash hands w/soap and water -Avoid use of antibiotics -Clean surfaces with clean -Place in CONTACT D

C.Diff Diagnoses and Treatment

Diagnosis: Stool sample 48 hrs Treatment: Plenty of fluids and nutrition Antibiotics Surgery Fecal implantation Probiotics

Bowel Inctontinence

-Inability to control passage of feces and gas from the anus

Bowel Incontinence: Causes

-Muscle or nerve damage -Any physical condition that impairs the anal sphincter function -Large volume stools -Surgery -Rectal Prolapse

Bowel Incontinence: Risk Factors

-Age -Female -Nerve damage -Dementia -Physical Disability

Bowel Incontinence: Treatment

Anti-diarrheals Bulk laxatives

Bowel Incontinence: Complicaitons

-Body image -Skin irritation

Bowel Incontinence: Prevention

-Reduce Constipation -Control Diarrhea -Avoid straining

Flatulence: Symptoms

-Distention -Cramping -Bloating -Pain

Flatulence: Causes

-Constipation -Food -Gi disease -Stress

Nursing Care: Flatulence

Avoid foods that cause gas Eat small and eat slowly Eat more insoluble fiber

Hemorrhoids

Dilated or engorded veins in lining of rectum

Hemorrhoids: Causes

-Increased pressure from straining -External or Internal

Hemorrhoids: Treatment

Treat the problem Topical agents Surgery but high risk

Colon Cancer

#2 leading cause of cancer deaths in the US

Colon Cancer: Risk Factors and Warning Signs

-African Americans -Diet: High intake of red meat or processed meats, low fiber -Obesity -50+ -Lack of PA -Alcohol -FX

Colon Cancer Screening

Start at 45 Want a flex sig q 5 Colonoscopy every 10

Assessment: Nursing History

Head to toe questions

GI tract: Physical Assesment

-Starts at mouth -Abdomen -Rectum

Laboratory Tests

No blood test for most GI disorders Of blood is in stool order H&H

Fecal Specimens

Not sterile

Test for C.Diff

DNA test

Fecal Occult Blood Test

-Check for hidden blood -Ordered to check cancer or evaluate possible causes of anemia -Stool sample from 2 different areas -Often ordered from 3 different occasions -Can be false positives

Goals and Outcomes for Bowel elimnination

-Developing the goal consider the patient as a whole. How long will it take my patient to reach this goal Outcome: Ask yourself what will the patient demonstrate to prove their bowel elimination pattern is normal

Implementation: Health Promotion

Promote Normal Defecation Promote well balanced diet

NG TUBE

On the PT Lecture

Bowel Training

Patients with chronic constipation or fecal incontinence -Set up daily routine -Requires time, patience, and consistency

Bowel Training: Program Includes

-Assessment and Documentation -Choosing Patient-Centered time -Offer fluids to stimulate defecations around normal time -Assistance in using commode -Provide privacy