Bowel Eliminstion

Question 1

Internal sphincter

Answer 1

• autonomic control

- when relaxed ales stool to travel from sphenoid colon to rectum

Question 2

External sphincter

Answer 2

• skeletal muscle, able to control from toddler age

- need for continence of stool

Question 3

Constipation

Answer 3

• stool becomes hard,dry, and difficult to pass through the body
• decrease in # of stools
• decrease in pattern and consistency

Question 4

Vasalva Maneuver

Answer 4

• voluntary contraction of abdominal muscles to push stool
• don’t not do with: cardiac pt’s, eye surgery pt’s, or neurosurgery
• may stimulate A Vagal response lowering HR

Question 5

Hemorrhoids

Answer 5

• dilated veins in anal area
• internal(can’t see from outside)
• external( can see from outside)
• obesity, pregnant, liver disease, and constipation can be causes

Question 6

Tap water and saline enema

Answer 6

• 750-1000mL
• work by dis tending the bowel, increases the tone, and stimulated peristalsis and dedication

*choice enema for children is saline

Question 7

Soap suds enema

Answer 7

• 750-1000mL
• tap water enema with a pack of soap suds added to it
• soap is an irritant when in the colon(promotes peristalsis)

Question 8

Hypertonic enemas(fleets)

Answer 8

• 120-150mL

- draws fluid into the colon and distended the colonq

Question 9

Inserting enema

Answer 9

• lubricate and insert 3-4” for adults
• in bed laying on left side with upper leg flexed forward

*do not give enema while on toilet

Question 10

Height of enema bag

Answer 10

The higher you hold the bag, the more vigorously the solution will go in the patient

Question 11

“enemas until clear”

Answer 11

Outflow that comes out of patient should be clear

Question 12

Rule of 3

Answer 12

After 3 enemas if stool not clear, use no more and call provider

Question 13

Oil retention emema

Answer 13

• 120 mL
• mineral oil gets into feces and softens it, causing easier elimination
• doesn’t produce peristalsis

Question 14

Fecal impaction

Answer 14

A hardened fecal mass that can’t be passed/evacuated from the rectum

Question 15

Digital removal of stool

Answer 15

Use of two fingers to go into rectum to break apart fecal mass

Question 16

Medicinal enemas

Answer 16

To deliver medication to the rectal mucosa

Question 17

Documentation

Answer 17

• type of enema
• amount given
• results of enema
• abdominal assessment
• patient tolerance

Question 18

Diarrhea

Answer 18

-passage of stools that are liquid and unformed

Question 19

Fecal incontinence

Answer 19

• don’t have the ability to control your bowel movements

- more common in women(weakened pelvic muscles)

Question 20

Clostridium difficile

Answer 20

• causes diarrhea
• relapse occurs in 20% of patients
• elderly at increased risk of serious outcomes
• overgrowth due to antibiotic therapy
• spreadable
• treatments include metronidazole(Flagyl)

Question 21

Peristalsis

Answer 21

• rhythmic contractions of the GI tract to move food and fluid through the GI system
• strongest one hour after meal time