Bowel Elmination Flashcards
of servings of fiber each day
5
2 positions for enemas
left side laying or knee- chest
4 types of bowel sounds
Normal
hyperactive
hypoactive
absent
a cathartic is a substance
that accelerates defecation
a colostomy close to the sigmoid colon will produce
solid feces.
A fiberoptic endoscope, a long, flexible tube with a light and lens, is introduced through the mouth and advanced for direct visualization of the esophagus, stomach, and duodenum.
Esophagogastroduodenoscopy (EGD)
a mixture of fiber, undigested food, shed epithelial cells, inorganic material (e.g., calcium and phosphates), bacteria, and water. Small amounts of fat may be present.
feces
A person can increase the pressure to expel feces by contracting the abdominal muscles (straining) while maintaining a closed airway (e.g., holding the breath). This is called the
Valsalva Maneuver
a response to infection or unusual foods.
Acute diarrhea
A rigid metal scope or a flexible fiber-optic scope is used to visualize the anal canal, rectum, and sigmoid colon.
Sigmoidoscopy
a surgical procedure that brings a portion of the colon through a surgical opening in the abdomen
colostomy
a surgically created opening for elimination of digestive waste products
a bowel diversion
are dilated blood vessels in the anal canal
hemorrhoids
are large-volume enemas. The volume causes intestinal distention and leads to rapid evacuation of stool.
Hypotonic and isotonic enemas
are usually smaller volume (2.5–4 oz or 70–120 mL). attracts water into the colon, causing distention and stimulating peristalsis and defecation.
Hypertonic enemas
As long as the person passes stools without excessive urgency (needing to rush to the toilet), with minimal effort and no straining, without blood loss, and without the use of laxatives, you can regard bowel function as
normal
Auscultate before
palpitation
Because most of the ______ is absorbed from the feces in the________, drainage at this level is ______ and continuous. The patient must wear an ostomy appliance at ____ times to collect the drainage.
water
large intestine
liquid
all
Bowel assessment includes
inspection, auscultation, palpation
brings a portion of the ileum through a surgical opening in the abdomen, bypassing the large intestine entirely.
ileostomy
broccoli, onions and beans can cause
gas
Bulking agents (laxatives) are
non-foods, high in fiber
Chronic constipation: lasts for
3 months and may persist for years
Chronic diarrhea: persists for
more than 1 month.
Chronic diarrhea: persists for
more than 1 month.
Chronic pressure on the veins within the anal canal, as with prolonged sitting or retained feces, can cause
hemorrhoids
Colonoscopy prep:
strong cathartic and laxative
clear liquid diet (no red or purple) 24048 hrs prior
NPO after midnight before exam
Direct visualization studies are_________procedures and are conducted by a gastroenterologist, who inserts various instruments (e.g., endoscopes) to examine the interior of the GI tract.
invasive
Direct visualization studies are_________procedures and are conducted by a gastroenterologist, who inserts various instruments (e.g., endoscopes) to examine the interior of the GI tract.
invasive
Encourage a daily intake of ___ to ___g of fiber to attract water into the stool, and promote peristalsis.
25 to 30
Enemas may be classified as
- Cleansing
- Retention
- Return-flow (Harris flush)
external anal sphincters are
voluntary controlled (about the age of 3)
gives feces its brown color.
bile pigment
Good fiber sources
fresh fruits and vegetables (especially raw), whole-grain foods, flaxseeds, popcorn, dried beans, peas, and legumes.
how long to listen in a quadrant before determining absent bowl sounds
3-5 min (pp says 2 min)
Identify the factors that affect bowel elimination.
Age • Stress • Dietary intake • Fluid intake • Activity • Medications • Surgery • Anesthesia • Pregnancy • Pathological conditions (e.g., food allergies and intolerances, diverticulosis, diverticulitis)
If passage through the colon is slowed… More _____ is ________ from the feces and stool becomes
water
reabsorbed
dry and hard
If transit time through the colon is faster than normal….._____ water is _______ and stools are
less
reabsorbed
watery
in abdominal assessment, the order of the exam is
inspection, auscultation, percussion, and palpation.
Indirect visualization studies are ________ views of the lower GI tract
radiographic (x-rays)
Internal anal sphincter are
involuntary controlled
is the presence of a hardened, dry, fecal mass in the rectum.
Fecal impaction
is useful in detecting lower GI disease. It is also often used for cancer screening instead of a sigmoidoscopy, because it provides better visualization of the colon. This is the preferred test for clients with suspected problems above the level of the sigmoid colon.
colonoscopy
kock pouch is a _________ ileostomy because it allows the patient to ________
continent
drain the pouch several times a day and not have to wear a bag
large intestine also known as the
colon
live in the cecum. They come to the anal area to deposit eggs during the night and migrate back up through the rectum during the day.
pinworms
low-fiber foods ______ peristalsis
slow
Medications that cause constipation
opioids
antacids
iron
Medications that cause constipation
opioids
antacids
iron
diuretics
Medications that cause diarrhea
antibiotics
too much laxatives
Minimum fluid intake for healthy bowl function
6-8 8oz glasses (1500, 2000 ml)
Names of some bulking agents
Metamucil, citrucel, FiberCon
Normal bowel sounds are (description) and how many should you hear
high pitched
5-15 gurgles per min
Occult blood is
not seen (hidden)
occurrence of intestinal blockage in the absence of an actual physical obstruction
Paralytic ileus
potential complications of direct visualizations:
perforation
Prevention measures for C-diff
hand hygiene - soap and water
PPE
Killing spores on surfaces
Promoting healthy defecation
regular schedule for eating
adequate fiber intake
fluids
activity
Provides direct visualization of the rectum, colon, entire large intestine, and distal small bowel.
Fiber-Optic Colonoscopy
reabsorption of water from chyme in the large intestine results in a semisolid mass known as
feces
small sac-like pouches in the mucosa, in which fecal matter becomes trapped
Diverticulosis
small sac-like pouches in the mucosa, in which fecal matter becomes trapped and can be caused by
Diverticulosis
low fiber diet
Tape for pinworms is used to assess presence of _______. Done in the _______
eggs
morning
The closer the colostomy is to the ascending colon and the ileocecal valve (between the small and large intestine)
the more liquid and continuous the drainage will be.
The effluent, also called
fecal matter
The ileum joins the
small and large intestine
the introduction of solution into the rectum to soften feces and distend or irritate the colon, in order to stimulate peristalsis and evacuation of feces.
enema
The location of the colostomy determines
the consistency of the feces eliminated as well as the need to wear an ostomy appliance
The process by which the bowel eliminates waste is called
defecation
The______ in the bowel the colostomy is placed (i.e., the closer to the rectum and anus), the more ______ the effluent.
lower
solid
Total bilirubin lab value
0.1 - 1.0
Treatment for D-diff
depends on on strain but antibiotics and in severe stool transplant
type of surgery done to remove part of your large intestine called your colon. Once the affected part is removed, the remaining ends are joined together
hemicolectomy
Valsalva Maneuver cautioned in clients with ____, ____, ____ or because it can do what?
heart disease, glaucoma, increased intracranial pressure, or a new surgical wound
increases pressure within the abdominal cavity, raises blood pressure, and is associated with an increased risk for cardiac arrhythmias.
What are the major functions of the large intestine?
absorption of water, vitamins, and minerals.
What are the major functions of the small intestine
digestion and absorption of carbohydrates, fat, and protein.
what do bulking agents do or fiber in general….
attracts fluid into the colon, and the increased bulk of the stool stimulates the urge to evacuate
What does a healthy stoma look like?
colored from deep pink to brick red regardless of skin color and is shiny and moist at all times. The stoma will protrude above the level of the abdomen by approximately 0.5 to 1.0 inches.
what does yogurt do to peristalsis
stimulates and promotes healing of intestinal infections
What type of of OTC laxative is best at providing relief of constipation among older adults
Bulking agents
Why is skin care around a stoma so important?
essential to prevent skin breakdown, which may lead to infection, discomfort, and leakage of ostomy output from around the appliance.
_________ drugs are not used for acute diarrhea
antidiarrheal - because you want it out