Bowel Exam 3 Flashcards
What is the primary objective of the urinary and bowel elimination review?
Review anatomy and physiology of urinary & bowel elimination
This includes understanding the structure and function of the urinary and gastrointestinal tracts.
What are the segments of the small intestine?
- Duodenum
- Jejunum
- Ileum
These segments play vital roles in digestion and nutrient absorption.
What are the two ring-like muscles that function as sphincters in the rectum and anus?
- Internal sphincter
- External sphincter
These sphincters control the passage of stool.
At what age do children typically gain control over defecation?
By 2 – 3 years old
This is an important developmental milestone for children.
What is the Valsalva maneuver and why should it be cautioned in certain patients?
A maneuver that can cause the patient to vagal (slow heart rate)
Valsalva maneuver – caution pts with heart disease, glaucoma, new surgical wounds, and increased intracranial pressure to avoid bearing down. Performing
Bearing down means that you try to breathe out with your stomach muscles, but you don’t let air out of your nose or mouth. This can be effective when a patient is having supraventricular tachycardia (SVT).
It is important to caution patients with heart disease, glaucoma, new surgical wounds, and increased intracranial pressure.
Name three personal and sociocultural factors affecting bowel elimination.
- Privacy
- Time constraints
- Stress
These factors can significantly influence a person’s bowel habits.
List some medications that can affect bowel elimination.
- Antacids
- Magnesium
- Aspirin
- Antibiotics
- Iron
- Pain medication
- Laxatives
Each of these medications can have varying effects, such as constipation or diarrhea.
What is a barium enema and what is it used for?
An X-ray exam that detects changes or abnormalities in the large intestine
This procedure involves injecting a liquid into the rectum.
What are the normal bowel sounds and their characteristics?
Normal: high pitched, 5 – 15 gurgles per minute
Changes in bowel sounds can indicate various gastrointestinal conditions.
What are the components of a bowel elimination assessment?
- Health history
- Bowel movement patterns
- Appearance of stool
- Changes in bowel habits
- Stoma care (if applicable)
This assessment helps identify potential issues with bowel function.
What is constipation and what are its contributing factors?
Constipation is a symptom, not a disease
Contributing factors include improper diet, reduced fluid intake, lack of exercise, medications, age, and immobility.
What dietary recommendations can help alleviate constipation?
- Increase fiber intake (25 – 30 g per day)
- Adequate fluid intake (1500 mL per day)
- Encourage physical activity
A balanced diet is crucial for maintaining normal bowel function.
What is diarrhea and what are some of its causes?
Passage of loose, unformed, or watery stools
Causes can include viral or bacterial infections, allergies to foods, medications, and surgeries.
What are some nursing interventions for managing diarrhea?
- Encourage hand hygiene
- Educate on foods that can cause diarrhea
- Monitor stools
- Clear liquid diet
These interventions aim to manage symptoms and prevent complications.
What is a colostomy and how does its location affect stool consistency?
A surgically created opening when a portion of the colon or rectum is removed
The location determines whether the output is solid or liquid.
What is the purpose of stoma care?
To assess stoma appearance and preserve peristomal skin
Proper care is crucial to prevent complications such as skin excoriation.
True or False: An ileostomy always produces solid feces.
False
An ileostomy produces watery feces and requires a collection appliance.
Fill in the blank: The _______ maneuver is effective for patients with supraventricular tachycardia (SVT).
[Valsalva]
What is the recommended fluid intake for patients to promote normal bowel function?
1500 mL per day
Adequate hydration is essential for maintaining healthy bowel movements.
Lactulose
is prescribed to lower ammonia levels through stool. - Diarrhea
Kaexylate
is given to lower potassium levels through stool elimination. - Diarrhea. Lower K+
pain meds
1 way to prevent constipation give fliuds
BM not moving?
Give TPN
*active bowel sounds/moving gas = moving bowels
Factors affecting Bm
neurolgical
bacterial
colitis- autoimmune bloody
chrons- autoimmune-unpredictable
Bowel Assessment
-pain level
- listen to bowels- hypo active
-last bm
-distended, give water
LOOK, LISTEN AND FEEL
kid? no bathroom use?
sexual abuse
LISTEN BM
Bowel Sounds
Normal: high pitched, w/ approximately 5 – 15 gurgles every minute
Hyperactive: very high pitched and more frequent than normal. May occur with small bowel obstructions and inflammatory disorders.
Hypoactive: low pitched, infrequent, and quiet. Indicates decreased peristalsis, can indicate constipation.
Absent: no sounds, listen 3 – 5 minutes in each quadrant. Can occur post surgery. May indicate paralytic ileus.
Lab tests
Occult Blood – GI bleed
Intestinal Parasites – tapeworms, etc.
Culture and Sensitivity- antibotic resistence
Cologuard - DNA- risk of colon cancer- screening start at 45
Diagnostic tests
Give consent form!
NPO FOOD/WATER AFTER MIDNIGHT
-give bowel prep
Diagnostic test
barium enema is an X-ray exam thatcan detect changes or abnormalities in the large intestine (colon). The procedure is also called a colon X-ray.
CT scan
no metformin
check bun and creatine levels
no shellfish
MRI
no metal
Esophagogastroduodenoscopy (EGD)
Informed Consent
NPO
Remove dentures
Sedation requirement
Check vitals and gag reflex post procedure
NPO until gag reflex returns
Resume normal activity in 24 hours
Educate bowel perforation or esophageal perforation
Sore throat or hoarseness
Belching, bloating, or flatulence
Colonoscopy
Indicated for GI Bleed (dark blood upper GI, bright red blood from rectum or hemmorrhoid)
interventions
Pain, Potty, Position
Constipation
symptom
Administer laxatives as ordered – Milk of Mag, Magnesium Citrate, Senna
Administer enema as ordered
Digital removal of stool
Encourage fluid intake eight to ten 8oz glasses of water/day
Encourage client not to ignore urge to defecate
Increase fiber intake
Encourage physical activity
Monitor pattern of bowel movements
Constipation what meds
Administering Enemas
Patient positioning
Low volume vs high volume
Retention enemas
Cleansing enemas
Diarrhea
monitor fliuds
monitor electrolytes
worried about dehydration
meds
Laxatives
Cathartics
Antibiotics
Anticholinergics
Aspirin
Antacids
Bowel diversions
Colostomy
Surgically created when a portion of the colon or the rectum is removed, and the remaining is brought through the abdominal wall.
Location of the colostomy determines the consistency of the feces eliminated.
Typically, more solid than ileostomy output.
Typically, not as easily reversed.
ileostomy
Ileostomy
Surgically created opening in the small intestine, usually at the end of the ileum
Bypasses the large intestine entirely
Feces is watery, must wear collection appliance at all times.
Will always have diarrhea – need to drink plenty of water
Lomotil (Loperamide) can be given for too much output. Lomotil slows bowel motility.
Can be reversed most of the time.
Stoma care
Stoma Care
Assess Stoma Appearance
Should be moist and red or pink
Protruding or retracted stomas
Preserve Peristomal Skin
Skin excoriation can cause an ineffective seal between wafer and the skin
Use moisture proof barrier creams and skin care products
Empty pouch as scheduled or when 1/3 full.
Change pouch as scheduled or every 2-3 days.
Assess Patient’s self-care ability
Promote psychological adaptation
colostomy
formed poop normally permanent
illeostomy
can be temporary normally diarrhea
illeostomy
Lomotil (Loperamide) can be given for too much output. Lomotil slows bowel motility.
concern is skin breakdown
