C9- Elimination GI System Flashcards
Small intestine stools consistency
Loose/watery stools
Large intestine stools consistency
Formed stools
The longer it sits in large intestine- the more formed it is
Valsalva Maneuver definition
Bearing down to defecate
Bearing down to defecate results in
Temporarily lowering cardiac output
Once bearing down ceases, pressure is lessened and
more than normal amount of blood returns to heart resulting in
slow HR and syncope
Factors affecting bowel elimination
Food and fluid intake
Activity and muscle tone
Lifestyle
Psychological variables
Pathological conditions
Subjective nursing assessment
Usual bowel elimination pattern
Any elimination aids used
Recent changes in bowel patterns
Objective nursing assessment
Abdominal assessment (order)
1) inspection
2) auscultation
-use warmed stethoscope
-4 quadrants (1 min per quadrant)
3) Percussion
-normal= tympanic
4) Palpation (light)
Peri-rectal area
-rectum and anus
-skin and mucous membranes
-hemorrhoids
Pain
-use pain scale
Common test for bowel assessment
CBC (complete blood count)
wbc elevated = bowel rupture
Guaiac or hemocult
blood in stool?
test blue= blood
Stool for O&P (ova and parasites)
sample
X-ray (NPO after midnight)
upper gi
lower gi
MRI and CT scans
Sigmoidoscopy
Colonoscopy
-clear liquids 24-48 hours prior
- bowel prep
-GoLytely
Common nursing diagnosis for bowl elimination
Constipation
Risk for constipation
Diarrhea
Deficient fluid volume
Dysfunctional gastrointestinal motility
Promoting regular bowel habits (nursing interventions)
Timing
-same time (after meal)
Positioning
-elevate HOB w/ bedpan
Privacy
Nutrition
Exercise
Gastrocolic reflex
Natural reflex that signals your colon to empty food once food gets into your stomach
Constipation
Passage of dry, hard stools
Slow transit time in colon
increased fluid absorption
May experience pain or discomfort
strain
Who is at risk for constipation?
Patients:
On bedrest
especially if taking constipating medications (opioids)
W/ Low fluid or fiber intake
who are depressed
CNS disease or pain in local area
Treatment of constipation (interventions)
Teach nutrition
Teach and plan exercises
Respond to the urge
Research shows
Teach about laxatives
Teach (nutrition)
High fiber foods
Fluid intake
8-10 glasses of fluid a day
fresh water necessary
Teach/Plan (Exercise)
Assist client with identifying realistic routine
movement increases peristalsis
Research shows:
Nutrition, fluids and exercise are effective as medications in controlling constipation
Bulk forming laxives
Magnesium sulfate
Psyllium (Metamucil)
Stool softeners:
For someone needing to avoid strain
Docusate sodium (colace)
Mineral oil
Stimulates peristalsis (laxatives)
Disacodyl (duolax)
Senna
Castor oil
Habitual use of laxatives is a common cause of ________________
CONSTIPATION
Diarrhea categorized by:
> 3 loose stools a day
-intestinal craps
-loss of fluid and electrolytes
Rehydration
Oral if possible
IV if necessary
Probiotics
Replace healthy intestinal flora
Chronic diarrhea
> 3-4 weeks
-need evaluation of underlying cause
-antidiarrheal meds
Bowel diversions
Sigmoid colostomy
Descending colostomy
Transverse colostomy
Ascending colostomy
Ileostomy
Ileostomy
Loose stools
Closer to rectum that stoma is
More formed the BM
