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Fundamentals Ch 30 > Ch 30 bowel > Flashcards

Ch 30 bowel Flashcards

1
Q

The bacteria interact with the chyme, which produces a gas called

A

Flatus

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2
Q

____ or stretching out the intestinal walls and making them appear inflated stimulates the walls stretch receptors and sends impulses to the central nervous system which turn on signals to the muscular walls of the sigmoid colon causing the rectum to contract

A

Distention

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3
Q

Infants will normally have bowel movements ____

A

Daily

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4
Q

Children will accomplish voluntary control of elimination between the ages ___ and ___ years after their neuromuscular structures developed

A

2 and 3

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5
Q

Peristalsis decreases as the individual ages making the elderly individuals more prone to ____ or hard stools that are difficult to pass

A

Constipation

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6
Q

You must make certain your patient has had a bowel movement at least every ___ says to prevent constipation

A

3

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7
Q

____ is the process of bowel elimination

A

Defecation

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8
Q

The urge to defecate typically occurs around ____ minutes to ___ hour(s) after eating

A

30 min- 1Hr

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9
Q

Newborns typically have black shiny sticky stools called ____

A

Meconium

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10
Q

Several liquid or watery stools per day are classified as

A

Diarrhea

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11
Q

A change in bowel habits can indicate

A

Cancer

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12
Q

To determine the presence of occult blood a _____ year must be performed via stool sample

A

Guaiac test

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13
Q

Documentation of bowel elimination should always include
1.
2.

A

Color

Amount

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14
Q

Stool that appears fluffy, floats on water, and has a foil odor due to an abnormally high content of undigested fat and is called

A

Steatorrhea

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15
Q

Stool that is pale or clay colored indicated a lack of bile in the intestine which may be due to liver or gallbladder disease. Can also cause stool to be white

A

Know

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16
Q

Small amounts of bright red blood will indicate bleeding or hemorrhage of the colon

Larger amounts of bright red blood will indicate bleeding or hemorrhage of the colon

Large amounts of maroon colored blood indicates bleeding from small intestine
Stool that is black and tarry with a foul odor indicates bleeding from the stomach, blood has been partially digested giving it a black tarry appearance called Malena

A

Know

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17
Q

_____ blood is visible to the eye

A

Frank blood

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18
Q

____ blood is hidden or not visible

A

Occult blood

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19
Q

When doing a focused assessment to determine objective signs what do you do first

A

Assess the shape of abdomen

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20
Q

After checking the abdominal shape what do you do next during an assessment

A

Auscultate the Bowel sounds using the diaphragm surface and listen in all 4 quads and should be assessed once per shift

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21
Q

Name the bowel sound

Soft gurgles, irregular clicks, between 5 and 30 per minute

A

Normal bowel function

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22
Q

Name the bowel sound

Fewer than 5 per minute

A

Hypoactive

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23
Q

Name the bowel sound

More than 30 per min or continuous

A

Hyperactive

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24
Q

Name the bowel sound

Excessively loud gurgling may be high pitched and tinkling in one quad and absent or decreased in the LLQ

A

Borborgymi

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25
Q

_____ sounds May indicate hunger or if not hungry can indicate bowel obstruction

A

Borborgymi

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26
Q

____ May he heard when patient has diarrhea

A

Hyperactive

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27
Q

____ May indicate constipation

A

Hypoactive

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28
Q

An absence of bowel sounds indicated a problem and should be reported to

A

The health care provider

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29
Q

Avoid palpating the abdomen until you have assessed the bowel sounds because palpation may stimulate bowel sounds that we’re not there naturally

A

Know

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30
Q

A patient with severe constipation may complain of loss of appetite known as

A

Anorexia

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31
Q

Elderly people who are not physically active are prone to

A

Constipation

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32
Q

What are some factors that contribute to constipation

A
  1. Decreased activity level
  2. Changes in food intake
  3. Decreased fluid intake
  4. Medication side effects
  5. Surgery
  6. Pregnancy
  7. Depression
  8. Aging
  9. Laxative overuse
  10. Nerve damage or impairment
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33
Q

Which part of the stool do you obtain a sample from

A

Middle

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34
Q

How much fiber should you have daily

A

25-35 g of fiber qd

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35
Q

Nursing interventions for constipation

A
  1. Increase activity
  2. Increase fluid and fiber intake
  3. Provide privacy
  4. Assist with positioning
  5. Admin medications
  6. Admin enemas
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36
Q

Fluid intake should be maintained between ____ and ____ mL per day

A

1,500 to 2,500 mL

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37
Q

Stool softeners and those that add bulk are safer than using laxatives that stimulate peristalsis

A

Know

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38
Q

How many days should you change a face plate or wafer of ostomy

A

3-5 days

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39
Q

What is the temp for water when doing enema

A

105-110 F

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40
Q

How full should a colostomy bag be when you change it

A

1/3-1/2 full

41
Q

Large volume enema is ___-____ amount of water

A

500-1000 ML

42
Q

Continent ileostomy has to be changed every ____-___ hours

A

4-6 hours

43
Q

What position do you put the patient in before performing enema

A

Left lateral sims

44
Q

How long should you hold the enema before elimination

A

5-15 mins

45
Q

When the vagus nerve is stimulated it can drop the heart rate as low as 30 to 40 bpm and cause constriction of the bronchioles of the lungs

A

Know

46
Q

Signs and symptoms of vagus nerve stimulation

A 
Sxs 
Chest pain
Chest heaviness
SOB or inability to breathe 
Dizziness
Feeling like going to faint 
Nausea

Signs
Pallor
Clammy skin
Pulse rate under 60

Stop admin enema or removing impaction

47
Q

If patient has any signs or symptoms of vagus nerve stimulation you should

A 
Stop the enema 
Remove tube from rectum
Place patient in supine position
Assess pulse rate, skin color, and whether or not the patient is diaphporetic 
Call for assistance but don’t leave pt 
If pulse is below 60 place the patient in the shock position with head lower than feet 
Asses BP 
Supply oxygen if needed
48
Q

How far should you insert an enema

A

4-6 inches

49
Q

An ____ is a blockage of the movement of feces through the intestine by a mass of very hard stool. May occur in rectum, sigmoid flexure, or any part of large colon

A

Impaction

50
Q

What is a common cause of constipation-impaction In elderly adults

A

Abuse of laxatives

51
Q

Sometimes small amounts of diarrhea is a indication of

A

Impaction

52
Q

Small amounts of liquid stool seepage or just smears in the underwear are more indicative of

A

Fecal impaction

53
Q

If an impaction is not relieved an obstruction or perforation of the bowel wall can occur

A

Know

54
Q

When your patient has a fecal impaction it typically requires a digital removal before a cleansing enema

A

Know

55
Q

To make the procedure of fecal impaction removal less painful it is helpful to instill an oil retention enema ____ hr prior to digital removal

A

1

56
Q

____ is a persistent desire to empty the bowel when no feces are present causing ineffective straining efforts

A

Tenesmus

57
Q

What three age groups dehydrate quicker than young or middle aged adults so

A

Elderly; infants; and small children

58
Q

____ that occurs frequently or lasts a long time can lead to fluid and electrolyte loss

A

Diarrhea

59
Q

Factors contributing to diarrhea

A
  1. Lactose intolerance
  2. Med side effects
  3. Anxiety and stress
  4. Diverticulosis
  5. Inflammatory processes
  6. Food allergies
60
Q

What can occur if a barium enema is not passed

A

Fecal impaction

61
Q

____ is the destention of the abdomen or intestines Bc of gas

A

Typanites

62
Q

____ means burp/belch

A

Eructation

63
Q

____ and ____ is used to identify microorganisms infecting the stool and the antibiotics that will kill the microorganisms

A

Culture and sensitivity

64
Q

___ and ___ test for presence of parasites and worms and their eggs

A

Ova and parasites

65
Q

You should obtain a clear liquid diet during the first 24 hours of diarrhea caused by infection and inflammation

During the first 24 hours avoid serving extremely hot or cold liquids as they increase peristalsis

If diarrhea lasts longer 24-36 hours, full liquids along with any type of cooked fruits and veggies such as apple sauce and carrots can be given

A

Know

66
Q

___ ___ is a common treatment for diarrhea

A

Apple pectin

67
Q

Why do we check maconium stool on newborns

A

For drug test

68
Q

____ ____ is where the voluntary control is lost

A

Fecal incontinence

69
Q

Times to assist the patient with the bed pan

A
  1. When the patient arises each day
  2. After each meal
  3. Anytime the patient says that his or her bowels have to move
70
Q

It is recommended to train the bowels to move within ___ hour after breakfast. The first meal of the day stimulates peristalsis

A

1 hour

71
Q

____ is expelled intestinal gas

A

Flatus

72
Q

____ is excessive has in the GI tract

A

Flatulance

73
Q

What can cause flatulance

A

Laughing, chewing gum, yeast bread

74
Q

A new stoma should be pink to red, shiny and moist.

Pallor or cyanosis or a dusky color indicates impaired blood supply, black depicts necrosis

A

Know

75
Q

The correct size will fit around around the stoma and allow only a ___ to ___ inch of periostomal skin

A

1/16 to 1/8

76
Q

Colostomies May be irrigated to evacuate stool due to contipation or irrigation may be used postoperatively for stoma locates In descending or sigmoid colon

A

Know

77
Q

The goal when irrigating a descending or sigmoid colostomy, evacuate at the same time each day.

A

Know

78
Q

Most common medicated enema is

A

Kayexalak enema

79
Q

What is the function of return flow enema

A

Remove gas

80
Q

What enema softens hard stool. Wait 30 mins before elimination

A

Oil retention enema

81
Q

How high should the enema bag be above the patient

A

12-18 inches above hip level

82
Q

Hold the rectal tube in place for ___

A

20 sec

83
Q

The cleansing enema for small children is

A

100-250 mL

84
Q

The amount for a cleansing enema for school age children is

A

250-500 mL

85
Q

What’s the amount for a small vol enema

A

120 mL

86
Q

Tap water enema

A

3

87
Q

Rectal tube

A

22-32

88
Q

Insert the enema ___-___ into the rectum

A

3-4 inches

89
Q

If the patient complains of cramping during enema clamp the tubing for ___-___ seconds instruct the patient to take deep slow, breathes pursed lips or lower the container to decrease flow

A

15-30

90
Q

Cover the patient and instruct them to hold the enema solutions for approx __-___ min to improve effectiveness of enema

A

5-15 min

91
Q

Raise the bed 80-90 degrees making certain that toilet tissue and call light is within reach

A

Know

92
Q

When admin. Prepackaged enema encourage the patient to hold the solution for ___ to ___ min

A

5-10 min

93
Q

For oil retention enema the patient should be instructed to hold the oil for at least ___ min

A

30

94
Q

When obtaining a stool specimen for culture and ova and parasites obtain ___ to ___ inches of formed stool

A

1-2 inch

95
Q

What position should you use when removing a fecal impaction

A

Left lateral sims

96
Q

When removing a fecal impaction you should generously lubricate your ___ finger to reduce discomfort

A

Index finger

97
Q

When doing a fecal impaction removal flex the fiber toward the center of fecal mass, allowing you to break up the mass so it can be removed

A

Know

98
Q

When changing a patients ostomy appliance, if patient is unable to use toilet what position should you place patient in

A

Low semi Fowler’s

Fundamentals Ch 30 (1 decks)

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