Ch 47: Bowel Elimination - SP Assessment Flashcards
Some common clinical manifestations of altered bowel function are:
- Bloating
- Flatulence
- Abdomincal discomfort or pain
- Nausea and Vomiting
Some clinical manifestations of bowel DISORDERS are:
- Diarrhea
- Incontinence
- Constipation
- Impaction
Give examples of Objective and Subjective data regarding Incontinence.
- Objective data
- Patient soiling linen or clothes
- Subjective data
- Patient may or may not recognize the occurrence of bowel movement due to mental status
Give examples of Objective data regarding Constipation
- Hypoactive bowel sounds
- Extended time gap between bowel movements
- Excessive straining
- Hard feces
- Abdominal distention
Give examples of Subjective data regarding Constipation
- Rectal pain
- Abdominal cramping, pain, and/or pressure
- Urgency
- Anorexia
- Headache
Give examples of Objective data regarding Impaction
- Continuous leaking of stool, a common sign of impaction, resulting from the liquid stool above the area of the impaction seeping around the fecal mass
- Palpation of fecal mass by digital exam
- Abdominal distention
Give examples of Subjective data regarding Impaction
- Rectal pain
- Abdominal cramping, pain, and/or pressure
- Anorexia
What is the order of abdominal assessement?
- Inspection
- Auscultation
- Palpation
Abdominal inspection involves observing the…
- abdomen for:
- Symmetry (all quadrants are equal)
- Position of umbilicus
- Contour (flat, round, protuberant, as in pregnancy or obesity)
- Distention (protuberant abdomen with tight skin)
- Presence of any scars, stomas, or lesions
- Stool for
- Consistency
- Color
- Presence of blood or mucus
Describe normal bowel sounds
- High-pitched
- Soft gurgling or clicking
- Occur 4-12 times per minute
Describe abnormal Hyperactive bowel sounds
- High-pitched
- Loud
- Growling
- Occur 12 to more than 30 times per minute
Describe abnormal Hypoactive bowel sounds
- Slow
- Sluggish
- Occur less than 5 times per minute
Abscent bowel sounds are defined as…
What does this indicate?
- Definition
- No sound for five full minutes
- Indication
- obstruction or paralytic ileus
- Requires immediate medical attention
Abdomincal paplation involves…
- light pressure over the abdomen to assess for:
- Masses
- Pain
- Rigidity
- Pt reported pain sensitve areas are saved for LAST
What are the two assessement tests for fecal matter?
- Stool Culture
- Fecal Occult Blood Test
How is a Stool Culture performed?
A small feces sample is smeared onto a special medium for growing microorganisms.
Why is a Stool Culture ordered?
To detect abnormal microorganisms that can cause diarrhea
When is a Stool Culture ordered?
- Prolonged diarrhea
- Blood or mucus present in loose stools
What does a positive Stool Culture indicate?
Indicates intestinal presence of pathogens in the sample.
How is a Fecal Occult Blood Test performed?
A small feces sample that is exposed to a chemical indicator that changes color with exposure to blood.
Why is a Fecal Occult Blood Test ordered?
To detect microscopic amounts of blood in the feces.
When is a fecal Occult Blood Test ordered?
- Routine screening for colorectal cancer
- Suspicion of certain intestinal disorders, such as:
- Colon polyps
- Ulcerative colitis
- Crohn’s disease
- GI tract bleeding
What does a positive Fecal Occult Blood Test mean?
- presence of blood in stool;
- additional diagnostic testing may be necessary.
What are the three types of Gastrointestinal Diagnostic Studies?
- Barium
- Endoscopic (EDG)
- Colonoscopy
What is a major contraindication of barium studies?
Patients with renal disease
What are the two types of Barium studies?
Upper and Lower GI series
If an upper and lower GI series is ordered, which must be done first? Why?
- Lower GI must be done first as it would not effect the Upper GI results
- However, if the Upper GI were done first, it would effect the Lower GI series
How is an Upper GI Series performed?
- Barium is swallowed.
- Barium coats intestinal lining, making anatomic structures visible.
- Radiographic (X-ray) images are taken.
What is the purpose of an Upper GI Series?
- Visualizes upper digestive tract.
- Used to diagnose upper GI diseases and conditions such as:
- Ulcers
- Tumors
- Hiatal hernias
- Scarring
- Blockages
How is a Lower GI Series performed?
- Barium is inserted into colon via an enema (lower GI).
- Barium coats intestinal lining, making anatomic structures visible.
- Radiographic (X-ray) images are taken.
What is the purpose of a Lower GI Series?
- Visualizes the colon and rectum.
- It is used to diagnose conditions such as:
- Abnormal growths
- Ulcers
- Polyps
- Diverticula
- Colon cancer
What is an EGD?
It is the collective term for a procedure that includes esophagoscopy, gastroscopy, and duodenoscopy
What is the puprose of an EGD?
- It is used to diagnose upper GI conditions in patients with:
- Swallowing difficulties
- Vomiting
- GI bleeding
- Gastric reflux
- Abdominal or chest pain
- Abnormalities seen on X-ray
How is an EGD performed?
The endoscope is inserted into the mouth, down the throat, and into the stomach.
What is the purpose of a Colonoscopy?
- Performed to visualize the lower GI tract, including the anus, rectum, and colon.
- It is used to:
- Screen for colorectal cancer
- Assess for complaints of abdominal pain, bleeding, and weight loss
How is a colonoscopy performed?
The endoscope is inserted into the anus and slowly guided into the rectum and colon.
Impaction may occur secondary to
prolonged constipation.
It is important that palpation be performed last because
it alters peristalsis.
Auscultation of the abdomen focuses on listening to bowel sounds to determine whether they are
normal, hyperactive, hypoactive, or absent.
