Ch 47: Bowel Elimination - Vid/PP Notes Flashcards
Defecation reflexes are found…
- There are two
- One in the brain
- One in the spinal cord
Describe the Valsalva maneuver.
- a voluntary contraction of the diaphragm and abdominal muscles, raises intra-abdominal pressure and triggers peristalsis in the colon and rectum, causing relaxation of the internal sphincter.
- When rectal pressure exceeds sphincter pressure, defecation occurs.
- The pushing action of pooping
Changes in usual defecation pattern may signify…
changes in internal function.
Food intolerances result in
- diarrhea
- gas distention
- cramping
Antibiotics can cause…
diarrhea
High calcium antacids and pain (opioid) medications can result in…
constipation
Common causes of constipation include:
- low-fiber diet, particularly diets high in meat, milk, or cheese.
- dehydration.
- lack of exercise.
- delaying the impulse to have a bowel movement.
- travel or other changes in routine.
- certain medications, such as high calcium antacids and pain medications.
- pregnancy.
Common causes of diarrhea include:
- Alcohol abuse
- Intollerance/Allergies to certain foods
- Diabetes
- Some cancers and Diseases of the intestines (such as Crohn’s disease or ulcerative colitis)
- Infection by bacteria
- Laxative abuse
- Medications
- Hyperthyroidism
- Radiation therapy
- Surgery on your digestive system
- Malabsorption
- Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome.
Anti-coagulants result in what coloration to stool?
dark/black color
Antacids result in what coloration to stool?
white/speckled
Where are patients with bowel incontinence at risk for ulcers?
If good hygene is not kept, the moisture of stool can cause skin breakdown
True or False
When assessing bowels, you should palpate the reported painful areas first.
False, do them last.
Barium procedures may be contraindicated for patients with…
impaired renal function
When a Lower and Upper GI serires needs to be done, which comes first and why?
- Lower comes first
- If Upper is done first, it can effects of the lower since the lower is later in directional flow
Inactivity can result in…
- Constipation
- Distention
- Impaction
What three treatments/actions address acute diarrhea?
- Hand hygiene
- Rehydration
- Avoidance of anti-diarrheal medication
What treatment is used for chronic diarrhea?
- fluid and electrolyte replacement
- use of antidiarrheal medications
What is the definition of chronic diarrhea?
Diarrhea that lasts 2-4 weeks
What are somethings we can do to avoid/manage diarrhea?
- Maintain hydration
- Ingest probiotics
- Avoid foods w/ laxative effects
What is the amount of a small volume enema?
<200mL
What is a retention enema?
An enema is held in the bowel for a prolonged period of time so that it has time to perform the desired therapeutic effect.
What are the characteristics to keep in mind regarding a Loop colostomy?
- Temporary procedure
- Located in the transverse colon
- Performed on an emergenct basis
What are the characteristics to keep in mind for an End colostomy?
- Permanent procedure
- Proximal end forms stoma
- Distal end is removed or sewn closed
What are the characteristics to keep in mind regarding a Double-barrel colostomy?
- Reversable procedure
- Bowel is surgically cut and both ends are brought through the abdomen
- Proximal end is functional that excretes effluent
- Distal end is non-functional (though may secrete mucus)
- It is a bowel diversion without connection to the urinary system
What is the BRAT diet and what does it address?
- Banana, Rice, Applesauce, Toast
- Diarrhea
How do opioids address diarrhea?
- Decrease intestinal motility
- Allow more fluid to be absorbed
- Decrease secretion of fluid into small intestines and increase absorption of fluid and salt
Name two opioids that address diarrhea.
- Diphenoxylate (Lomotil)
- Loperamide (Imodium)
What is the difference of effect between laxatives and cathartics?
- Laxative
- Production of soft, formed stool over a period of 1 or more days
- Relatively mild
- Cathartics
- Prompt fluid evacuation of the bowel
- Fast acting and intense
Docusate sodium (colace) and Bisacodyl (Ducolax) are of…
Laxatives
What is the use of stimulant cathartics?
- increase bowel motility
- prep bowel for diagnostic procedures
Biscodyl (Ducolax) is a
Stimulant Cathartic
Carminative enemas provide relif from…
gaseous distention
An enema with kayexalate treats patients with…
dangerously high potassium levels
Lactulose treats patients with…
high ammonia levels
