Ch.31 Bowel Elimination

Question 1

Describe the process of defecation

Answer 1

Defecation (bowel elimination) is the act of expelling feces (stool) from the body.

To do so, all structures of the gastrointestinal (GI) tract, especially the components of the large intestine (also referred to as the bowel or colon ), must function in a coordinated manner.

In the large intestine, 10% or approximately a pint to a quart of water is removed from the remnants of digestion, causing the bowel’s contents to become a consolidated mass of residue before being eliminated.

Question 2

Name components of a bowel elimination assessment

Answer 2

A comprehensive assessment of bowel elimination involves:

1. Collecting data about the client’s elimination patterns (bowel habits)
2. The actual characteristics of the feces.

Question 3

List common alterations in bowel elimination

Answer 3

Constipation
Fecal impaction 
Flatulence 
Diarrhea  
Fecal incontinence.

Question 4

Name types of constipation

Answer 4

Primary: It results from lifestyle factors such as inactivity, inadequate intake of fiber, insufficient fluid intake, or ignoring the urge to defecate.

Secondary: Secondary constipation is a consequence of a pathologic disorder such as a partial bowel obstruction.

Iatrogenic: Iatrogenic constipation occurs as a consequence of other medical treatments.

Pseudo Constipation: Pseudo Constipation may occur in people who are extremely concerned about having a daily bowel movement.

Question 5

Identify measures within the scope of nursing practice for treating constipation.

Answer 5

Oil Retention Enema

Remove Stool Digitally

Question 6

Identify interventions that promote bowel elimination when it does not occur naturally

Answer 6

Nurses commonly use two interventions—inserting suppositories and administering enemas—to promote elimination when it does not occur naturally or when the bowel must be cleansed for other purposes, such as in preparation for surgery and endoscopic or X-ray examinations.

Question 7

Name categories of enema administration

Answer 7

Oil retention enema

Rectal Suppository

Question 8

List common solutions used in a cleaning enema

Answer 8

Tap Water and Normal Saline
Soap and Water
Hypertonic Saline
Mineral, Olive, or Cottonseed Oil

Question 9

Explain the purpose of an oil retention enema

Answer 9

One type of retention enema is called an oil retention enema because the fluid instilled is mineral, cottonseed, or olive oil.

Oils lubricate and soften the stool, so it can be expelled more easily.

Question 10

Describe nursing activities involved in ostomy care

Answer 10

Providing Peristomal Care
Securing an Ostomy Appliance
Draining a Continent Ileostomy
Irrigating a Colostomy

Question 11

____________ is the rhythmic contractions of intestinal smooth muscle that facilitate defecation.

Answer 11

Peristalsis

Question 12

____________ is eventually released when the anal sphincters relax.

Answer 12

Stool

Question 13

____________ is an elimination problem characterized by dry, hard stool that is difficult to pass.

Answer 13

Constipation

Question 14

The incidence of constipation tends to be high among those whose dietary habits lack adequate ____________.

Answer 14

Fiber

Question 15

Prolonged use of narcotic analgesia tends to cause ____________ constipation.

Answer 15

iatrogenic

Question 16

Clients with a fecal ____________ usually report a frequent desire to defecate but an inability to do so.

Answer 16

Impaction

Question 17

____________ results from swallowing air while eating or sluggish peristalsis.

Answer 17

Flatulence

Question 18

A(n) ____________ enema holds a solution within the large intestine for a specified period, usually at least 30 minutes.

Answer 18

Rentention

Question 19

____________ constipation is a consequence of a pathologic disorder such as a partial bowel obstruction.

Answer 19

Secondary

Question 20

Dietary fiber that becomes undigested cellulose attracts ____________ within the bowel.

Answer 20

Water

Question 21

Identify the procedure.

Answer 21

The figure shows a nurse removing a fecal impaction.

Question 22

When is the procedure required?

Answer 22

This procedure is required when a client has fecal impaction caused by a large, hardened mass of stool that interferes with defecation, making it impossible for the client to pass feces voluntarily.

Question 23

Influence color, odor, and volume

Answer 23

Types of food consumed

Question 24

Influences moisture content of stool

Answer 24

Fluid intake

Question 25

Ability to control rectal muscles

Answer 25

Neuromuscular function

Question 26

Ability to increase intra-abdominal pressure

Answer 26

Abdominal muscle tone

Question 27

Inhibits or facilitates elimination

Answer 27

Opportunity for defecation

Question 28

Presented here, in random order, are steps that occur during the procedure of testing stool for occult blood. Write the correct sequence in the boxes provided.

1. Take the sample from the center of the stool.
2. Place two drops of chemical reagent onto the test space.
3. Collect stool within a toilet liner or bedpan.
4. Apply a thin smear of stool onto the test area.
5. Wait for 60 seconds and observe for a blue color.

Answer 28

3. Collect stool within a toilet liner or bedpan.
4. Take the sample from the center of the stool.
5. Apply a thin smear of stool onto the test area.
6. Place two drops of chemical reagent onto the test space.
7. Wait for 60 seconds and observe for a blue color.

Question 29

What problems with elimination do clients with musculoskeletal disorders face?

Answer 29

Clients with musculoskeletal disorders, such as arthritis of the hands, may face the problem of not being able to care for an ostomy appliance or perform colostomy irrigations.
In such a situation, an occupational or enterostomal therapist can offer suggestions for promoting self-care.

Question 30

What is defecation?

Answer 30

Defecation or bowel elimination is the act of expelling feces from the body with the help of all structures of the gastrointestinal tract, especially the components of the large intestine, which must function in a coordinated manner.

Question 31

What is involved in a comprehensive assessment of bowel elimination?

Answer 31

A comprehensive assessment of bowel elimination involves collecting data about the client’s elimination patterns or bowel habits and the actual characteristics of the feces.

Question 32

What are the common problems faced by clients related to bowel elimination?

Answer 32

Clients often have temporary or chronic problems with bowel elimination and intestinal function such as constipation, fecal impaction, flatulence, diarrhea, and fecal incontinence.

Question 33

How does a client develop pseudo constipation?

Answer 33

Pseudoconstipation (perceived constipation) occurs when clients believe that they are constipated, even though they are not.
Pseudoconstipation may occur in people who are extremely concerned about having a daily bowel movement.

Question 34

What is diarrhea?

Answer 34

Diarrhea is the urgent passage of watery stool and is commonly accompanied by abdominal cramping.
Simple diarrhea usually begins suddenly and lasts for a short period.

Question 35

A nurse is caring for a client who is complaining of constipation. During the initial assessment, the nurse finds out that the client has a sedentary job and eats convenience store food for lunch and dinner. 1. What kind of diet should the nurse recommend to the client to promote quick and easy elimination?

Answer 35

The nurse should recommend a diet that is high in fiber, such as raw fruits and vegetables, whole grains, seeds, and nuts.
Dietary fiber, which becomes undigested cellulose, is important because it attracts water within the bowel, resulting in bulkier stool that is more quickly and easily eliminated.
The incidence of constipation tends to be high among those whose dietary habits lack adequate fiber.

Question 36

What are the various signs and symptoms that accompany constipation?

Answer 36

Constipation is accompanied by various signs and symptoms, such as complaints of abdominal fullness or bloating, abdominal distension, complaints of rectal fullness or pressure, pain on defecation, decreased frequency of bowel movements, inability to pass stool, and changes in stool characteristics, such as oozing liquid stool or hard small stool.