Chapter 15 Flashcards
Absorption
The transfer of nutrients from the intestines to the cells
Anatomy
The study of body structure
Biology
The study of all life forms
Body systems
Groups of organs that perform specific functions in the human body
Bowel elimination
The physical process of releasing or emptying the colon or large intestine of solid waste, called stool or feces
Cells
The basic structural units of all organisms
Chyme
Semi-liquid substance made as a result of the chemical breakdown of food in the stomach
Colon
The large intestine
Colostomy
Surgically-created opening through the abdominal wall into the large intestine to allow feces to be expelled
Constipation
The inability to eliminate stool, or the infrequent, difficult and often painful elimination of hard, dry stool.
Crohn’s disease
A disease that causes the lining of the digestive tract to become inflamed (red, sore, swollen)
Defecation
The process of eliminating feces from the rectum through the anus.
Diarrhea
Frequent elimination of liquid or semi-liquid feces
Digestion
The process of converting food so that it can be absorbed into the blood and used by body tissues
Diverticulitis
Inflammation of sacs that develop in the wall of the large intestine due to diverticulosis
Diverticulosis
A disorder in order in which sac-like pouching develop in weakened areas of the wall of the large intestine
Duodenum
The first part of the small intestine, where the common bile duct enters the small intestine
Electrolytes
Chemical substances that are essential to maintaining fluid balance and homeostasis in the body
Elimination
The process of expelling wastes
Enema
A specific amount of water, with or without an additive, introduced into the colon stimulate the elimination of stool
Fecal impaction
A mass of dry, hard stool that remains packed in the rectum and cannot be expelled
Fecal incontinence
An inability to control the muscles of the bowels, which leads to an involuntary passage of stool or gas
Feces
Solid body waste excreted through the ants from the large intestine; also called stool
Flatulence
Air in the intestine that is passed through the rectum; also called gas or flatus
Fracture pan
A bedpan that is flatter than a regular bedpan; used for small or thin people or those who cannot lift their buttocks onto a standard bedpan
Gastroesophageal reflux disease
A chronic condition in which the liquid contents of the stomach back up into the esophagus
Gastrointestinal tract
A continuous tube from the opening of the mouth all the way to the anus, where solid wastes are eliminated from the body
Heartburn
A condition that results from a weakening of the sphincter muscle which joins the esophagus and the stomach; also known as acid reflux
Hemorrhoids
Enlarged veins in the rectum that can cause itching, burning, pain, and bleeding
Homeostasis
The condition in which all of the body’s systems are balanced and are working at their best
Ileostomy
Surgically-created opening into the end of the small intestine, the ileum, to allow feces to be expelled
Ingestion
The process of taking food or fluids into the body
Irritable bowel syndrome
A chronic condition of the large intestine that is worsened by stress
Malabsorption
A condition in which the body cannot absorb or digest a particular nutrient properly
Occult
Hidden
Organ
A structural unit in the human body that performs a specific function
Ostomy
Surgical creation of an opening from an area inside the body to the outside
Pathophysiology
The study of the disorders that occur in the body
Peristalsis
Muscular contractions that push food through the gastrointestinal tract
Physiology
The study of joe body parts function
Portable commode
A chair with a toilet seat and a removable container underneath that is used for elimination; also called bedside commode
Specimen
A sample such as tissue, blood, urine, stool, or sputum, used for analysis and diagnosis
Stoma
An artificial opening in the body
Suppository
A medication given rectally to cause a bowel movement
Tissues
A group of cells that performs similar tasks
Ulcerative colitis
A chronic inflammatory disease of the large intestine
Ureterostomy
A type of urostomy in which a surgical creation of an opening from the ureter through the abdomen is made for urine to be eliminated
Urostomy
The general term used for any surgical procedure that diverts the passage of urine by redirecting the ureters
What are the ten systems that make up the human body?
1) gastrointestinal or digestive
2) urinary
3) reproductive
4) integumentary or skin
5) circulatory or cardiovascular
6) respiratory
7) musculoskeletal
8) nervous
9) endocrine
10) immune and lymphatic
What is homeostasis?
The condition in which all of the body’s systems are balanced and are working at their best. Keeping body temperature around 98.6 degrees Fahrenheit, regardless of how cold or hot it is outside is an example of homeostasis.
Important points about the gastrointestinal or digestive system
1) digestion prepares food for absorption into cells
2) elimination is expelling solid wastes
What are the functions of the gastrointestinal system?
1) ingestion of food and fluids
2) digestion of food
3) absorption of nutrients
4) elimination of waste products form food/fluids
Changes in the gastrointestinal system due to aging
1) ability to taste decreases
2) process of digestion takes longer and is less efficient
3) body waste moves more slowly through the intestines,causing more frequent constipation
4) difficultly chewing and swallowing may occur
5) absorption of vitamins and minerals decreases
6) production of saliva and digestive fluids decreases
Important points about normal bowel elimination
1) stool is normally brown , soft, moist, and formed
2) there should be no pain with passing stool
3) there should not be blood, pus, mucus, or worms in the stool
List the signs and symptoms to report about stools
1) bloody or abnormally colored stool
2) hard, dry stools
3) diarrhea
4) constipation
5) pain with bowel movements
6) blood, pus, mucus, or discharge in stool
7) fecal incontinence
List the factors that affect elimination
1) growth and development
2) psychological factors
3) diet
4) fluid intake
5) physical activity and exercise
6) personal habits
7) medications
Growth and development may affect bowel elimination in what ways?
1) aging affects the regularity of bowel elimination
2) peristalsis slows due to a decrease in muscle tone
3) nutrients are not absorbed as well, making digestion more difficult
What do you do to promote normal elimination?
Encourage fluids and nutritious meals. Encourage regular exercise and activity as allowed.
List the psychological factors that may influence bowel elimination
1) lack of privacy may affect bowel elimination
2) having a roommate for the first time, being in a place that is not home
3) anxiety, stress, fear, or anger can increase the frequency of bowel movements, causing watery, loose stools, and may even cause incontinence
4) depression can decrease the frequency of elimination
To promote normal elimination, nursing assistants should always do what?
Provide privacy and allow plenty of time for elimination.
Respond to call lights immediately. If residents want to talk about their concerns, NAs should take the time to listen to them, and report their concerns to the nurse
How can diet affect bowel elimination?
1) A diet low in fiber may decrease elimination and cause constipation
2) foods high in animal fats, such as dairy products, red meat, and eggs may also cause constipation
3) beans, whole grains, apples, cabbage, onions, dairy products, and carbonated drinks are examples of foods that can cause gas
To promotes normal elimination with diets, nursing assistants should do what?
Encourage nutritious meals
Increase fiber intake and decreasing fatty, sugary foods can help if constipation is a problem.
How does fluid intake affect bowel elimination?
1) the sense of thirst decreases as a person ages
2) a decrease in fluids may cause constipation
3) a lack of strength or coordination can also lower fluid intake. Some beverages, such as orange or prune juice, can cause an increase in bowel elimination.
How do nursing assistants promote normal elimination with fluid intake?
Encourage fluid intake, generally, 64 ounces of fluid each day
How does lack of physical exercise affect bowel elimination?
1) a lack of exercise and mobility can weaken muscles and slow elimination
2) regular physical activity helps bowel elimination by strengthening abdominal and pelvic muscles. This helps peristalsis
How can personal habits affect bowel elimination?
1) certain times of day may be more common for having bowel movements
2) drinking warm fluids can increase bowel movements
3) familiar places, such as the resident’s own bathroom, may encourage bowel elimination
4) positioning in bed also affects elimination. A resident who is lying flat on his back (supine) will have difficulty with elimination because it is difficult to contract the muscles in this position.
How can nursing assistants use personal habits to help promote normal elimination?
Make sure residents are helped to the bathroom at the time of day that is best for each person.
Use the bathroom the resident prefers or get s portable commode if the resident cannot make it to the bathroom.
Raise the head of the bed for residents who use a bedpan.
The best position for elimination is squatting and leaning forward.
How do medication affect bowel elimination?
Antibiotic can cause diarrhea
Pain relieves may cause constipation
How can a nursing assistant use medication to promote normal elimination?
Laxatives may be ordered.
Nursing assistants should report diarrhea or constipation to the nurse promptly
How do you assist a resident with a bedpan?
Turn the resident towards you, and place the bed protector underneath the resident’s buttocks and hips.
Ask the resident to remove his undergarments.
Place the bedpan near his hips in correct position.
What is the cause of heartburn?
Weakening of the sphincter muscle which joins the esophagus and the stomach
What are the symptoms o heartburn?
Burning feeling in the esophagus, chest pain, bitter taste in the mouth, feeing of food coming back up into the throat or the mouth
Pain usually occurs directly after a meal and may worsen when person is lying down
What is the treatment for heartburn?
Medication, change in diet or sleep position
What is the cause of gastroesophageal reflux disease?
Liquid contents of the stomach back up into the esophagus; can inflate and damage lining of the esophagus and cause bleeding, ulcers,or diffiyswallowing
What are the symptoms of gastroesophageal reflux disease?
Frequent heartburn, chest pain, hoarseness in the morning, difficulty swallowing, tightness in the throat, coughing, bad breath
What are the possible causes of gastroesophageal reflux disease?
Obesity, hiatal hernia, weak lower esophageal sphincter, slow digestion, diets, diets high in acidic and spicy foods, smoking, alcohol use
Important points about ulcers
1) they are raw sores in the stomach or small intestine
Cause of ulcers
Excessive acid
Symptoms of ulcers
Dull or burning pain after eating, belching, vomiting
Treatment for ulcers
Antacids and medications, change in diet
What do you avoid when you have ulcers?
Alcohol, caffeine, and cigarette use
Types of gall bladder disorders
gallstones, pancreatic disorders, and tumors
What do gallbladder disorders cause?
Decreased or stopped bile flow
When are gallstones formed?
When the substances in the bile solidify
Treatment for gallbladder disorders
Medications, dietary changes, or surgery
What are the causes of cirrhosis?
Liver damage from alcohol abuse, hepatitis, and fatter liver syndrome
What are the symptoms of cirrhosis?
Fatigue, bruising easily, itchy skin, jaundice, as it’s in the abdomen, and edema on the legs
Treatment for cirrhosis
Eliminating alcohol, maintaining a healthy weight, medications, liver transplant
Causes of a hernia
Pressure pushing a body cavity out through a muscle or tissue due to heavy lifting or constipation
What are the symptoms of a hernia?
Swelling in the area of the abdomen or the goin and discomfort in the abdominal area or groin when lifting
Treatment for a hernia
Surgery
Cause of Crohn’s disease
The intestines become inflamed
Symptoms of Crohn’s disease
Diarrhea, abdominal cramping and pain, rectal bleeding, fever, weight loss
Treatment for Crohn’s disease
Medication, dietary changes, stopping smoking, surgery
Symptoms of ulcerative colitis
Diarrhea, abdominal pain, cramping, rectal bleeding, poof appetite, fever, weight loss
Treatment for ulcerative colitis
Medication, dietary changes, stopping smoking, surgery
What does diverticulosis cause?
Sac-like pouches to develop in weakened areas of the intestinal wall. Some people will eventually develop diverticulitis, or inflammation inside the pouching.
Cause of diverticulosis
Low-fiber diet
Treatment for diverticulosis and diverticulitis
Rest, medications, special diets, surgery
Causes of flatulence
High-fiber foods, intolerance of foods, swallowing air when eating, antibiotics, malabsorption, IBS
How may flatulence be relieved?
Positioning of by a rectal tube
What is constipation?
The inability to eliminate stool, or the infrequent, difficult s day often painful elimination of s hard, dry stool
Causes of constipation
Changes of aging, poor diet, lack. Of exercise, decrease in fluid intake, mediation, disease, or ignoring urge to eliminate
Signs of constipation
Abdominal swelling, gas, lack of exercise
Treatment for constipation
Increasing fiber intake, physical activity, and medication
What is diarrhea?
The frequent elimination of liquid or semi-liquid feces.
What are the causes of diarrhea?
Infections, microorganisms, irritating foods, medication
Treatment for diarrhea
Medication, change of diet
What is fecal incontinence?
The inability to control the bowels
Causes of fecal incontinence
Muscle and nerve damage, disorders of the spinal cord or anus, fecal impaction, constipation, tumors
Treatment for fecal incontinence
Changes in diet, medication, bowel training, surgery
What is fecal impaction?
Buildup of dry, hardened feces on the rectum
Signs of fecal impaction
No stool for several days, cramping, abdominal and rectal pain, abdominal swelling, nausea, and vomiting.
Treatment for fecal impaction
Nurse of doctor will break mass into fragments
What are hemorrhoids?
Enlarged veins in the rectum
What are the causes of hemorrhoids?
Constipation, obesity, pregnancy, diarrhea, overuse of enemas and laxatives, straining during bowel movements
Symptoms of hemorrhoids
Rectal itching, burning, pain, and bleeding
Treatment for hemorrhoids
Changes in diet, surgery
What does obesity increase the risk of?
Obesity increases the risk for certain gastrointestinal diseases or disorders, including GERD, gallbladder disease, fatty liver syndrome, and cancers of the gastrointestinal system
What are the different types of enemas?
1) Tap water enema
2) soap suds enema
3) saline enema
4) commercial enema
What position must a resident be in to receive an enema?
The left-lying (Sim’s) position
When should an enema be stopped?
If the resident complains of pain or if you feel resistance.
Important guidelines about enemas
1) provide plenty of privacy for the resident
2) place the resident in the Sim’s position
3) when giving a cleansing enema, remove the air from the enema tubing before inserting the tube into the rectum
4) give the enema slowly, holding the tubing in place
5) be reassuring and gentle during the procedure
6) observe for cramping, pain, or discomfort, bleeding, ability to retain the fluid, and any change in the resident’s condition during and after the enema
When should enemas be performed?
Only when the facility allows it, and if they are specially trained to perform the procedure
Important points about stool
1) stool is tested for blood, pathogens, and other things, such as parasites
2) stool must be warm if being tested for ova and parasites, so these specimens must be taken to the lab immediately
3) urine or tissue in a stool sample can ruin the sample
How is hidden, or occult, blood found inside stool?
Inside stool with a microscope or a special chemical test. This may be a sign of a serious physical problem, such as cancer.
How do you test a stool specimen?
Get a small amount of stool from a specimen container on a tongue blade. Smear the small amount onto Box A of the test card. Do the same with other side of the tongue blade, but into Box B of the test card. Close the test card, and turn it over to the other side. Wait the amount of time listed on the instructions, and watch the squares for any color changes. Record the color changes.
Where is stool or feces eliminated if a resident has an ostomy?
It is eliminated through the ostomy rather than through the anus.
What do residents with an ostomy wear?
A disposble drainage bag, or appliance, that fits over the stoma to collect the feces.
What are the emotions that people with an ostomy can have?
Embarrassment or anger
How should nursing assistants act towards people who have an ostomy?
They should help the residents feel better about themselves by being supportive and sensitive, and always provide privacy for ostomy care.
Guidelines for ostomy care
1) Follow Standard Precautions
2) Provide good skin care and hygiene
3) Remove ostomy pouches carefully
4) Before removing pouches, allow a little air out of the bag
5) Observe contents of pouch
6) Empty, clean, and replace the ostomy pouch whenever stool is eliminated
More guidelines for ostomy care
1) Assist residents to wash hands
2) Observe for skin irritation, rashes, swelling, or bleeding around stoma
3) Use skin barriers as ordered
4) Make sure pouch is attached securely before completeing care
5) be supportive, empathetic, and caring
What is a urostomy?
The general term used for any surgical procedure that diverts the passage of urine by re-directing the ureters.
What is a ureterostomy?
A type of urostomy in which an opening from a ureter is brought through the abdomen for urine to be eliminated
How should you wash the area around the stoma?
Using a washcloth and warm water, wash the area gently in one direction, away from the stoma. Rinse,. Pat dry with another towel. Temporarily cover stoma opening with a wipe
What is bowel retraining?
The process of assisting resident to regain control of their bowels. Typically after a resident has had an illness, injury, or a period of inactivity.
What type of attitude should you have when residents struggle with bowel retraining?
Positive Attitude
How may nursing assistants assist with bowel retraining?
1) Explain the schedule to the resident. Follow the schedule
2) Follow standard precautions. Wear gloves
3) Observe resident’s elimination habits
4) Keep a record of elimination
5) Offer bedpan or trip to the bathroom at specific times each day
6) Answer call lights promptly
More ways NAs can assist with bowel retraining
1) Provide privacy
2) Help with perineal care
3) Encourage fluids and proper diet
4) Dispose of wastes properly
5) Praise attempts and successes in controlling bowels
6) Never show frustration or anger
