Chapter 35 Flashcards

0
Q

Large intestine

A

Lower GI tract. Length 5-6 cm. primary organ of bowel elimination

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1
Q

Contraction that propels food through the length of the GI tract

A

Peristalsis

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2
Q

Surgical creation of a stoma

A

Ostomy

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3
Q

Having fewer than three BMs per week, more than 25% of which are hard and require straining

A

Constipation

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4
Q

Preventing flatulence

A

Limit sodas
No straw or chewing gum
Avoid foods such as cabbage, beans, onions and cawliflower

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5
Q

Constipation caused by

A
Irregular bowel habits 
Chronic illnesses such as Parkinson's, MS, RA, depression, eating disorders, bowel dx
Low fiber diet
Low fluid intake 
Stress
Mobility
Environmental factors
Lack of privacy 
Neuro conditions
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6
Q

What foods slow parastalsis

A
Low fiber foods such as
Pasta 
White rice
White bread
Cheese
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7
Q

What is the adequate fluid intake

A

1.5-2 liters daily

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8
Q

Physiological factors that cause acceleration of digestion and parastalsis

A

Stress
Anxiety
Fear
All these initiate parasympathetic impulses

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9
Q

What slow parastatals

A

Emotional depression

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10
Q

Which drugs depress parastalsis

A

Opiates and snticholinergics

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11
Q

Drugs that contain iron sometimes turns stools

A

Black

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12
Q

Slowing or halting parastalsis

A

General anesthesia

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13
Q

Causes of diarrhea

A

Infection
Inflammation
Food intolerance

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14
Q

Inability to control passage of feces

A

Fecal incontinence

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15
Q

What results in hemorrhoids

A

Pregnancy
CHF
Chronic liver failure

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16
Q

Blood in stool

A

Melena

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17
Q

Measures msc amts of blood in the feces

A

Fecal occult blood test or guaiac
You repeat three times
If positive follow up with a sigmoidoscopy or colonoscopy
Avoid eating red meats 3 days before testing
Stop taking aspirin or any NSAIDs for 7 days before test because could produce false negative test
Vitamin c and citrus fruits and juices stopped 3 days before

18
Q

Stepwise progression of laxatives

A

Bulk forming laxatives
Stool softener and osmotic stimulants
Suppositories/enemas if all else unsuccessful

19
Q

Most common anti diarrheal agents

A

Loperamide or diphenoxalate with atropine

20
Q

If infection causative factor for diarrhea

A

Antibiotic is given

21
Q

If inflammation is cause

A

Give steroids

22
Q

Temporary cessation of peristalsis

A

Ileus

23
Q

Single lumen tube with holes near tip

A

Levin tube

24
Q

Tube with two lumina and preferable for stomach decompression

A

Salem tube
Blue pigtail is the air vent
Never use for irrigation
Ng tube is clean technique

25
Q

Most common use of an enema

A

Temporary relief of constipation

26
Q

Lower GI bleeding

A

Bright red bleeding

27
Q

Symptoms of fecal impaction

A

Anorexia
Distended abdomen
N/v

28
Q

Patient teaching for diarrhea

A
Eat foods containing pot and sodium 
Avoid caffeine
Decrease fiber
Limit fatty foods
Avoid hot, cold or spicy foods

Treatment
Rehydration is key

29
Q

Patient teaching for constipation

A
Increase fiber
Whole grains, raw fruit and veggies
8-10 glasses of water 
Prune juice
Warm/ hot liquids

Treatment
Laxatives
Enemas
Mess

30
Q
Distends colon
Stimulates parastalsis
Softens feces
15-20 mins to work 
Contains 500-1000 tap water
Adverse effects - fluid and electro balance and water intoxification
Do not use in CHF and renal conditions

Is hyper or hypotonic

A

Hypotonic enemas

31
Q

Fleets enema
Works in 5-10 mins
90-120 ml of fluid
Adverse effect retention of sodium

A

Hypertonic

32
Q

Enema lubricate
2-5
2.5-3 inches

A

2.5 to 3 inches

33
Q

Administering enema

A

Put patient in left lateral sims position

Insert 3-4 inches as patient takes deep breath

34
Q

Ostomy in

right or left lower quadrant

A

Right lower quadrant

35
Q

Causes of diarrhea

A
Stress
Meds like abx and iron
Allergies
Food intolerance
Asian Americans are more likely to be lactose intolerant
Colon dx
Surgery
36
Q

Causes of constipation

A
Low fiber or fluid intake
Decreased activity
Irregular toilet habits 
Change in routine
Lack of privacy
Chronic use of laxative
Diseases/disorders
Neuro disorders
37
Q

Accumulation of hardened fecal material in the rectum or sigmoid colon

A

Fecal impaction

38
Q

Symptoms of fecal impaction

A

Anorexia
Distended abdomen
N/V

39
Q
Impaction with overflow 
Changes in neural innervation
Prolapsed rectum
Extreme debilitation 
Cognitive impairment
A

Bowel incontinence

40
Q

Blood in the stool

A

Melena

41
Q

Drugs that act to promote bowel evacuation

A

Laxatives

42
Q

Procedure involving introduction of a solution into the rectum for cleansing or therapeutic purposes

A

Enema

43
Q

What can result in stimulation of the vagus nerve

A

Bradycardia

Hypotension