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Fundamentals 1 > Chapter 38 Bowel Elimination > Flashcards

Chapter 38 Bowel Elimination Flashcards

1
Q

GI tract route:

A
  • mouth to anus

- esophagus to the stomach to the small intestine to the large intestine to the anus.

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2
Q

Functions of the large intestine:

A
  • Absorption of water
  • Formation of feces
  • Expulsion of feces from the body (secretion)
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3
Q

Functions of the small intestine:

A

-the reabsorption of the GI system occurs!!!

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4
Q

The large intestine extends from the __ to the __.

A

-ileocecal valve to the anus

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5
Q

What is a thick fluid mass of partially digested food and gastric secretions that is passed from the stomach to the small intestine.?

A

-Chyme

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6
Q

What is the wave of progressive contraction and relaxation of the walls of the intestine?

A

-Peristalsis

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7
Q

What does peristalsis do when it comes to chyme?

A

-This forces chyme into the large intestine through the ileocecal valve, which prevents regurgitation of chyme.

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8
Q

Peristalsis is under control of ___.

A

the nervous system

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9
Q

Contractions for peristalsis occur every:

A

3-12 minutes

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10
Q

Mass peristalsis sweeps occur:

A

once to four times every 24 hours.

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11
Q

___ of food waste is excreted in stool within 24 hours.

A

One-third to one-half

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12
Q

Who could have issues with peristalsis?

A

-people with spinal cord injuries

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13
Q

What can cause temporary cessation of intestinal movement?

A

Surgery and anesthesia that requires manipulation of the intestines

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14
Q

What is the stoppage of peristalsis?

A

Paralytic ileus

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15
Q

___ ease defecation and stimulate bowel movement

A

laxatives

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16
Q

What are 5 different types of laxatives?

A
  • bulk forming
  • osmotic
  • stimulant
  • stool softeners
  • lubricants
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17
Q

What laxative absorbs liquid in intestines and allows the stool to swell which forms a softer stool to pass?

A

Bulk Forming (psyllium, methylcellulose)

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18
Q

What laxative draws water into the bowel, softens stool mass, increases bowel action, and can be used prior to some diagnostic tests too (the PEG in particular)?

A

Osmotic (PEG, lactulose, sorbitol, magnesium citrate, sodium phosphate)

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19
Q

What laxative is found over the counter, increases muscle contractions that help move the stool along, and have the most potential to leave side effects.

A

Stimulant (biscodyl, sena (PO or rectal)

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20
Q

What laxative brings liquid into the stool so it prevents the stool from being hard and dry?

A

Stool Softener (colace)

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21
Q

What laxative puts a protective seal over the stool with like a waterproof stool, to keep the moisture and water in the stool ot make it easier to pass?

A

Lubricants (mineral oil)

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22
Q

What is a chronic problem in older adults?

A

constipation, diarrhea, and fecal incontinence.

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23
Q

What affects bowel elimination?

A
  • developmental considerations
  • daily patterns
  • food and fluid intake
  • activity and muscle tone
  • lifestyle
  • psychological variables
  • pathologic conditions
  • medications
  • diagnostic studies
  • surgery and anesthesia
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24
Q

Which food is a recommended for an older adult who is constipated?

A

Fruits

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25
Q

__ helps soften the stool.

A

Fiber

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26
Q

What are some constipating foods?

A

cheese, lean meat, eggs, pasta

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27
Q

What are some foods with laxative effect?

A

fruits and vegetables, bran, chocolate, alcohol, coffee

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28
Q

What are some gas-producing foods?

A

onions, cabbage, beans, cauliflower

29
Q

What effect does aspirin have on stool color?

A

pink to red to black stool.

30
Q

Black stool w/o medications is a sign of ___.

A

bleeding in some sort. (they could be taking too much medication)

31
Q

What effect do iron salts have on stool color?

A

Black stool

32
Q

What effect does bismuth subsalicylate have on stool color?

A
  • black stools

- treats diarrhea

33
Q

What effect do antacids have on stool color?

A

white discoloration or speckling in stool

34
Q

What effect do antibiotics have on stool color?

A

green-gray color

35
Q

What are some details on obtaining a stool sample?

A
  • medical aseptic
  • hand hygiene before and after glove use
  • wear disposable gloves
  • do not contaminate outside of container with stool
  • obtain stool and package, label, and transport according to agency policy.
36
Q

What are the patient guidelines for stool collection?

A
  • void first so that urine is not in the stool sample-defecate into the container not the toilet
  • do not place toilet paper in bedpan or specimen container
  • avoid contacts with soaps, detergents, and disinfectants as they may affect the test results
  • notify nurse when specimen is available
37
Q

What is a timed stool collection?

A
  • collect stool over time

- 1st stool is the start of the collection

38
Q

What is a screening to see if there’s blood or not and also tests for cancer, GI bleeds, ulcers, polyps, inflammatory bowel disease, etc?

A

Fecal occult blood test

39
Q

What is an invasive test, that is a direct visual of the bowel and can take pictures and perform a biopsy?

A

endoscopic examinations

40
Q

What test involves swallowing a liquid and then an x-ray is used to see what is lit up inside the body?

A

Barium studies (should precede UGI)

41
Q

What is the fluoroscopic examination of the esophagus, stomach, and small intestine.
It is done after ingestion of barium medication.
It is a radiographic (X-ray) that lights up the areas we need to look at.

A

Upper gastrointestinal (UGI) study

42
Q

What is a series of x-rays that examine the large intestine after a rectal infusion of barium into the rectum?

A

barium enema

43
Q

What test visualizes organs with a small transducer that’s placed on the skin?

A

abdominal ultrasound

44
Q

What test is noninvasive, and is a detailed atomic view of tissues using a magnet?

A

MRI- magnetic resonance imaging

45
Q

What is an x-ray directed at the abdomen and the computer can take pictures of it. We also need to have a patient take an oral contrast or IV iodine.

A

abdominal CT scan

46
Q

Any kind of contrast necessary study, is contraindicated for people ___

A

who are allergic to iodine

47
Q

A visual exam of the esophagus, stomach, and duodenum. Can have an endoscope. Can take biopsies.

A

Esophagogastroduodenoscopy (EGD)

48
Q

A visual examination of the large intestine from the anus to ileocecal valve.
Need to take a laxative before surgery to clean out the colon.

A

Colonoscopy

49
Q

Uses a scope. A visual examination of the sigmoid colon, rectum and anal canal.

A

Sigmoidoscopy

50
Q

A tiny wireless camera takes pictures of your digestive tract
It is swallowed.

A

Wireless capsule endoscopy

51
Q

Patient outcomes for normal bowel elimination? (3)

A
  • Patient has a soft, formed bowel movement every 1 to 3 days without discomfort.
  • The relationship between bowel elimination and diet, fluid, and exercise is explained.
  • Patients should seek medical evaluation if changes in stool color or consistency persist.
52
Q

5 ways to promote regular bowel habits?

A
  • timing
  • positioning
  • privacy
  • nutrition (increase in fluids and fiber)
  • exercise
53
Q

Individuals at High Risk for Constipation: (4)

A
  • Patients on bedrest taking constipating medicines
  • Patients with reduced fluids or bulk in their diet
  • Patients who are depressed
  • Patients with central nervous system disease or local lesions that cause pain while defecating
54
Q

4 Nursing Measures for the Patient With Diarrhea:

A
  • answer call bell immediately
  • remove the cause of diarrhea whenever possible (meds, parasite, etc)
  • If there is impaction, obtain physician order for rectal examination
  • give special care to the region around the anus.
55
Q

a stool in the rectum that causes a blockage that results in a little diarrhea.

A

Impaction

56
Q

4 ways to empty colon of feces?

A
  • enemas
  • rectal suppositories
  • oral intestinal lavage
  • digital removal of stool
57
Q

What can be a laxative used to stimulate the bowel to relieve constipation?

A

rectal suppositories

58
Q

We take this before a procedure like a CT scan.
Polyethyl Glycol solution is used, trade name is “go lightly”.
Makes it easier to go.

A

oral intestinal lavage

59
Q

What are used to simply empty the colon of feces?

A

enemas

60
Q

4 types of enemas:

A
  • cleansing
  • retention
  • small volume
  • large volume
61
Q

retention enema: Lubricate the stool and intestinal mucosa, easing defecation

A

oil-retention

62
Q

retention enema: help expel flatus (gas) from the rectum

A

carminative

63
Q

retention enema: provide medications absorbed through the rectal mucosa

A

medicated

64
Q

retention enema: destroy intestinal parasites

A

anthelmintic

65
Q

Goal of bowel-training programs:

A

Eliminate (have) a soft, formed stool at regular intervals without laxatives.

66
Q

5 types of ostomies?

A
  • sigmoid colostomy
  • descending colostomy
  • transverse colostomy
  • ascending colostomy
  • Ileostomy
67
Q

Colostomy care: (5)

A
  • Keep the patient as free of odors as possible; empty the appliance frequently.
  • Inspect the patient’s stoma regularly (stoma should be moist. Keep the skin around the stoma site clean and dry).
  • Measure the patient’s fluid intake and output.
  • Explain each aspect of care to the patient and self-care role.
  • Encourage the patient to care for and look at ostomy.
68
Q

Patient teaching for colostomies: (6)

A
  • Explain the reason for bowel diversion and the rationale for treatment.
  • Demonstrate self-care behaviors that effectively manage the ostomy.
  • Describe follow-up care and existing support resources.
  • Report where supplies may be obtained in the community.
  • Verbalize related fears and concerns.
  • Demonstrate a positive body image.
69
Q

Whether the goals include a return to normal bowel function or maintaining existing function within the parameters of the patient’s condition, it is important for the nurse to:

A

determine whether they have been met, and if not, why.

Fundamentals 1 (24 decks)

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