Class 28- Bowel Elimination

Question 0

Role of the gallbladder

Answer 0

1- Storage of bile

2- Concentrating bile (water,electrolyte reabsorbed)

3- Production of mucus (mucin) by its epithelial cells to lubricate small intestine for acid chyme (frm stomach)

4-Mantain the pressure in biliary system for the release of bile into small intestine

Question 1

Role of the liver

Answer 1

• Filters your blood
• Makes proteins, including blood-clotting factors (needed to help you heal)
• Stores vitamins, sugars, fats, and other nutrients
• Helps regulate hormones
• Releases chemicals and nutrients into the body when needed
• Makes bile needed for digesting fats

Question 2

Role of the pancreas

Answer 2

The enzymes secreted by the exocrine gland in the pancreas help break down carbohydrates, fats, proteins, and acids in the duodenum. These enzymes travel down the pancreatic duct into the bile duct in an inactive form. When they enter the duodenum, they are activated. The exocrine tissue also secretes a bicarbonate to neutralize stomach acid in the duodenum.
The hormones secreted by the endocrine gland in the pancreas are insulin and glucagon (which regulate the level of glucose in the blood), and somatostatin (which prevents the release of the other two hormones).

Question 3

Review digestive anatomy and physiology

Answer 3

Kaplan flashcards

Question 4

What are the bowel elimination maneuvers?

Answer 4

Transit time (peristalsis)
Chyme from the stomach
Mucus from the intestine
Haustral churning
Fluid absorption, flatus
Mass peristalsis

Question 5

How many mL of fluid a day are absorbed and how many are secreted?

Answer 5

1500mL; 100mL

Question 6

What is the rule of threes?

Answer 6

3 a day to 3 a week is adequate

Question 7

What determines the consistency of the stool?

Answer 7

Intestinal motility

Compliance and contractility of the rectum

Question 8

How much fills the rectum?

Answer 8

150 to 400mL (also flatus)

Question 9

Things that affect intestinal motility and rectal accommodation?

Answer 9

Rectal filling
Rectal contractions
Rectal accommodation
Postponement of defecation
Absorption of water from stool
Constipation --> hemorrhoids

Question 10

What kinds of medications can cause GI bleeding?

Answer 10

Aspirin

Question 11

What two health risks can slow down bowel movements?

Answer 11

Obesity and diabetes

Question 12

How many bowel sounds are normal in one minute to hear?

Answer 12

5 to 20

Question 13

After how many hours is it necessary to seek medical attention for diarrhea in adults? In children?

Answer 13

48 hours; 24 hours

Question 14

What are some factors that influence elimination?

Answer 14

Age/stage
Diet
Fiber (helps elimination by absorbing liquid)
Type
Eating times
Timed to go

Question 15

What is normal elimination for an infant?

Answer 15

1 to 2 BMs a day; soft is normal

Question 16

What factors related to agin affect bowel movements?

Answer 16

Digestion ability
Muscle tone (system involves a lot of muscle)
Response
Nutrition and hydration

Question 17

What is considered a proper amount of fluid intake?

Answer 17

2,000 to 3,000 ml a day (1500ml minimum)

Question 18

What is constipation?

Answer 18

Infrequent and difficult passage of hardened stool.
Common is pediatrics and geriatrics
Dietary factors, dehydration, low dietary bulk
Diverticulosis
Neuropathic conditions
Limited motility and exercise
Medication side effects

Question 19

What is perceived constipation? What decreases? What increases?

Answer 19

Influenced by psychological and emotional stress
Constipation is the one of the primary concerns of the elderly
Decreased- mobility, nutrition, motility, thirst, income
Increased- depression, worry, transit time

Question 20

What are the characteristics of constipation?

Answer 20

Decreased frequency of defecation
Hard dry formed stools with blood and pain
Straining for stool, pain during defecation
Feeling of pressure/incomplete evacuation
Abdominal pain, cramps, distention
Anorexia, nausea, headache

Question 21

What is a normal adult amount of bowel elimination?

Answer 21

1 cup per day

Question 22

What causes hemorrhoids?

Answer 22

Frequent high pressure to the veins in the rectum; topical relief like Prep. H or surgery may be required

Question 23

What needs to be done for impaction?

Answer 23

Encopresis
Impaction could be a block, or liquid or ribbon like stool
Dry, hard, frequent urge (no production)

Question 24

Predisposing factors to constipation…

Answer 24

Decreased mobility, dehydration, pain or depression
Inadequate or inconsistent toilet training
Psychological stress

Question 25

What could predisposing elimination factors produce?

Answer 25

Soiling without warning
Elder preoccupied with bowel care
Child ashamed or embarrassed
Parents frustrated, guilt, shame, etc.

Question 26

Primary causes of diarrhea

Answer 26

Psychological stress
Colon diseases
Intolerance of food or fluid
Side effects of medication
Laxative or enema misuse

Question 27

What causes infectious diarrhea?

Answer 27

Pathogens, bacteria, tainted food or water, antibiotics

Question 28

Anti-diarrheal?

Answer 28

Ioperamide- Imodium

Question 29

Signs of colorectal cancer

Answer 29

Change in bowel habits lasting more than 5 days
Feeling of continued pressure even after evacuation
Rectal bleeding or blood in stool
Cramping or steady abdominal pain
Weakness and fatigue

Question 30

Normal infant feces

Answer 30

Green meconium, yellow curry, unformed, sour milk

Question 62

Bulk forming

Answer 62

Metamucil, citrucel, fibercon

Question 63

Osmotic

Answer 63

Miralax (absorbs fluid into GI tract- works in 24 hours)

Question 64

Emollient

Answer 64

Oil stool softener allows fat and water to enter stool- avoids straining

Question 65

Stimulent

Answer 65

Promotes peristalsis- irritant to mucosa/nerve endings 8-12 hours

Question 66

Saline osmotic

Answer 66

Fleet enema draws water into GI tract and stimulated peristalsis 2-30 minutes