Class 36- Bowel Elimination

Question 0

Observe the stool! Volume, color, odor, consistency, shape, abnormalities

Answer 0

Infant- yellow, adult- brown
Adult-pungent, infant-sour milk
1-2 inches in diameter

Question 1

Order of abdominal assessment

Answer 1

Inspection
Auscultation 5-35 sounds
Percussion
Palpation

Question 2

Guaiac test

Answer 2

Looks for blood in stool sample (needs three consecutive stools)

Question 3

Steatorrhea

Answer 3

Mushy, fatty stools

Question 4

Barium enema

Answer 4

X-ray of the large intestine

Question 5

Barium swallow

Answer 5

X-ray for the upper GI

Question 6

Stool collection

Answer 6

Only need 1 inch or 15-30 ml of liquid stool

Question 7

Hypertonic enema solution

Answer 7

NaPO4, draws water, less than 10 minutes

Question 8

Oil retention/mineral

Answer 8

Lubricate mucosa feces, retain 1/2 to 3 hours (fleet enema)

Question 9

Carminative (Harris Flush)

Answer 9

Expel flatus, coffee and molasses mix, 60-80ml

Question 10

Hypotonic solution

Answer 10

Tap water, distended colon less than 20”, only enema you can heat

Question 11

Isotonic solution

Answer 11

NaCl 0.09%, distended colon less than 20%

Question 12

Soapsuds solution enema

Answer 12

3-5 ml of soap to 1000ml of water, irritates mucosa, distends colon 10-15 inches

Question 13

Preparing for enema

Answer 13

Left lateral Sims, bend rt knee, raise HOB 15 degrees,

Question 14

Enema rules

Answer 14

Solution 12-18 inches above rectum
Lubricate and insert tube toward umbilicus smoothly and slowly
Give breaks and ask patient to let nurse know when they cramp

Question 15

Purpose of cleansing enemas

Answer 15

Prevent feces escape during surgery
Prepare intestines for tests
Remove constipation or impaction

Question 16

Borborygmus

Answer 16

Rumble in stomach, limit food high in fiber, don’t mix fruits/veg and fats/CHOs

Question 17

Retention enema

Answer 17

Oil or medication in liquid to retain for up to 3 hours

Question 18

Harris flush

Answer 18

Return flow enemas 5-6, alternating flow of 100-200ml repeated

Question 19

How far into rectum for large volume enema on adults? Children? Infants?

Answer 19

3-4”
2-3 inches
1-1.5 inches

Question 20

How long to hold saline fleets enema? Oil retention fleets enema? Large volume enema?

Answer 20

10 min, 30 min, 15 min

Question 21

Normal stoma

Answer 21

Deep pink, moist, stabilizes in 6-8 weeks

Question 22

Kariya

Answer 22

Soft gummy ring, needs to warmed to stick to skin