Constipation and Diarrhea Flashcards
factors that influence bowel elimination
- age
- diet
- fluid intake
- physical activity
- psychological factors
- personal habits
- positioning during elimination
- pain
- pregnancy
- surgery and anesthesia
- medication
- diagnostic tests
older adult care focuses
- trouble chewing
- esophageal emptying slows
- impaired absorption
- weakened sphincters
- decreased
– HCl, absorption of vitamins, peristalsis, sensation to defecate, lipase which aids in digestion
common bowel elimination problems
- constipation
- impaction
- diarrhea
- bowel incontinence
- flatulence
- hemorrhoids
constipation
having fewer than 3 bowel movements a week
- a symptom not diseases
- need to think about it in relation to pts normal
symptoms of constipation
- infrequent BMs
- discomfort
- hard dry stool that are difficult to pass
causes of constipation
- irregular bowel habits
- improper diet –> fiber
- reduced fluid intake
- lack of exercise
- stress
- certain meds
- advanced age
- ignoring the urge to defecate
- GI disorders
older adults and constipation
- lack of muscle tone (bowels and abdomen)
- slowed peristalsis
- lack of exercise
- inadequate fluid intake
- too many diary products
- lack of fiber
- meds
complications of constipation
- hemorrhoids
- anal fissure
- fecal impaction
- rectal prolapse
constipation prevention
- include plenty of high fiber foods
- drink plenty of water
- stay active
- manage stress
- don’t ignore urge to go
- create a schedule
types of laxatives
- bulk forming (pulls bulk like fiber into stool)
- emollient or wetting (pulls water into GI)
- osmotic (stimulate urge)
- stimulant cathartics (stimulate urge)
what do laxatives and cathartics do
initiate or facilitate stool passage
- stimulate need to defecate
- not only a stool softener
implementation of cathartics and laxatives
- PO or rectal (suppository or enema)
- short term action
- may be used to cleanse the bowels for dx test, procedure, surgery
- potentially harmful so do not overuse
enemas
- verify order
- gather equipment
- position
- pt teaching
- admin of enema
things to know when admin an enema
- cramping/pain: slow rate by lowering height of bed
- abdomen rigid: stop procedure
what to document of enema
- medication
- how much was instilled
- measure color, amount, consistency
- how pt tolerated
enema precaution/complications
- fluid, electrolyte imbalance
- tissue trauma
- vagal nerve stimulation
- abdominal pain/cramping
- pain
- perforation
impaction
hardened feces that remain in the rectum when there is an inability to expel usually from unrelieved constipation
- if unresolved, can result in intestinal obstruction
ind most at risk for impaction
- debilitation
- confused
- unconscious
impaction symptoms
- inability to pass stool for several days despite repeated urge to defecate
- continuous oozing of liquid stool
- loss of appetite
- n/v
- abdominal distention
- cramping
- rectal pain
digital removal of stool
- assess
- digital removal of stool using finger to break up fecal mass and remove in sections
painful and there are risks involved
diarrhea
loose watery bowel movements that can happen frequently and w urgency
causes of diarrhea
- foodborne pathogens
- food intolerances or allergies
- surgery
- diagnostic testing
- enteral feeding
common complications of diarrhea
skin irritation
dehydration
nutritional concerns
antidiarrheal agents
- decrease intestinal muscle tone to slow passage of feces
- body absorbs more water
need to determine cause before admin
examples of antidiarrheal agents
- loperamide
- diphenoxylate w atropine
- some have opiates but use caution bc bowel forming
nursing care for diarrhea
- identify the problem
- provide soft and digestible food (prevents further irritation of lining)
- maintain fluid and electrolyte balance
- prevent the spread –> hand hygiene
nursing interventions for fecal incontinence and diarrhea
- meticulous skin care
- prevent and monitor for dehydration
- fecal management systems (only used for severe cases and often would check w health care provider first)
