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NUR 333 > E4 Bowel Elimination > Flashcards

E4 Bowel Elimination Flashcards

1
Q

Factors influencing bowel elimination

A

-Age
-Diet
-Fluid intake
-Physical activity
-Psychological factors (going in public or ritualistic about going)
-Personal habits
-Positioning during defecation
-Pain
-Pregnancy
-Surgery & Anesthesia
-Medications
-Diagnostic tests

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2
Q

Older adult care focus for bowel elimination

A

-Trouble chewing
-Esophageal emptying slows
-Impaired absorption
-Weakened sphincters

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3
Q

Older adults have decreased

A

-Hydrochloric acid (start of food breakdown)
-Absorption of vitamins
-Peristalsis (motility of GI)
-Sensation to defecate
-Lipase to aid in fat digestion

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4
Q

Constipation is a ______ - not a _______

A

symptom
disease

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5
Q

Constipation is having ______ bowel movements a week

A

3

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6
Q

Symptoms of constipation

A

-Infrequent BMs
-Discomfort
-Hard, dry stools difficult to pass

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7
Q

Causes of constipation

A

-Irregular Bowel Habits
-Improper diet-fiber
-Reduced fluid intake
-Lack of exercise
-Stress
-Certain meds
-Advanced age
-ignoring the urge to defecate
-GI disorders

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8
Q

Older adults & constipation

A

-Lack of muscle tone
-Slowed peristalsis
-Lack of exercise
-Inadequate fluid intake
-Too many dairy products
-Lack of fiber
-Medications

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9
Q

What does slowed peristalsis do?

A

Gives water more time to be reabsorbed making stool hard and firm

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10
Q

Complications of constipation

A

-Hemorrhoids
-Anal fissures
-Fecal impaction
-Rectal prolapse

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11
Q

Constipation prevention

A

-Include plenty of high fiber foods
-Drink plenty of fluids
-Stay active
-Manage stress
-Don’t ignore urge to go
-Create a schedule

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12
Q

What are the common types of laxatives & cathartics

A

-Bulk forming
-Emollient or Wetting
-Osmotic
-Stimulant Cathartics

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13
Q

Bulk forming laxatives

A

-Most natural treatment
-Methylcellulose
-Pyslliumm
-Polycarbophil

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14
Q

Emollient & Wetting Laxatives

A

-Stool softner
-Lower surface tension of feces
-Docusate Sodium

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15
Q

Osmotic laxatives

A

-Stimulants
-Increase peristalsis & pull fluid back into bowel
-Saline-based
-Magnesium Citrate
-Magnesium Hydroxide
-Sodium Phosphate
-Polyethylene
-Lactulose

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16
Q

Stimulant cathartics

A

-Bisacodyl
-Senna

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17
Q

How to use and what are cathartics & laxatives?

A

-Meds that initiate stool passage
-PO or Rectal suppositories
-Short term
-May be used to cleanse the bowel for a GI dx test, procedure, or surgery
-Potential harmful effects if overused

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18
Q

Treatment order for constipation

A
  1. Bulk forming agents
  2. PO meds such as stool softners or laxatives
  3. Suppository
  4. Enema
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19
Q

Enema Nursing Care

A

-Verify order
-Gather equipment
-Position in Left Lateral Sims
-Teach pt to hold in as long as possible
-If pt cramps or has pain slow rate by lowering height of bag
-If abdomen rigid STOP
-Document amount of enema given

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20
Q

Enema precautions/ complications

A

-Fluid & electrolyte imbalance
-Tissue trauma
-Vagal nerve stimulation
-Abdominal pain/ cramping
-Pain
-Perforation

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21
Q

Impaction results from

A

unrelieved constipation and the inability to expel the hardened feces retained in the rectum

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22
Q

If impaction is not resolved can lead to

A

intestinal obstruction

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23
Q

What individuals are most at risk for impaction?

A

-Debilitated (spinal cord injury)
-Confused
-Unconscious

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24
Q

Impaction symtoms

A

-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

25
Q

Digital removal of stool

A

-Assess
-Digital removal of stool
-Nurses use finger to break up fecal mass and removes it in sections
-Very painful
-Risks involved (tissue damage & vagal nerve

26
Q

What is diarrhea?

A

Loose, watery bowel movements
-Can happen frequently and with urgency

27
Q

Common causes of diarrhea

A

-Foodborne pathogens
-Food intolerance & allergies
-Surgery
-Diagnostic testing
-Enternal feeding (tube feeding intolerance)

28
Q

Common complications of diarrhea

A

-Skin irritation
-Dehydration
-Nutritional concerns

29
Q

Antidiarrheal agents

A

-Decrease intestinal muscle tone to slow the passage of feces
-Body absorbs more water
-Must determine cause of diarrhea
-Ex. loperamide & diphenoxylate

30
Q

Nursing care for Diarrhea

A

-Identify problem & eliminate
-Provide soft easily digestible food (Bland like chicken and rice)
-Does not mean to place on clear liquids
-Maintain fluid & electrolyte balance
-Prevent spread with hand hygiene

31
Q

Nursing interventions for management of fecal incontinence & diarrhea

A

-Meticulous skin care
-Prevention & monitoring for dehydration
-Fecal management systems

32
Q

Nursing interventions: Maintenance of skin integrity

A

-Meticulous skin care
-Frequent checks
-Apply skin barrier
-Consult WOCN

33
Q

Who is at risk for C-diff?

A

-Antibiotics
-Elderly
-Immunocompromised
-Long-term care facility
-GI procedure
-Previous Cdiff

34
Q

C-diff complications

A

-dehydration
-kidney failure
-toxic megacolon
-bowel perforation
-death

35
Q

C-diff prevention

A

-Wash hands with soap & water
-Avoid unnecessary use of antibiotics
-Clean surfaces with bleach
-Place in isolation

36
Q

Treatment of C-diff

A

-Plenty of fluids & nutrition
-Antibiotics
-Surgery
-Fecal implantation
-Probiotics

37
Q

Causes of incontinence

A

-Muscle nerve damage
-Any physical condition that impairs the anal sphincter function
-Constipation & diarrhea
-Large volume of stools
-Surgery
-Rectal prolapse

38
Q

RIsk factors of bowel incontinence

A

-Age
-Female
-Nerve damage
-Dementia
-Physical disability

39
Q

Treatment of bowel incontinence

A

Anti-diarrheals or Bulk laxatives

40
Q

Prevention of bowel incontinence

A

-Reduce constipation
-Control diarrhea
-Avoid straining

41
Q

What is faltulence?

A

Passing Gas by burping or tooting

42
Q

Symptoms of flatulence

A

-Abdominal distention
-Cramping
-Bloating
-Pain

43
Q

Causes of flatulence

A

-Constipation
-Food intolerance
-GI distress
-Stress

44
Q

Nursing care for flatulence

A

-Avoid foods that cause gas (avoid soluble fiber)
-Eat small, more frequent meals
-Eat & drink slowly
-Avoid straws
-Avoid laying down after eating
-Limit carbohydrates
-Limit carbonated drinks
-Drink water & exercise

45
Q

What foods should be avoided for flatulence?

A

Soluble fibers- black beans, lima beans, broccoli, turnips, brussel sprouts, avocado

46
Q

Hemorrhoids: what are they and treatment

A

-Dilated or engorged veins in lining of rectum
-Treatment: Treat cause like constipation, topical creams, warm sitz baths, surgery

47
Q

Causes of hemorrhoids

A

-Increased venous pressure from straining
-Pregnancy
-Liver disease
-Heart failure
-Sitting on toilet for longtime

48
Q

What is the 2nd leading cause of cancer death in U.S.?

A

Colon Cancer

49
Q

Risk factors of Colon cancer

A

-African American
-Diet: High intake of red meat or processed meats, low fiber
-Obesity
-50+
-Lack of physical activity
-Alcohol, tobacco use
-Family hx
-Hx of inflammatory bowel disease

50
Q

Colon cancer screening

A

-Begin screening at age 45 than depends on results & family hx for how often
-DNA & occult test but not as accurate as a scope
-Flex sigmoid Q5
-Colonoscopy Q10

51
Q

If a fecal specimen sterile?

A

No

52
Q

Fecal Occult Blood Test

A

-Check for hidden blood
-Ordered to detect cancer or evaluate possible causes of unexplained anemia
-Stool sample from 2 diff areas
-Often ordered for 3 different occurrences
-Be aware of false positives (redmeat)

53
Q

Goal for Bowel elimination issues

A

Patient will have normal bowel elimination patterns

54
Q

Purpose of NG tube

A

-Decompression (keep things out of stomach)
-Enteral feeding or medication
-Administration
-Lavage

55
Q

Assessment of NG tube

A

-Abdominal
-Respiratory
-Nose/skin integrity
-Tube (cm tube at)
-Suction (what drainage looks like, low wall suction)

56
Q

Nursing care of NG tube

A

-Verify HCP orders
-Assessment
-Verify placement (pH strip & X-ray)
-Know how to hook to suction
-Administration of feedings & medications
-Recording I&Os

57
Q

Bowel training

A

-Pts with chronic constipation or fecal incontinence
-Set up daily routine
-Requires time, patience, & consistency
-Choosing patient-centered time
-Offer fluids
-Assist to comode
-Exercise & Privacy

58
Q

Diet recommendations

A

Whole grains, legumes, fresh fruit, Veggies
Fiber intake varies per individual (increase fluid with it)

59
Q

Older adult considerations

A

-Encourage screening
-Adequate fiber & fluid intake
-Regular exercise program
-Older adults are less able to compensate from fluid loss from diarrhea

NUR 333 (15 decks)

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