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N11 - Nursing Foundations > Elimination (Fecal) > Flashcards

Elimination (Fecal) Flashcards

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1
Q

excreted waste products are referred to as

A

Feces or stool

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2
Q

_____extends from the ileocecal (ileocolic) valve, which lies between the small and large intestines, to the anus.

A

Large Intestine

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3
Q

colon (large intestine) in the adult is generally about ______ cm long

A

125 to 150 cm

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4
Q

The colon’s main functions are:

A
  1. absorption of water and nutrients,
  2. the mucoid protection of the intestinal wall
  3. fecal elimination.
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5
Q

The waste products leaving the stom- ach through the small intestine and then passing through the ileocecal valve are called______

A

Chyme

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6
Q

The _____ regulates the flow of chyme into the large intestine and prevents backflow into the ileum.

A

ileocecal valve

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7
Q

As much as ______mL of chyme passes into the large intestine daily, and all but about ____ mL is reabsorbed in the proximal half of the colon.

A

1500 mL; 100mL

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8
Q

_____ serves to protect the wall of the large intestine from trauma by the acids formed in the feces, and adherent for holding the fecal material together.

A

Mucus

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9
Q

______is largely air and the by-products of the digestion of carbo- hydrates.

A

Flatus

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10
Q

_____ wavelike movement produced by the circular and longitudinal muscle fibers of the intestinal walls; it propels the intestinal contents forward.

A

Peristalsis

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11
Q

The rectum in the adult is usually _____ cm long

A

10-15 cm

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12
Q

The anal canal, which is the distal portion is ______ cm long

A

2.5 to 5cm

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13
Q

______ has folds that extend vertically. Each of the vertical folds contains a vein and an artery.

A

Rectum

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14
Q

What helps retain the feces within the rectum?

A

vertical folds that contains a vein and an artery.

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15
Q

When the veins become distended, as can occur with repeated pressure, a condition known as _____

A

hemorrhoids

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16
Q

The _____ sphincter is under involuntary control; innervated by the autonomic nervous system

A

Internal sphincter

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17
Q

The ____ sphincter normally is voluntary controlled; innervated by the somatic nervous system.

A

external sphincter

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18
Q

______is the expulsion of feces from the anus and rectum. It is also called a bowel movement.

A

Defecation

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19
Q

Repeated inhibition of the urge to defecate can result in ________ to accommodate accumulated feces and eventual loss of sensitivity to the need to defecate.

A

expansion of the rectum

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20
Q

If the defecation reflex is ignored, ______ can be the ultimate result

A

Constipation

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21
Q

Normal feces are made of about _____ and _____

A

75% water and 25% solid materials

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22
Q

Feces are normally brown, chiefly due to the presence of ______ and ______

A

stercobilin and urobilin

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23
Q

Bacteria which are normally present in the large intestine

A

Escherichia coli or staphylococci

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24
Q

_____ is the first fecal material passed by the newborn, normally up to 24 hours after birth.

A

Meconium

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25
Q

_____ promotes the movement of material through the digestive system and increases stool bulk.

Ex. whole-wheat flour, wheat bran, nuts, and many vegetables.

A

Insoluble fiber

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26
Q

______ dissolves in water to form a gel-like material. It can help lower blood cholesterol and glucose levels.

Ex. oats, peas, beans, apples, citrus fruits, carrots, barley, and psyllium

A

Soluble fiber

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27
Q

_____ foods, such as rice, eggs, and lean meats, move more slowly through the intestinal tract.

A

Low residue foods

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28
Q

Gas-producing foods:

A

cabbage, onions, cauliflower, bananas, and apples

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29
Q

Laxative-producing foods:

A

bran, prunes, figs, chocolate, and alcohol

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30
Q

Constipation-producing foods:

A

cheese, pasta, eggs, and lean meat

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31
Q

________ fluid intake slows the chyme’s passage along the intestines, further increasing the reabsorption of fluid from the chyme.

A

Reduced fluid intake

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32
Q

Healthy fecal elimination usually requires a daily fluid intake of ______

A

2000 to 3000 mL

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33
Q

What psychologic factors that increases the peristaltic activity and subsequent nausea or diarrhea?

A

Being anxious or angry

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34
Q

What psychologic factor that slows down the intestinal motility, resulting in constipation?

A

Individuals who are depressed

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35
Q

Many individuals defecate after breakfast due to the ______ reflex; increased peristalsis of the colon after food has entered the stomach

A

gastrocolic reflex

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36
Q

Medication that causes diarrhea:

A

Tranquilizers

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37
Q

Medication that causes constipation:

A

Opioids

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38
Q

______ are medications that stimulate bowel activity and so assist fecal elimination.

A

Laxatives

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39
Q

Any drug that causes gastrointestinal bleeding (e.g., aspirin products) can cause the stool to be ______ or _____

A

Red or black

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40
Q

Iron salts lead to ______ stool because of the oxidation of the iron;

A

Black stool

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41
Q

Medication such as _______ may cause a gray-green discoloration

A

Antibiotics

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42
Q

Medication such as ________ can cause a whitish discoloration or white specks in the stool

A

Antacids

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43
Q

_________ cause the normal colonic movements to cease or slow by blocking parasympathetic stimulation to the muscles of the colon.

A

General anesthetics

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44
Q

Surgery that involves direct handling of the intestines can cause temporary stoppage of intestinal movement. This condition, called______, usually lasts 24-48 hrs

A

ileus

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45
Q

______ may be defined as fewer than three bowel movements per week. This infers the passage of dry, hard stool or the passage of no stool.

A

Constipation

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46
Q

_______associated with constipation is often accompanied by holding the breath.

A

Straining

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47
Q

______ can present serious problems to people with heart disease, brain injuries, or respiratory disease. Holding the breath while bearing down increases intra- thoracic pressure and vagal tone, slowing the pulse rate.

A

Valsalva maneuver

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48
Q

______ is a mass or collection of hardened feces in the folds of the rectum. It results from prolonged retention and accumulation of fecal material.

A

Fecal Impaction

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49
Q

_____ or _____ are usually given to ensure removal of the barium from the radiologic examination of the GI tracts.

A

laxatives or enemas

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50
Q

Impaction can also be assessed by _____ examination of the rectum, during which the hardened mass can often be palpated.

A

digital examination

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51
Q

______ refers to the passage of liquid feces and an increased frequency of defecation. t is the opposite of constipation and results from rapid movement of fecal con- tents through the large intestine.

A

Diarrhea

52
Q

diarrhea is thought to be a protective flushing mechanism. It can create serious ____ and _____ losses in the body.

A

Fluid and electrolytes

53
Q

__________ produces mucoid and foul-smelling diarrhea

A

Clostridium difficile infection (CDI)

54
Q

_____ refers to the loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter.

A

Bowel incontinence, also called fecal incontinence

55
Q

The prevalence of bowel incontinence increases with ____

A

Age

56
Q

Major causes of Diarrhea:

A
  1. Psychologic factors
  2. Medications
  3. Allergy to food, fluids, drugs
  4. Intolerance of food or fluids
  5. Diseases of the colon
57
Q

The three primary sources of flatus are:

A

(1) action of bacteria on the chyme in the large intestine,
(2) swallowed air, and
(3) gas that diffuses between the bloodstream and the intestine.

58
Q

Most gases that are swallowed are expelled through the mouth by _____

A

Eructation (Belching)

59
Q

_______ is the presence of excessive flatus in the intestines and leads to stretching and inflation of the intestines (intestinal distention).

A

Flatulence

60
Q

Physical examination of the abdomen in relation to fecal elimination problems includes:

A

IAPerPal
1. Inspection
2. Auscultation
3. Percussion
4. Palpation

61
Q

Why auscultation precedes palpation?

A

because palpation can alter peristalsis

62
Q

For clients who have difficulty sitting down and getting up from the toilet, an ________ can be attached to a regular toilet.

A

elevated toilet seat

63
Q

______, a portable chair with a toilet seat and a receptacle beneath that can be emptied, is often used for the adult client who can get out of bed but is unable to walk to the bathroom

A

Bedside commode

64
Q

Clients restricted to bed may need to use a _____, a receptacle for urine and feces.

A

bedpan

65
Q

The two main types of bedpans:

A
  1. Regular high-back pan
  2. Slipper pan
66
Q

If the bedpan is metal, warm it by rinsing it with_____

A

warm water

67
Q

_____ are drugs that induce defecation. They can have a strong, emptying effect.

A

Cathartics

68
Q

_____ is mild in comparison to a cathartic, and it produces soft or liquid stools that are sometimes accompanied by abdominal cramps.

A

Laxative

69
Q

Some laxatives are given in the form of ______. These act in various ways: by softening the feces, by releasing gases such as carbon dioxide to distend the rectum, or by stimulating the nerve endings in the rectal mucosa.

A

suppositories

70
Q

The best results can be obtained by inserting the suppository _____ mins before the client’s usual defecation time or when the peristaltic action is greatest, such as after breakfast.

A

30 mins

71
Q

These medications slow the motility of the intestine or absorb excess fluid in the intestine.

A

Antidiarrheal Medications

72
Q

_____, medication that do not decrease the formation of flatus but they do coalesce the gas bubbles and facilitate their passage by belching through the mouth or expulsion through the anus.

A

Antiflatulent Medications

73
Q

A combination of ____ and_____ (Imodium Advanced) is effective in relieving abdominal bloat- ing and gas associated with acute diarrhea;

A

simethicone and loperamide

74
Q

_____ are herbal oils known to act as agents that help expel gas from the stomach and intestines.

A

Carminatives

75
Q

There are a number of ways to reduce or expel flatus, including:

A

exercise, moving in bed, ambulation, and avoiding gas-producing foods

76
Q

_____ is a solution introduced into the rectum and large intestine. The action of an it is to distend the intestine and sometimes to irritate the intestinal mucosa, thereby increasing peristalsis and the excretion of feces and flatus.

A

Enema

77
Q

he enema solution should be at _____ because a solution that is too cold or too hot is uncomfortable and causes cramping.

A

37.7°C (100°F)

78
Q

Enema that is intended to remove feces

A

Cleansing Enema

79
Q

______ exert osmotic pressure, which draws fluid from the interstitial space into the colon. The increased volume in the colon stimulates peristalsis and thus defecation.

A

Hypertonic solutions

80
Q

_____ exert a lower osmotic pressure than the surrounding interstitial fluid, causing water to move from the colon into the interstitial space.

A

Hypotonic solutions

81
Q

Because the water moves out of the colon, the tap water enema should not be _____ because of the danger of circulatory overload

A

repeated

82
Q

______ such as physiologic (normal) saline, are considered the safest enema solutions to use. They exert the same osmotic pressure as the interstitial fluid surround- ing the colon. Therefore, there is no fluid movement into or out of the colon.

A

______ enemas stimulate peristalsis by increasing the volume in the colon and irritating the mucosa.

83
Q

_____ enema is given to cleanse as much of the colon as possible. The client changes from the left lateral position to the dorsal recumbent position and then to the right lateral position during administration

A

_____ enema is used to clean the rectum and sigmoid colon only. The client maintains a left lateral position during administration.

84
Q

The higher the enema solution container is held above the rectum, ____ the flow and the greater the force (pressure) in the rectum.

A

the faster

85
Q

During most adult enemas, the solution container should be no higher than _____ cm above the rectum.

A

30 cm (12 in)

86
Q

During a high cleansing enema, the solution container is usually held ____ cm

A

30 to 48cm (12 to 18 in)

87
Q

_____ enema introduces oil or medication into the rectum and sigmoid colon. The liquid is retained for a relatively long period (e.g., 1 to 3 hours)

A

Retention enema

88
Q

_____ enema acts to soften the feces and to lubricate the rectum and anal canal, thus facilitating passage of the feces.

A

Oil retention

89
Q

_____ enemas are used to treat infections locally, anthelmintic enemas to kill helminths such as worms and intestinal parasites

A

Antibiotic enemas

90
Q

_____ enemas to administer fluids and nutrients to the rectum.

A

Nutritive enemas

91
Q

____ enema is given primarily to expel flatus. The solution instilled into the rectum releases gas, which in turn distends the rectum and the colon, thus stimulating peristalsis

A

Carminative enema

92
Q

_____ also called a Harris flush, is occasionally used to expel flatus. Alternating flow of ____mL of fluid into and out of the rectum and sigmoid colon stimulates peristalsis. This process is repeated five or six times

A

Return flow enema; 100 to 200 mL

93
Q

_____ involves breaking up the fecal mass digitally and removing it in portions.

A

Digital Removal

94
Q

Before disimpaction it is suggested an _____ enema be given and held for 30 minutes.

A

oil retention

95
Q

Because manual removal of an impaction can be painful, the nurse may use, if the agency permits, 1 to 2 mL of _______ gel on a gloved finger inserted into the anal canal as far as the nurse can reach.

A

lidocaine (Xylocaine)

96
Q

To collect and contain large volumes of liquid feces, the nurse may place a ______ around the anal area

A

fecal incontinence collector pouch

97
Q

The artificial sphincter consists of three parts:

A

a cuff around the anal canal, a pressure-regulating balloon, and a pump that inflates the cuff

98
Q

_____ is an opening for the gastrointestinal, urinary, or respiratory tract onto the skin

A

ostomy

99
Q

_____ is an opening through the abdominal wall into the stomach

A

Gastrostomy

100
Q

_____ opens through the abdominal wall into the jejunum

A

jejunostomy

101
Q

_____ opens into the ileum (small bowel); empties from the distal end of the small intestine. It produces liquid fecal drainage.

A

ileostomy

102
Q

____ opens into the colon (large bowel).

A

Colostomy

103
Q

____ and _____ are generally performed to provide an alternate feeding route.

A

Gastrostomies and jejunostomies

104
Q

The purpose of ______ is to divert and drain fecal material.

A

bowel ostomies

105
Q

_____ , the opening created in the abdominal wall by the ostomy; generally red in color and moist.

A

Stoma

106
Q

The client does not feel the stoma because there are ______

A

no nerve endings in the stoma

107
Q

____ empties from the ascending colon; drainage is liquid and cannot be regulated, and digestive enzymes are present.

A

Ascending colostomy

108
Q

_____ empties from the cecum (the first part of the ascending colon)

A

Cecostomy

109
Q

____ empties from the transverse colon; produces a malodorous, mushy drainage because some of the liquid has been reabsorbed. Usually there is no control

A

transverse colostomy

110
Q

_____ empties from the descending colon; produces increasingly solid fecal drainage.

A

descending colostomy

111
Q

_____ empties from the sigmoid colon; normal or formed consistency

A

sigmoidostomy

112
Q

____ is created when one end of bowel is brought out through an opening onto the anterior abdominal wall. This is referred to as an_______ ; the stoma is permanent

A

Single stoma; end or terminal colostomy

113
Q

______ a loop of bowel is brought out onto the abdominal wall and supported by a plastic bridge or by a piece of rubber tubing

A

Loop colostomy

114
Q

____ consists of two edges of bowel brought out onto the abdomen but separated from each other

A

Divided colostomy

115
Q

the distal end in In divided colostomy situation is often referred to as a _____, since this section of bowel continues to secrete mucus

A

mucous fistula

116
Q

_____ resembles a double- barreled shotgun; the proximal and distal loops of bowel are sutured together for about 10 cm (4 in.) and both ends are brought up onto the abdominal wall.

A

double-barreled colostomy

117
Q

_____ absorbs moisture and also creates a dry coating, increasing adhesion of the stoma appliance

A

Stoma powder

118
Q

____ available as wipes or spray, act as a barrier against the fecal material and are applied prior to attaching the appliance.

A

Protective films

119
Q

Appliances can be _____ where the skin barrier is already attached to the pouch

A

One piece

120
Q

appliance can consist of two pieces: a ____ with a flange and a separate _____ with a flange where the pouch fastens to the barrier at the flange

A

separate pouch; skin barrier

121
Q

_____ pouch that usually has a clip where the end of the pouch is folded over the clamp and clipped. Used by clients who need to empty the pouch more than twice a day.

A

Drainable pouch

122
Q

____ pouches are often used by clients who have a regular stoma discharge (e.g., sigmoid colostomy) and only have to empty the pouch one or two times a day.

A

Closed pouches

123
Q

The most common routine for changing the appliance is every ______ days

A

2-3 days

124
Q

If the skin is erythematous, eroded, or ulcerated, the pouch should be changed every _____ hrs

A

24-48 hrs

125
Q

The pouch is emptied when it is ______ of discharge or gas.

A

one-third to one-half full

126
Q

_____ similar to an enema, is a form of stoma management used only for clients who have a sigmoid or descending colostomy.

A

colostomy irrigation (CI)

N11 - Nursing Foundations (10 decks)

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