Exam 4 Bowel Elimination Flashcards
What are the elimination concepts?
control, retention, and discomfort
What is the process of peristalsis?
under control of nervous system, contractions every 3 to 12 minutes; mass sweeps 1-4 times in 24 hour period
What are variables influencing bowel elimination?
developmental considerations, daily patterns, food and fluid, activity and muscle tone, lifestyle, psychological variables, medications, diagnostic studies, surgery and anesthesia
What foods cause constipation?
cheese, lean meat, eggs, pasta
What foods have laxative effects?
fruits and vegetables, bran, chocolate, alcohol, coffee
What are gas-producing foods?
onions, cabbage, beans, cauliflower
Who are at highest risk for bowel incontinence?
people with cognitive issues and people who have had radiation to the area
Who are at highest risk for retention?
those with inadequate fluid intake, fiber or exercise, on certain meds, and pregnancy
What to inspect during abdomen assessment?
observe contour, any masses, scars, or distention
What to auscultate during physical assessment on abdomen?
listen for bowel sounds in all 4 quadrants, note frequency and character, audible clicks, and flatus; describe as hypoactive, hyperactive, absent or frequent
What to inspect and palpate during physical assessment of anus and rectum?
lesions, ulcers, fissures, inflammation, and external hemorrhoids; ask pt to bear down as if they were having a BM, assess appearance of internal hemorrhoids or fissures and fecal masses; inspect perineal area for skin irritation secondary to diarrhea or incontinence
What are the types of direct visualization studies?
esophagogastroduodenoscopy, colonoscopy, sigmoidoscopy, wireless capsule endoscopy
What are the indirect visualization studies?
upper GI, small bowel series, barium enema, abdominal ultrasound, MRI, abdominal CT scan
Order of scheduling diagnostic tests
- fecal occult blood test
- barium studies
- endoscopic exam
What are patient outcomes for normal bowel elimination?
pt has soft, formed bowel movement every 1-3 days without discomfort; relationship between diet, fluid, and exercise is explained; pt to seek eval if changes in stool color or consistency persist
How do you promote regular bowel habits?
timing, positioning, privacy, nutrition, exercise (abdominal and thigh strengthening)
Who is at high risk for constipation?
pt on bedrest taking constipating medicine, pt with reduced fluid intake or bulk in their diet, pt who is depressed, pt with CNS disease or local lesions that cause pain while defecating
What are the methods of emptying the colon of feces?
enemas, rectal suppositories, oral intestinal lavage, digital removal of stool
What are the types of enemas?
cleansing; retention: oil, carminative, medicated, anthelmintic; large volume; small volume
How do oil-retention enemas work?
lubricate the stool and intestinal mucosa, easing defecation
How do carminative enemas work?
help expel flatus from rectum
How do medicated enemas work?
provide meds absorbed through rectal mucosa
How do anthelmintic enemas work?
destroy intestinal parasites
What are nasogastric tubes used for?
to allow the GI tract to rest before or after abdominal surgery to promote healing; inserted to decompress or drain the stomach of fluid or unwanted stomach contents; monitors GI bleeding
