Exam 4: Chapter 38 Bowel Elimination Flashcards
Variables Influencing Bowel Elimination: Infants: What is easiest for infants intestines?
Breast milk
Variables Influencing Bowel Elimination: Stool color for breastfed infants?
Have more frequent stools and are yellow to golden and loose, and usually have little odor
Variables Influencing Bowel Elimination: Stools for formula fed infants?
Yellow to brown, and are paste like. Have a strong odor because of decomposition of protein
Variables Influencing Bowel Elimination: Stools of both breastfed and formula fed infants have
curds and mucus
Variables Influencing Bowel Elimination: Number of Stools of Breastfed vs Formula Fed Infants
Breastfed: 2-10 a Day
Formula: 1-2 a day
Variables Influencing Bowel Elimination: Food and Fluid: How much fiber and fluid should you intake?
25-30 G Fiber
2000-3000 mL of fluid
Variables Influencing Bowel Elimination: What are some high fiber foods?
WHole grains and brain, dried peas and beans, and freesh fruis and vegetables increase bulk
Variables Influencing Bowel Elimination: Some Constipation foods?
Processed Cheese, Lean Meat, Eggs, Pasta, Rice, White Bread, Iron, and Calcium Supplements
Variables Influencing Bowel Elimination: Foods with Laxative Effects?
Certain Fruits and Veggiees, Bran, Chocolate, SPicy Foods, Alcohol, Coffee
Variables Influencing Bowel Elimination: Gas Producing Foods?
Onions, Cabbage, Beans, Cauliflower
Variables Influencing Bowel Elimination: Short term of stress?
Diarrhea
Variables Influencing Bowel Elimination: Long term of stress?
May lead to frequent constipation
Variables Influencing Bowel Elimination: Stool color with any drug that may cause GI bleeding?
Pink to red to black
Variables Influencing Bowel Elimination: Stool color with iron salts?
Black stools
Variables Influencing Bowel Elimination: Stool color with bismuth subsalicylate?
black stools
Variables Influencing Bowel Elimination: stool color with antacids?
white discoloration or speckling
Variables Influencing Bowel Elimination: stool color with antibiotics?
green-gray color related to impaired digestion
Variables Influencing Bowel Elimination: Common cause of medication induced constipation?
Opioids
Variables Influencing Bowel Elimination: What other drugs can cause constipation?
Antacids containing iron sulfate, almuninum, and anticholinergic
What is Paralytic ileus?
Direct manipulation of the bowel during abdominal surgery inhibiting peristalsis
Abdominal assessment order?
Inspection, Auscultation, Percussion and Palpations
Physical Assessment of the Abdomen: How long should you listen to the abdomen?
Listen 2 minutes before absence of sounds
Physical Assessment of the Abdomen: Inspection
Observe contour, any masses, scars, or distention
Physical Assessment of the Abdomen: Auscultation
Listen for bowel sounds in all quadrants
Physical Assessment of the Abdomen: What should you do in Auscultation?
Note frequency and character, audible clicks and flatus.
Describe bowel sounds as hypoactive, hyperactice, absent or infrequent
Physical Assessment of the Abdomen: Percussion and Palpations
Performed by advanced practice professionals
Physical Assessment of the Abdomen: When performing palpation, how should the patients knees be?
Bend the patients knees if possible
Stool Collection: What technique should you use
Medical Aseptic technique. Always wear disposable gloves when any contact or handling of a stool specimen is likely
Stool Collection: Hand Hygiene
Before and after glove use is essential
Stool Collection: How much liquid stool do you need?
15-30 mL
Stool Collection: What should be placed on the container?
Date, time, patient info, who took/initials
What do black stools represent in turn of bleeding?
Upper GI Bleeding
What do red stools represent in terms of bleeding?
Lower GI Bleeding
What is FOBT used for?
Used to detech occult blood in stool, and can detect cancer and for GI bleeding when ulcer disease, inflammatory bowel disorders, adn intestinal polyps present
What is a gFOBT?
Chemical test that detects the enzyme peroxidase in hemoglobin molecules when blood is present in the blood sample
Positive gFOBT indicates?
Abnormal bleeding is occuring somewhere in teh digestive tract
How does a FIT test work??
Uses antibodies directed against human hemoglobin to detect blood in the stool
Positive FIt is more specific for bleeding in the
Lower GI tractr
Promoting REgluar Bowel Habits: What should we focus on?
Timing, Positioning, Privacy, Nutrition, and Exercise
Promoting Regular Bowel Habits: What exercises could be performed?
Abdominal setting and thigh strengthening
Individuals at high risk for constipation?
Patients on bedrest taking constipation medicine
Patients with reduced fluids or bulk in their diet
Pateitns who are depressed
Nursing Measurs for Patient with Diarrhea
Answer call bells immediately
Remove cause of diarrhea when possible
If impaction, obtain physician for rectal examination
Give special care around anus
Food Safety
Never buy food with damaged packaging
Use separate cutting boards for foods
Do not wash meat, poultry, or eggs to prevent spreading microorganisms to sink and other kitchen surfaces
When emptying colon, what position do you have to be in?
Side lying or Sims
Options for emptying the colon of feces?
Enemas
Rectal Suppositories
Oral Intestinal Lavage
Digital Removal of Stool
Type of Oral Intestinal Lavage?
GoLYTELY
Considerations for Oral Intestinal Lavage?
Use Lubricated Tip. Do not insert too fast and make sure its at room temperature
WHat is Incontinence-Associated Dermatitis?
Prolonged contact of the skin with urine or feces that leads to a form of moisture-associated skin damage
What is a Levine Tube?
A common single-lumen tube. It lacks a venting system and mucosal damage can occur when suction is applied continuously
What is a Ileostomy?
Allows liquid fecal contant from teh ileum of the small intestine to be elimanted through the stoma
What is Colonstomy?
Permits formed feces int he colon to exit through the stoma
Types of Ostomies?
Sigmoid Colostomy Descending Colostomy TRansverse Colostomy Ascending Colostomy Ileostomy
How should an stoma look?
Dark pink to red to moist
Colostomy Care: Odor
Keep the patient as free of odors as possible, empty the appliance frequently
Colostomy Care: Inspect
Insepct the patients stoma frequently
Colostomy Care:Measure
Measure the pateitns fluid intake and output
Colostomy Care: Explain
Explain each aspect of care to the patient and self-care role
Colostomy Care: Encourage
Encourage the patient to care for and look at ostomy
Colostomy Care: How long will it take to have stool?
It will take a few days before stool comes
Patient teaching for Colostomies: Explain
Explain the reason for bowel diversion and the rationale for treatment
Patient teaching for Colostomies: Demonstrate
Demonstrate self-care behaviors that effectively manage the ostomy and positive body-image
Patient teaching for Colostomies: Describe
Describe follow up care and existing support resources
Patient teaching for Colostomies: Report
Report where supplies may be obtained in the community
Patient teaching for Colostomies: Verbalize
Verbalize related fears and concerns
Patient teaching for Colostomies: Fluids
2 Quarts Fluid Per Day
Patient teaching for Colostomies: Avoid High Fier for
6-8 weeks after surgery
Patient teaching for Colostomies: Avoid
Laxatives, Enemas, and Enteric Meds