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EPCC Nursing Foundations > Fecal Elimination Power Point > Flashcards

Fecal Elimination Power Point Flashcards

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1
Q

True or False:

ostomy’s closer to the stomach fecal matter have less smell and less liquid

A

True

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2
Q

True or False:

Ostomy’s closer to the rectum fecal matter has greater smell and is more formed

A

True

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3
Q

The function of this organ absorbs water and nutrients

A

small intestine

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4
Q

The function of this organ excretes waste, reabsorbs water and electrolytes, and stores and mixes food with secreations

A

Large intestine (colon)

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5
Q

The function of this organ forms and secretes bile that is essential for breakdown of fats

A

Liver

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6
Q

Constipation is more common in this age group because of the use of OTC, decreased activity level/ fluid and fiber intake

A

Older adult

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7
Q

Define meconium

A

the first fecal material passed by the newborn up to 24 hours after birth

Dark
Green
Tarry
Odorless
Sticky

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8
Q

What affects peristalsis?

A

Activity
Medications
Anesthesia
Obstructions
Adhesions
Diet

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9
Q

Describe a normal finding of the GI after surgery

A

no bowel sounds after 24 hours
hypoactive bowel without n/v/d

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10
Q

What is the treatment for a pt who has had GI surgery?

A

ambulation

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11
Q

True or false: the intestine are highly vascular - bleeding more easily and absorbing things more easily

A

true

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12
Q

Iron supplements and Pepto-Bismol both turn poop which color

A

black

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13
Q

Which medications affect gastric motility

A

opioids
antihistamines
antidepressants

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14
Q

Describe what normal feces looks like for the adult

A

o brown
o firmed, soft, semi-solid, moist
o cylindrical (contour of the rectum) ~2.5 cm / 1 inch in diameter
o odor will vary with diet
o will also vary with food ingested and persons own bacterial flora
o Constituent [made up of]: small amounts of undigested roughage, sloughed dead bacterial and epithelial cells, fat, protein
o Dried constituent of digested juices like bile pigments and inorganic matter

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15
Q

The recommended daily fiber is what for people 50 years and younger

A

men: 38 grams
women: 28 grams

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16
Q

The recommended daily fiber is what for people 50 years and older

A

men: 30 grams
women: 21 grams

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17
Q

What are gas producing foods?

A

cabbage
onion
cauliflower
bananas
apples

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18
Q

What are laxative producing foods?

A

bran
prunes
figs
chocolate
alcohol

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19
Q

What are constipation producing foods?

A

cheese
pasta
eggs
lean meat

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20
Q

when is it best to listen to bowel sounds

A

between meals
peristalsis is more active

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21
Q

Describe abnormal feces

A

clay or white (lack of bile/ pancreatic or liver diseases)
black or tarry (from drugs like iron or bleeding from upper GI [small intestine or stomach]
red (bleeding from lower GI)
Pale (malabsorption of fats)
orange or green (intestinal infection)
hard / dry (dehydration decreased intestinal motility from lack of fiber, lack of activity, laxative abuse)
diarrhea (increased motility due to bacteria in the colon)
narrow pencil shaped or string like (obstruction of the rectum)
pungent odor (infection of blood)
pus/ parasites/ blood/ large quantities of fat

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22
Q

What is the therapeutic response for docusate sodium (colace) and docusate calcium (Surfak)

A

lowering the surface tension of fecal material
allowing water into the stool
resulting in soft fecal mass

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23
Q

What should the nurse teach families and the pt about docusate sodium (colace) and docusate calcium (Surfak)?

A

drink a glass of water (or fluid juice / milk) with the medication
effectiveness of the medication is 1-3 days
DO NOT take within 2 hours of other laxatives especially mineral oil (docusate sodium (colace) and docusate calcium (Surfak) may increase the absorption of mineral oil since it absorbs water)
Discuss other forms of bowel regulation like increasing fluid, fiber, and activity.

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24
Q

The longer the poop is in the GI the harder and __________ it is.

A

dryer

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25
Q

In older adults who have fecal impaction may show signs of delirium, which is a sudden change in

A

mental status

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26
Q

List factors that affect elimination

A

diet (fiber/ water)
positioning
privacy
medications
activity (stimulates peristalsis)
defecation habits (do NOT ignore urge)

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27
Q

What is the purpose of soluble fiber and where is it found?

A

Purpose - helps with diarrhea
Dissolves in water

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28
Q

What is the purpose of insoluble fiber and where is it found?

A

mixes with stool
apples have high fiber but also found in the skin of fruits and vegetables

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29
Q

Describe fecal impaction

A

mass or collection of hardened feces in the folds of the rectum
seeps fecal liquid
no normal stool

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30
Q

A method to help a pt with fecal impaction is digital desimpaction. What are the risks in doing this?

A

vagal nerve stimulation
bleeding
fissures
perforation [hole developed through the wall of a body organ]

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31
Q

A pt with hypothyroidism and an slowed down metabolism can have which sx that effects elimination?

A

constipation

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32
Q

A pt with hyperthyroidism can have with sx that effects elimination ?

A

diarrhea

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33
Q

Can fiber be digested

A

no

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34
Q

If the vagal nerve is stimulated during fecal desimpaction, what can happed to the pt?

A

They can pass out

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35
Q

Describe diarrhea

A

passage of liquid feces AND increased frequency of defecation
gets rid of bacteria that is NOT supposed to be there
pt will be dehydrated
increased bowel sounds

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36
Q

A healthy daily fluid intake is how many mL

A

2000 - 3000

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37
Q

Define gastrocolic reflex

A

defecating after breakfast

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38
Q

Define ileus

A

this is caused when a pt has surgery where handling the intestines is necessary.

There will be 24-48 hours of bowel stoppage of intestinal movement

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39
Q

This is another way to treat fecal impaction

A

oil enema
2-4 hours later
cleansing enema
suppository or stool softener

40
Q

A nurse can teach a pt how to control bowel incontinence by teaching them

A

modify their diet (water / fiber)
eating at a regular schedule so that they eliminate at a regular schedule
weight loss
surgery

41
Q

When palpating the abdomen, what will flatulence feel like

A

soft

42
Q

If there is blood in the stool caused by hemorrhoids, what is the characteristics and why?

A

The rectum is a highly vascular area, hemorrhoids are dilated veins that have ruptured and cause bleeding

bright red bleeding / stringy bleeding due to proximity of rectum

43
Q

This medication induces defecation (big guns)

A

cathartics

44
Q

Describe how a cathartic works and provide example medications

A

may cause cramps
has a strong emptying effect
castor oil
cascara
bisacodyl
(frequent use can cause electrolyte imbalances // and reliance on medication)

45
Q

Describe how laxatives work and provide example medications

A

produce a soft or liquid stool
may be rapid acting or takes time
(frequent use can cause chronic constipation)
bulk forming - psyllium
stool softener - docusate
MOM - milk of magnesium
MiraLAX

46
Q

Magnesium laxatives are contraindicated for pts with

A

renal insufficiency or ESRD

47
Q

Describe constipation

A

under 3 BM a week
hard dry stool that is difficult to eliminate
painful BM

48
Q

List contraindications for enemas

A

pts who have:
appendicitis
thrombocytopenia [slow blood clotting / bruising easy]
neutropenia [low neutrophils due to infection]
diverticulosis [small pouches that bulge out of colon]

49
Q

What is the purpose of enemas

A

remove feces in constipation and fecal impaction

50
Q

What are the commonly used enemas

A

cleansing
retention
carminative
return flow

51
Q

What is the purpose of a cleansing enema

A

to remove feces
- prevent the escape of feces during surgery
- prepare the intestine for visualization (colonoscopy) or x ray
- remove feces due to constipation or impaction

52
Q

Fleet enemas (hypertonic solution) could be contraindicated to pts with this condition

A

renal failure

53
Q

More than one fleet enema (hypertonic solution) in _____ hours can be harmful

A

24 hours

54
Q

What is the purpose of retention enemas

A

induces oil or medication to the rectum and sigmoid colon

55
Q

How long should be retained for this long `

A

1-3 hours

56
Q

Antibiotic enemas are used to treat

A

infections locally

57
Q

Anthelmintic enemas are used to treat

A

worms and intestinal parasites

58
Q

Nutritive enemas are used to

A

administer fluids and nutrients to to the rectum

59
Q

What is the purpose of a carminative enema and how much fluid is instilled

A

primary purpose - to expel flatus
60-80 mL of fluid

60
Q

What is the purpose of a return flow enema and how much fluid is instilled

A

primary purpose - stimulate peristalsis
secondary purpose - expel flatus
100 - 200 mL alternating 5-6 times

61
Q

Purpose of hypertonic solution for an enema and example

A

draws in enter water in colon
fleet enema

62
Q

Purpose of hypotonic solution for an enema and example

A

stimulates peristalsis / softens feces
tap water

63
Q

This is the safest type of solution for an enema and an example is

A

Isotonic safe
Normal saline
stimulates peristalsis / softens feces

64
Q

Purpose of soapsuds solution for an enema and example

A

pure soap
irritates mucosa / distends colon

65
Q

Purpose of oil solution for an enema and example

A

lubricates feces and mucosa
mineral oil

66
Q

What temperature should the solution for enema be?

A

warm

67
Q

What is a stoma?

A

Opening created by an ostomy

68
Q

What kind of emotional support does the pt need when they have an ostomy

A

the nurse needs to know that the pt has accepted it and can look at it because they will be changing it at home

69
Q

A risk to ostomies or digestive enzymes is

A

skin irritation

70
Q

Describe stools that come from a colostomy

A

solid

71
Q

Describe stools that come from an ilieostomy

A

generally fluid

72
Q

When does bowel diversion ostomies begin to work?

A

they begin to function 4-5 days post op

73
Q

When does bowel diversion ostomies begin to work?

A

they begin to function 4-5 days post op

74
Q

What are cruciferous [spouty greeny vegetables of the cabbage family] vegetables

A

Arugula.
Bok choy.
Broccoli.
Brussels sprouts.
Cabbage.
Cauliflower.
Collard greens.

75
Q

In a bowel diversion ostomy, an ileostomy can make a pt deficient in what nutrients and why

A

Vit B12 (biotin)
Iron
Mg
Folic Acid
H2O
NA+
because there is no colon to absorb these vitamins into the blood stream

76
Q

Dietary considerations to avoid gas for a bowel diversion is which foods

A

Broccoli.
Brussels sprouts.
Cabbage.
Cauliflower.
Collard greens.
carbonated drinks
alcohol

77
Q

Dietary considerations to avoid odor for bowel diversion is which foods

A

onions
broccoli or sprouty vegetables
asparagus
eggs
fish

78
Q

Describe a normal stoma

A

pink / red
may bleed when touched due to being highly vascular

79
Q

How can a pt care for a stoma

A

asses the skin for irritation each time the appliance is changed
treat any irritation immediately
keep skin clean by washing off excretion and drying the skin thoroughly
colostomy irrigation

80
Q

What are the different types of stool samples

A

fecal occult blood (guaiac)
ova / parasites
culture

81
Q

What is the goal of bowel training

A

establish a normal defecation pattern

82
Q

A pt plan for bowel training would include

A

fluid
fiber
exercise
hot drinks

83
Q

How long should a bowel training routine be maintained

A

2-3 weeks
need to be consistent

84
Q

List other methods used with bowel training

A

cathartic suppositories positioning is key
prompt the response to urges
physical positioning

85
Q

What is the purpose of a fecal incontinence pouch

A

to get the pt to stop pooping due to rectal damage

86
Q

What are the nursing responsibilities for a fecal incontinence pouch other than assessing the skin

A

Changing the bag every 72 hours (sooner if there is leakage)
Maintain the drainage system
Explain the process and support the pt`

87
Q

What are the goals for pts with fecal elimination problems

A

maintain or restore bowel elimination pattern
maintain or regain normal stool consistency
Prevent risks like F&E imbalance, skin breakdown, abdominal distension, and pain

88
Q

How can the nurse promote healthy defecation

A

giving the pt privacy
timing - the pt needs to defecate when they have the urge. ambulating and bathing should not interfere with their normal defecation pattern/ defecation routine
Nutrition and fluids

89
Q

How can the nurse teach the pt how to establish a healthy defecation pattern

A

regular exercise
high fiber foods (vegetables, whole grains, fruits)
Fluid intake should be 2000-3000 mL /day
Do NOT ignore the urge to defecate
All the pt time to defecate - preferably around the same time everyday
avoid OTC to treat constipation and diarrhea

90
Q

Describe insoluble fiber

A

increases peristalsis and increases bulk

91
Q

Describe soluble fiber

A

dissolves in water to form gel-like material to help lower cholesterol and glucose levels

92
Q

How can the nurse teach a pt to manage diarrhea

A

drink 8+ glasses of water daily/ or even electrolyte fluids
Eat foods with Na+ or K+ (meat vegetables fuits)
Increase fiber (rice, oatmeal, potatoes)
Avoid caffeine and alcohol
Limit insoluble fiber (whole wheat / whole grain cereals)
limit fatty foods
discontinue meds for diarrhea

93
Q

If a pt has been having diarrhea and it is stopped, how can they reestablish normal GI flora

A

By eating fermented dairy products like yogurt or buttermilk

94
Q

A pt needs to monitor this if they have diarrhea

A

hypovolemia
dehydration

95
Q

A pt should seek a PCP right away if they have the following

A

weakness
dizziness
loose / persistent stools for more than 48 hours

EPCC Nursing Foundations (43 decks)

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