GI Elimination Flashcards
Explain the following common bowel elimination problems:
Constipation
Diarrhea
Flatulence
Constipation: A symptom, not a disease, infrequent stool and/or hard, dry, small stools that are difficult to eliminate
Diarrhea: Increase in number of stools and the passage of liquid, unformed feces
Flatulence: Accumulation of gas in intestines causing walls to stretch
Explain the following common bowel elimination problems:
Impaction
Incontinence
Hemorrhoids
Impaction: Results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel
Incontinence: inability to control passage of feces/gas to the anus
Hemorrhoids: Dilated, engorged veins in rectum lining
What are some risk factors to constipation becoming impaction?
Immobility
Decreased fluid intake
lifestyle
Not pooping when you feel the need to
What are some risk factors for diarrhea?
Stress
Illness (stomach bug, c. diff)
Antibiotics
What is a risk factor for hemorhoids?
Increased pressure for long time
-chronic constipation-pushing hard to poop
-giving birth
Define:
Stoma
Ileostomy/Colostomy
Stoma: temporary or permanent artificial opening in abdominal wall
Ileostomy/colostomy: surgical opening in the ileum or colon
What does a healthy stoma look like?
Pink/red, moist, surrounding skin is healthy, oozing the green/yellow fluid (feces)
No bright red blood
What are some nutritional considerations for ostomy care?
Low fiber for first few weeks
Eat slowly, chew completely
10-12 glasses of water daily
avoid gassy foods
What is the 3rd most common cancer in the USA?
Colorectal cancer
What are some ways to reduce risk for colorectal cancer?
Regular exercise
healthy weight
not smoking
high fiber
decrease red meat
Explain some medications for bowl elimination problems
Caathartics & Laxatives:
-Oral, tablet, powers, suppository forms
-Excessive use increases risk for diarrhea/abnormal elimination
Can enemas be delegated to AP?
NO- medication administration
Explain the types of cleansing enemas
Tap water
NS
Hypertonic solutions
Soapsuds (only pure castile soap)
Explain other types of enemas than oil retention and cleansing enemas
Carminative: improves ability to pass flatus
Kayexalate: increases removal of potassium
Is sterile technique necessary for enemas?
No
wear gloves
What is the last resort in managing severe constipation?
When is it used?
What is necessary for this to happen, and who usually does it?
Digital removal of stool
used if enemas fail
to remove impaction
Provider order is necessary, usually provider does it
Is a rectal tube insertion procedure clean or sterile?
What kind of condition can it be used for?
What is a concern for it?
clean
ONLY fully liquid feces
Skin integrity management
What are the purposes of NG tubes?
Decompression: pulling something out (intermittent suction)
Enteral feeding: Feeding something in
What are the categories of NG tubes?
Fine/small-bore: medication admin. and enteral feedings
Large-bore (12-French and above) for gastric decompression/removal of gastric secretions
What kind of technique is used for NG tube maintenance?
Clean
What is the only way to verify NG tube placement?
How is the length of an NG tube determined?
X-ray (or pH check)
Measure nose, ear, xiphoid process
Who is at risk for NG tube placement challenges?
Nasofacial trauma
What kind of tasks regarding an NG tube can be delegated?
Measure/record drainage from NG tube
Provide oral/nasal hygiene
Select comfort measures (positioning, ice chips)
How is comfort maintained for an NG tube?
How is tube patency maintained for an NG tube?
Dry mouth, tape
Drink water while inserting tube-keeps trachea blocked with epiglottis
Irrigate regularly with sterile water- NOT normal saline
What kind of meds cannot be given through an NG tube?
Enteric-coated, sublingual, extended-release, sustained release
You are caring for a patient who has an NG tube and you are very worried about aspiration. What will you do before starting feeds?
Verify placement-measure pH
Run feed while they’re sitting up
You have confirmed placement of the NG tube and have started the feeds at the ordered 100mL/hr. The patient is now complaining of abdominal cramping. What can you do?
Slow down the feeds
What is the difference between a budding and retracted stoma?
Budding: raised, protruding- GOOD
Retracted: surrounding skin is at risk for infection and breakdown
