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NUR1114 > Week 6 Nursing > Flashcards

Week 6 Nursing Flashcards

1
Q

Constipation:

A
  • An abnormal frequency of defaecation (infrequent)
  • An abnormal regularity of defaecation (irregular)
  • Abnormal hardening of stools (difficult passage)
  • Decrease in stool volume
  • Retention of stool in the rectum
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2
Q

Causes of Constipation

A
  • Medications
  • Rectal or anal disorders
  • Obstruction
  • Pre-existing conditions
    – Metabolic, neurological, neuromuscular
  • Endocrine disorders
  • Lead poisoning
  • Connective tissue disorders
  • Colon disease
  • Acute disease
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3
Q

Risk factors

A
  • Weakness and fatigue
  • Immobility and debility
  • Poor lifestyle habits
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4
Q

Pathophysiology

A

Interference with the 3 major functions of the colon:
– Mucosal transport
– Myoelectric activity
– Processes of defaecation
* Urge to defaecate stimulated by rectal distension
* Organic and idiopathic causes

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5
Q

Complications

A
  • Hypertension
  • Faecal impaction
  • Haemorrhoids
  • Fissures
  • Megacolon
  • Straining – Valsalva’s – arterial rupture
  • Seepage of liquid stools
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6
Q

Clinical Manifestations

A
  • Abdominal distension
  • Borborygmus
  • Pain and pressure
  • Decreased appetite
  • Headache
  • Fatigue
  • Indigestion
  • Sensation of incomplete emptying
  • Straining (at stool)
  • Reduced volume, hard and dry stools
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7
Q

Assessment and Diagnostic findings

A

Most commonly diagnosed by:
* Patient history
* Physical Assessment
But also:
* AXR (abdominal X-Ray)
* PR (per rectum)
* Barium enema
* Sigmoidoscopy
* Stool occult blood testing (FOB)
* Anorectal manometry
* Pelvic floor MRI

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8
Q

Laxative classifications

A

Types of laxatives
* Bulk forming: Stimulate peristalsis
* Saline agent: Stimulate peristalsis
* Lubricant: Lubricate intestinal mucosa
* Stimulant: Irritates the colon
* Faecal softener: Hydrates the stool
* Osmotic Agent: Induces diarrhoea

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9
Q

Nursing Management

A
  • Assessment:
    – Health History: Normal bowel elimination, lifestyle info
    – Medical/Surgical History
  • Medication: Laxative and enema use
  • Signs and symptoms of constipation
  • Patient education: Bowel habit training
  • Health promotion: Risk factors
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10
Q

Diarrhoea:

A
  • Increased frequency: > 3 per day
  • Increased amount of stool: > 200g day
  • Altered consistency: loose
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11
Q

Causes

A
  • Underlying disease: IBS, IBD, intolerances
  • Infection: bacterial or viral
  • Medications
  • Metabolic/Endocrine disorders:
  • Malabsorption
  • Intestinal obstruction
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12
Q

Pathophysiology - diarrhoea

A

Types
* Secretory: Increased secretion into intestinal mucosa
* Osmotic: water pulled into intestines via osmotic pressure
* Malabsorptive: Inhibited absorption of nutrients
* Exudative; Changes in epithelial integrity e.g – due to chemotherapy

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13
Q

Clinical Manifestations - diarrhoea

A
  • Increased frequency and volume of stools
  • Abdominal cramps
  • Distention
  • Borborygmus: rumbling
  • Anorexia: LOA
  • Thirst
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14
Q

Assessment and Diagnostic Findings - diarrhoea

A
  • Blood tests: Full blood count and chemical profile (FBC/FBE, U&E)
  • Urinalysis
  • Routine stool examination/culture
  • Endoscopy
  • Barium enema
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15
Q

Complications - diarrhoea

A
  • Fluid and electrolyte loss: especially potassium
  • Cardiac arrhythmias and death
  • Dehydration
  • Malnutrition: if chronic
  • Micronutrient deficiencies
  • Hypovolaemia: shock e.g due to Cholera
  • Skin complications: dermatitis
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16
Q

Nursing Management - diarrhoea

A
  • Assess: auscultation/palpation
  • Monitor: stool charts and FBC
  • Infection precautions
  • Diagnostic testing: stool samples
  • Rehydration
  • Nutrition
  • Anti-diarrhoeal medication: Loperamide (Imodium), Diphenoxylate Hydrochloride (Lomitil)
  • Skin care
17
Q

Causes - nausea and vomiting

A
  • Motion sickness
  • Early pregnancy
  • Intense pain
  • Emotional stress
  • Gall bladder disease
  • Food poisoning
  • Enteroviruses
  • Ulcers: gastric or duodenal: Haematemesis
  • Oesophageal varices: Haematemesis
18
Q

Pathophysiology - nausea and vomiting

A
  • Visceral afferent stimulation: Peritoneal irritation, infection, hepatobiliary disorders
  • CNS disorders: Vestibular, increased ICP, infection
  • Irritation of the chemoreceptor trigger zone: Radiation therapy, medications
19
Q

Assessment and Diagnostic Findings - nausea and vomiting

A
  • Health history
  • Physical examination
  • Neuro assessment: CT/MRI, Blood tests: electrolytes and urea
  • Abdo XRay: Seeking a mechanical cause
20
Q

Nursing Management

A
  • Assess: airway, pain, emesis: haematemesis?
  • Monitor: nausea, FBC, LOC, hydration status
  • Infection precautions
  • Diagnostic testing
  • Rehydration
  • Nutrition
  • Anti-emetics:
    – Pro-kinetic (metoclopramide)
    – Anti-histamines (promethazine)
    – Serotonin antagonists (ondansetron)

NUR1114 (17 decks)

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