Term
| What is the large intestine? |
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Definition
1)Primary organ of bowel elimination
2)Extends from the ileocecal valve to the anus |
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Term
| What are the primary functions of the large intestine? |
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Definition
Completion of absorption
Manufacture of some vitamins
Formation of feces
Expulsion of feces from the body |
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Term
| Describe the process of peristalsis. |
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Definition
1)Peristalsis is under control of the autonomic nervous system
2)Contractions occur every 3 to 12 minutes
3)Mass peristalsis sweeps occur 1 to 4 times each 24-hour period
4)One-third to one-half of food waste is excreted in stool within 24 hours |
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Term
| List some Variables Influencing Bowel Elimination |
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Definition
1)Developmental considerations
2)Daily patterns
3)Food and fluid
4)Activity and muscle tone
5)Lifestyle, psychological variables
6)Pathologic conditions
7)Medications
8)Diagnostic studies
9)Surgery and anesthesia |
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Term
| Foods Affecting Bowel Elimination |
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Definition
1)Constipating foods—cheese, lean meat, eggs, pasta
2)Foods with laxative effect—fruits and vegetables, bran, chocolate, alcohol, coffee
3)Gas-producing foods—onions, cabbage, beans, cauliflower |
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Term
| Effect of Medications on Stool |
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Definition
1)Aspirin, anticoagulants—pink to red to black stool
2)Iron salts—black stool
3)Antacids—white discoloration or speckling in stool
4)Antibiotics—green-gray color |
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Term
| What guidelines should be followed pertaining to stool collection? |
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Definition
1)Medical aseptic technique is 2)imperative
3)Wear disposable gloves
4)Wash hands before and after glove use
5)Do not contaminate outside of container with stool
6)Obtain stool and package, label, and transport according to agency policy |
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Term
| What guidelines should a patient follow when collecting their own stool? |
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Definition
1)Void first so urine is not in stool sample
2)Defecate into the container rather than toilet bowl
3)Do not place toilet tissue in the bedpan or specimen container
4)Notify nurse when specimen is available |
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Term
| When scheduling diagnostic tests, what guidelines should be followed? |
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Definition
1 — fecal occult blood test
2 — barium studies (should precede UGI)
3 — endoscopic examinations
Noninvasive procedures take precedence over invasive procedures |
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Term
| What factors need to be assessed when discussing bowel elimination? |
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Definition
1)Usual patterns of elimination
2)Do you use anything to aid in elimination
3)Have there been recent changes to bowel elimination
4)Are there any elimination problems
5)Is there an artificial orifice (colostomy or ileostomy) |
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Term
| Patient Outcomes for Normal Bowel Elimination |
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Definition
1)Patient has a soft formed bowel movement every 1 to 3 days without discomfort
2)The relationship between bowel elimination and diet, fluid, and exercise is explained
3)Patient should seek medical evaluation if changes in stool color or consistency persist |
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Term
| The nurse should promote regular bowel habits with emphasis on . . . ? |
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Definition
1)Timing
2)Positioning
3)Privacy
4)Nutrition
5)Exercise |
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Term
| Individuals at High Risk for Constipation |
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Definition
1)Patients on bed rest taking constipating medicines
2)Patients with reduced fluids or bulk in their diet
3)Patients who are depressed
4)Patients with central nervous system disease or local lesions that cause pain |
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Term
| Nursing Measures for the Patient With Diarrhea |
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Definition
1)Answer bell calls immediately
2)Remove the cause of diarrhea whenever possible (e.g., medication)
3)If there is impaction, obtain physician order for rectal examination
4)Give special care to the region around the anus
5)After diarrhea stops, suggest the intake of fermented dairy products |
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Term
| List ways to prevent food poisoning |
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Definition
1)Never buy food with damaged packaging
2)Never use raw eggs in any form
3)Do not eat ground meat uncooked
4)Never cut meat on a wooden surface
5)Do not eat seafood that is raw or has a strong unpleasant odor
6)Clean all vegetables and fruits before eating
7)Refrigerate leftovers within 2 hours of eating them
8)Give only pasteurized fruit juices to small children |
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Term
| Methods of Emptying the Colon of Feces |
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Definition
1)Enemas
2)Rectal suppositories
3)Rectal catheters
4)Digital removal of stool |
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Term
| What types of enemas are there? |
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Definition
1)Cleansing
2)Retention
3)Return-flow |
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Term
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Definition
1)Oil-retention—lubricate the stool and intestinal mucosa easing defecation
2)Carminative—help expel flatus from rectum
3)Medicated—provide medications absorbed through rectal mucosa
4)Anthelmintic—destroy intestinal parasites
5)Nutritive—administer fluids and nutrition rectally |
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Term
| What are important factors to consider when assisting patients in developing bowel training programs? |
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Definition
1)Manipulate factors within the patient’s control
2)Food and fluid intake, exercise, time for defecation
3)Eliminate a soft, formed stool at regular intervals without laxatives
4)When achieved, discontinue use of suppository if one was used |
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Term
| How does a bulk-forming laxative work and give an example? |
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Definition
| Metamucil - Psyllium, grain, or synthetic product that causes stool to absorb water and swell, thus stimulating peristalsis |
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Term
| How does a stool softener work? |
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Definition
| Colace - Agents with detergent activ-ity that allow water andfat to penetrate andlubricate the stool |
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Term
| What action does an emollient laxative take? |
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Definition
| Mineral oil - Lubricates the intestinal tract and retards colonic absorption of water, softening the stool, making it easier to pass. |
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Term
| How does a stimulant laxative work? |
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Definition
| Dulcolax - Drug promotes peristalsis by irritating the intestinal mucosa or stimulating nerve endings in intestinal wall. |
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Term
| How do Saline-osmotic laxatives work? |
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Definition
| MOM - Drug draws water into intestine and stimulatesperistalsis. |
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Term
| What are possible causes of chronic constipation in the older adult? |
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Definition
1)Decreased gastrointestinal motility
2)Effect of medications (e.g., antacids, opioids, antihypertensives)
3)Decreased fluid intake
4)Less active lifestyle
5)Inadequate fiber intake
6)Incomplete emptying of the bowel
NOTE: Can lead to laxative abuse |
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Term
| What are possible causes of diarrhea in the older adult? |
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Definition
1)Laxative abuse
2)Effect of medications/tube feedings
NOTE: Can lead to life-threatening dehydration and electrolyte imbalance |
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Term
| What are possible causes of fecal impaction in the older adult? |
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Definition
1)Can result from chronic constipation
2)May be preceded by oozing of liquid feces—often mistaken for diarrhea
NOTE: Can lead to distended abdomen, abdominal pain, and complete bowel obstruction |
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Term
| What are possible causes of fecal incontinence in the older adult? |
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Definition
1)Decreased muscle tone
2)Alteration in nervous system innervation to rectum
Altered cognition
NOTE: Can lead to skin breakdown and depression |
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Term
| Common diagnostic tests pertaining to bowel elimination |
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Definition
| Water, pH, Occult blood, urobilinogen, etc. |
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Term
| When doing a physical assessment what areas are assessed? |
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Definition
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Term
| In what sequence to you assess the abdomen? |
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Definition
| inspection, auscultation, percussion, & palpation |
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Term
| How does the antidiarrheal Opium (Paregoric) act on the body? |
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Definition
1)Increases smooth muscle tone
2)Decreases GI motility
3)Diminishes GI secretions |
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Term
| How does the antidiarrheal Diphenoxylate andatropine (Lomotil)act on the body? |
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Definition
| Slows gastric motility through local effect on gastrointestinal wall |
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Term
| How does the antidiarrheal Loperamide (Imodium)act on the body? |
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Definition
| Inhibits peristalsis via direct effect on gastrointestinal wall muscles |
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Term
| How does the antidiarrheal Kaolin-pectin (Kaopectate)act on the body? |
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Definition
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Term
| How does the antidiarrheal Bismuth subsalicylate(Pepto-Bismol)act on the body? |
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Definition
1)Decreases gastrointestinal tract secretion
2)Has antimicrobial action against bacterial and viral pathogens |
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Term
| What effects do cleansing enemas have on bowel elimination? |
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Definition
•Relieve constipation or fecal impaction
•Prevent involuntary escape of fecal material during surgical procedures
•Promote visualization of the intestinal tract by radiographic or instrument examination
•Help establish regular bowel function during a boweltraining program |
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Term
| Differences in administration of a small vs. a large volume enema |
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Definition
Volume - small volume enema is 130 - 250mL while a large can be from 500 - 1000mL
Temperature - small is administered at room temp while a large is warmed to 105 - 110 degrees
Time - it takes 1 to 2mins to administer a small vol vs. 5 to 10mins on a large
Position - the small is slowly administered from a side lying position while the large is hung from an IV pole 18 inches above the anus |
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Term
| What are some nursing interventions to manage bowel incontinence? |
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Definition
•Note when incontinence is most likely to occur, and place the patient on a bedpan at those times.
•Keep the skin clean and dry by using proper hygienic measures. Apply a protective skin barrier after cleaning the skin.
•Change bed linens and clothing as necessary to avoid odor, skin irritation, and embarrassment.
•Confer with the physician about using a suppository or a daily cleansing enema. |
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Term
| Bowel management nursing interventions |
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Definition
•Plan bowel program with patient and appropriate others
•Monitor bowel movements including frequency, consis-tency, shape, volume, and color, as appropriate
•Monitor bowel sounds
•Teach patient about specific foods that are assistive inpromoting bowel regularity
•Instruct patient on foods high in fiber, as appropriate
•Monitor hydration status
•Encourage fluids, as appropriate
•Ensure privacy |
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Term
| What some nursing measures for caring for patients with bowel diversions? |
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Definition
•Keep the patient as free of odors as possible. Empty the ostomy appliance frequently.
•Inspect the patient’s stoma regularly. It should be dark pink to red and moist.
•Note the size of the stoma, which usually stabilizes within 6 to 8 weeks. Most stomas protrude 1⁄2 to 1 inch from the abdominal surface and may initially appear swollen and edematous.
•Keep the skin around the stoma site (peristomal area)clean and dry. •Measure the patient’s fluid intake and output. Check the ostomy appliance for the quality and quantity of discharge.
•Explain each aspect of care to the patient and explain what his or her role will be when he or she begins self-care.
•Encourage the patient to participate in care and to look at the ostomy. |
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