Upgrade to remove ads
Only $35.99/year

PN Bowel Elimination Exam II

Terms in this set (71)

The major organ involved with bowel elimination is the __________ intestine, or the __________.
large intestine
colon
This part of the GI Tract stores food, secretes digestive fluids, churns food and pushed "chyme" into small intestine through the pyloric sphincter.
Stomach
This part of the GI Tract is 20 ft long and about 1 inch wide. It has 3 segments (D___________, J___________ & I___________). It digests food & absorbs nutrients into the blood stream. Digestive juices from the liver and pancreas enter at the duodenum.
Small Intestine

Duodenum
Jejunum
Ileum
This part of the GI Tract connect from the ileum and prevents things from moving in too fast and prevents backflow into the small intestine. It is the primary organ of bowel elimination and absorbs water. It is split into 5 sections:
C
A
T
S
R
Large Intestine (Colon)

Cecum
Ascending
Transverse
Sigmoid
Rectum
This procedure goes all the way to the cecum with a small camera then is removed slowly, capturing pictures on the way out.
Colonoscopy
This part of the GI Tract holds feces in itself temporarily, contains arteries and veins which are called ________________ if swollen and inflamed veins are present. (causes discomfort and bleeding).
Rectum

Hemorrhoids
If peristalsis is too fast, stool will be....
too soft or watery
If peristalsis is too slow, stool will be....
too hard
The more time stool is in the colon, the more ___________ is absorbed.
water
What sort of condition would cause fast peristalsis?
Ulcerative Colitis
What meds/treatments slow peristalsis?
-narcotics
-anesthesia
-bedrest
The part of the involuntary nervous system that serves to slow the heart rate, increase intestinal and glandular activity, and relax the sphincter muscles
Parasympathetic Nervous System
the part of the autonomic nervous system that contains chiefly adrenergic fibers and tends to depress secretion, decrease the tone and contractility of smooth muscle, and increase heart rate
Sympathetic
Which stimulates movement - parasympathetic or sympathetic?
parasympathetic!
The _____________ sphincter is run by voluntary control under normal conditions.
external
The _______________ sphincter is run by the autonomic nervous system.
internal
Emptying of the large intestine (poop!)
Defecation
What are the risks of "bearing down" when defecating?
Stimulate vegus nerve, stimulates the parasympathetic nervous system and heart rate can drop!
What are some factors affecting bowel elimination for infants?
Breastfeeding : mustard looking, frequent
Formula or cows milk: traditional, less frequent
Constipation
What are some factors affecting bowel elimination for toddlers?
Teaching considerations (place, positivity, skills etc.)
What are some factors affecting bowel elimination for school aged/adolescent/adults?
laxative use :(
What are some factors affecting bowel elimination for older adults?
-chronic constipation (due to lack of mobility, multiple meds, lack of hydration)
-Diarrhea
-Fecal impaction (stool becomes rock solid)
-Fecal incontinence (loss of bowel control)
Common Factors affecting bowel elimination include:

DP & L
F&F
A & MT
Psyc
Path
Daily Patterns & Lifestyle - how often?

Food & Fluids (fiber?)

Activity & Muscle Tone

Psychological (anxiety, emotional distress)

Pathologic conditions
How can taking certain medications affect bowel elimination?
-constipation (older adults)
-diarrhea
What sort of diagnostic studies can affect bowel elimination?
-barium enema
-barium swallow
-bowel cleansing
How can surgery/anesthesia affect bowel elimination?
-manipulation of bowel during abdominal surgery
-anesthesia (constipation)
Temporary stoppage of peristalsis, 24-48 hours. Food & fluids are held, this Pt is often receiving narcotics.
Paralytic Ileus
When assessing a Pt with bowel elimination issues, what subjective data should you inquire? What objective should you observe?
SUB: History, Pt's Norm

OBJ: Inspection (distention, scars)
Auscultation
Percussion (resonant vs. dull air?)
Palpitation (tenderness, enlargement, masses. light and deep in each quadrant)
What stool characteristics should a nurse be concerned about?
-volume
-color
-odor
-consistency
-shape
-constituents
Warning signs of colon __________ include change in elimination pattern, blood in stool, rectal or abdominal pain, change in character of stool, sensation of incomplete emptying.
cancer
When it comes to the various diagnostic studies available for bowel elimination, put these in order from least invasive to most invasive.

Endoscopy and/or Colonoscopy
Barium Upper Studies
Fecal Test
Barium Lower Studies
Fecal Test
Barium Upper Studies
Barium Lower Studies
Endoscopy and/or Colonoscopy
NURSING DIAGNOSIS
Bowel Elimination is the _____________ when it can be resolved by independent nursing intervention.
problem
NURSING DIAGNOSIS
Bowel Elimination is the _______________ when it is the cause for other human functioning problems.
etiology
What are some interventions we can make as RN's for our patients with bowel elimination problems?

-PRBH
-T
-Pos
-Pri
-Nut
-Ex
Promote regular bowel habits
Timing
Position
Privacy
Nutrition
Exercise
What are some comfort measures we can provide to patients with bowel elimination problems?
-easy passage of soft, formed stool
-hygiene
-maintain skin integrity, treat if not
-apply warm, moist heat to soothe the area
Dry, hard stool. Persistently difficult passage of stool, incomplete passage of stool.
Constipation
What are the 5 meds for Constipation? The 3 best?
BF
SS
E
S
S-O
Bulk Forming
Stool Softener 1
Emolient
Stimulant 2
Saline-osmotic 3
CONSTIPATION MEDS
Causes stool to absorb water and swell, stimulating peristalsis (Metamucil)
Bulk-forming

not for bed-ridden Pt's
CONSTIPATION MEDS
Allows water and fat to penetrate and lubricate stool (Miralax)
Stool Softener
Lubricates intestinal tract, slows absorption of water to soften stool (Mineral Oil)
Emollient
Promotes peristalsis by stimulating nerve endings in intestinal wall (Dulcolax)
Stimulant
Draws water in to stimulate peristalsis (magnesium citrate, sodium phosphate)
Saline-osmotic
More than 3 loose (watery) stools/day. Intestinal cramps, nausea and vomiting may occur.
Diarrhea
T/F: Diarrhea can be a protective response when irritants are in the intestinal tract.
TRUE! Think water from Mexico
What are 2 key things lost in Diarrhea (and vomiting) that must be replaced!
Fluid & Electrolytes
What is the goal of Antidiarrheal meds?
Reduce liquid in stool
Slow peristalsis
What are the 3 Antidiarrheal meds?
AOGISM
Abs
AS/AM
-Action on GI smooth muscle
-Absorbent
-Antisecretory/antimicrobial (Pepto-Bismol) decreases GI secretions & works against bacterial&viral pathogens
Procedure done to empty the colon of feces, the intestinal mucosa is irritated to stimulate peristalsis. What are the 2 types?
Enemas

-cleansing
-retention
A ___________ enema promotes complete evacuation of feces from the colon.
cleansing
A ________________ enema is used to oil or lubricate the feces and soften stool to allow for easier passing (retain for several hours if possible)
retention
What are the 3 types of Cleaning enemas?

-HT&I
-SS
-HT
Hypotonic & Isotonic

Soapsuds

Hypertonic
Which is given in a larger volume, Hypotonic or Hypertonic?
Hypotonic (more is necessary).
T/F: Injecting hypotonic fluid into the colon causes H20 to enter the colon.
FALSE! Hypertonic fluid draws water to it (osmosis, greater concentration). Hypotonic fluid in the colon would cause water to leave the colon.
What are the 4 types of Retention enemas?
O-R
C
M
A-H
Oil-retention enemas
Carminative
Medicated enemas
Antihelmintic
R. ENEMAS
lubricate rectum, soften stool
oil-retention
R. ENEMAS
relieves gas distention
Carminative
R. ENEMAS
Kayexalate , reduces K+ for those with hyperkalemia
Medicated enemas
R. ENEMAS
expels worms/parasites
Antihelmintic enemas
How should patients lay for an enema?
Left side lying or knee to chest position
T/F: Hypertonic fluid should be administered at a small volume at room temp over 5-6 minutes.
FALSE! everything is right except for time - 1-2 minutes.
How long should patient's hold an Oil-Retention enema? Why should it be administered at body temp?
30 mins.
To minimize muscle contractions
Inability of the anal sphincter to control passage of stool
Bowel Incontinence
Manipulating factors within a Pt's control to produce soft, formed stool at regular intervals w/o a laxative. Includes nutrition exercise, scheduling for toilet time.
Bowel Training
Used to decompress or drain the stomach while resting the bowel (post-op, treatment etc.), can be used to administer meds. 2 types (L&S)
Nasogastric tube

Levin & Salem Sump
Which NG tube is double lumen-ed (has a vent) and provides negative, continuous suction?
Salem Sump
Which NG tube has no vent and provides intermittent suction
Levin Tube
How can we test if an NG tube is placed correctly? What is the only true way?
-aspirate and visualize gastric contents, test pH
-Xray

XRAY BABAY
Surgical opening from the inside of an organ to the outside.
ostomy
Part of the ostomy that is attached to the skin, covered by protective bag, needs air & regular skin care, must be monitored for adequate blood flow.
Stoma
T/F: Ostomy's can be temporary or permanent.
TRUE!
What are some important things to cover when educating a Pt about their new ostomy?
Odor management (diet)
skin care
positive image
push fluids
Other sets by this creator