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Terms in this set (42)
the physical process of releasing or emptying the colon or large intestine of solid waste, called stool or feces
where does the greatest absorption occur?
what is a normal stool composition?
- Solids ( undigested fiber, intestinal bacteria, dietary fats)
- no blood
- no mucous
- no pus
- no harmful parasites
- pH 6
where does the brown color of stool originate from
bile pigments (stercobilin)
What prompts relaxation of the internal rectal sphincter
Which nerve innervates the external rectal sphincter
What is the valsalva maneuver?
straining results in generation of pressure / stool evacuation
What are the influences/ outcomes of decreased bowel motility
- food type (low fiber) has influence
- e.coli presence is inhibitory
- outcome of increased storage time, loss of fluid from fecal matter and potential return of waste products to circulation
What are the influences/ outcomes of increased bowel motility
- impaired nutrition
- increased loss of water and electrolytes
what are the potential causes of altered bowel elimination?
What is the pathophysiology of intestinal obstruction?
- impairs venous return
- edema develops
- can interfere with absorption
- hydrostatic forces can force water through the intestinal wall
- bacteria can gain access causing sepsis
- can cause perforation
What are the focal causes of perfusion changes in altered bowel elimination?
- obstruction (clot)
Results in: ischemia, pain, necrosis of bowel
what are the global causes of perfusion changes in altered bowel elimination?
- ventilation / perfusion mismatch
- inadequate vascular volume
- inadequate CO
What are the causes of patency changes in altered bowel elimination?
- partial / complete obstruction
(tumors, polyps, impacted feces)
What are the clinical manifestations of altered bowel elimination (generally)
- increase abdominal size/ gas trapping
- hardening and tightening of abdomen
- change in type of stool
- change in color of stool
- Abdominal pain
Describe the change in type of stool with altered elimination
Diarrhea - watery, loose ( bowel inflammation, infection, increased motility)
Constipation - (impaired motility / obstruction)
What does bright red color on toilet paper suggest?
What does frank blood suggest?
what color would be associated with a Mid GI bleed
darker color blood (maroon)
What does black stool suggest?
upper GI bleed
What would a light colored stool suggest?
problem in pancreas, gall bladder or liver
What color of stool would suggest hepatitis
white, gray or yellow
what would an increased fat content of stool suggest
what would a silver color stool suggest?
what are the diagnostic criteria for altered bowel elimination?
presence of fat
occult blood in stool (GUAIAC TEST)
what is the treatment for altered bowel elimination?
- anti-diarrheals (immodium)
- adsorbents - (kaopectate) caution in children
stool softeners (bulk forming laxatives) - dulcolax / docusate sodium
What is melena?
A black, tarry stool indicating a GI bleed
What is steatorrhea?
fat in stool
What is a diverticulum?
Saclike protrusion through the colonic wall
what is diverticula?
more than one diverticulum
what is diverticulitis?
a diverticula infection caused by the presence of fecal matter
What are the manifestations of diverticular disease?
What are the diagnostic criteria for diverticular disease?
- abdominal tenderness
- abdominal distention
- bloody stool
- low hemoglobin and hematocrit indicating anemia
- CBC count indicating infection
- inflamed or ruptured diverticula
What is the treatment for diverticular disease
- diet alteration
- Lifestyle alterations
- Pharm : bulk-forming laxatives, antispasmodic medications
- management of symptoms
- control infection
- bowel rest
- prevention of complications
- surgical correction of perforated diverticula
What is encopresis?
inability to control bowel movements which is not related to disease.
Describe functional non-retentive incontinence
- fecal incontinence characterized by inappropriate fecal soiling
- stool evacuation voluntary or involuntary
- no organic cause ( behavior related)
describe retentive incontinence
with-holding of feces from pain or fear of defecation
what are the clinical manifestations for encopresis
socially inappropriate defecation
absence of organic disease
what are the diagnostic criteria for encopresis?
history of fecal incontinence ( greater than or equal to 4 years of age)
-- diet history
-- emotional stress
-- associated symptoms
what is the treatment for encopresis
- toilet refusal behavior
- scheduled toileting time
prevention of constipation
what age is the start of functional non-retentive and retentive incontinence common?
4 / (+)
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