Altered Bowel Elimination

Bacteria ONLY...NO Enzymes!!

breakdown of bacteria

Constipation-cuz poop sits in lg intestine longer so more water is reabsorbed.  Hardens

• bacteria
• increase bowel transit time (less time from mouth to anus)
• malabsorption

Tell me what your normal BM practice is like? Diet? Exercise? Weight history? Narcotics? Gas? Pain, amount, shape and color of BM? Pruritis? Hemmorhoids? Pyrosis (heartburn)? odynophagia (painful swallowing) Travel history?

heartburn

painful swallowing

• What I see, hear, touch or smell.
• Pt. height and weight
• Oral cavity, condition, sores, thrush, halitosis
• Inspect and measure abdominal girth, stool observation, AUSCULATE, PERCUSS

spend 5 min. at each quadrant

LLQ

• Occult Blood
• Ova and Parasite

• pt. drinks white chalky substance
• pics taken of pharynx, esophagus, stomach, duodenum.

• NPO 8-12 hours before
• Post care....lots of liquids to prevent constipation

Looks at large intestine

• Pre-Laxatives
• Post-Laxatives and a ride home

• Pre-drink a litre of water
• Post-check BUN & Creatinine

• ENDO
• EGD
• ERCP

Looks for bleeding, inflammation, masses and polyps

• Prep NPO for 8 hrs. before
• Post NPO till gag reflex returns

Looks at the stomach, duodenum and upper GI problems

Looks at the gallbladder, liver, pancrease, stones in GB

Uses dyes

NPO till gag reflex returns

lack of development of nervous system so cant control the sphincter

• Decreased motility so slower peristalsis
• Dryer feces cuz drink less water
• More water absorbed cuz of slower peristalsis
• Decreased abd tone so harder to bear down
• Decreased anal sphincter tone
• Medications

• Muslims eat with their right hand and wipe with their left
• African Americans/Asians are lactose intolerant

infrequent bowel movements that are hard to pass

think constipated cuz have BM's every other day or 3 days.  But it is soft and not hard to pass, so it isnt constipation.

LAXATIVES

• increases absorption of water in to stool
• Doesnt require RX

• Examples:  Metamucil, Citrucel
• Bran and Prunes

Lower surface tension of feces allowing water to be absorbed by fecal mass make a soft stool

Examples:  Docusate Sodium, Colace

Increase fluid bulk in feces by pulling H2O thru the intestinal wall by osmosis

Example:  Milk of Magnesia, Miralax, Fleet Enema

Increase peristalsis by chemical irritation to the bowel nerve endings

Examples:  Castor oil, Dulcolax, Ex Lax

• fecal impaction
• constipation
• hemorrhoids
• anal fissures
• mega colon

• Fluid volume deficit
• risk for injury
• impaired skin integrity

high fiber foods, spicy foods, sugar and sugar substitutes, food poisoning, allergies and antibiotics, and bacteria

• eggs
• lean meat
• past
• bananas
• decrease in fluids
• sedentary life style
• opioids
• narcotics

Bowel evacuation that is stimulated by peristalsis in the colon.  Usually happens after the first meal of the day.

Humming or swishing sound heard with the stethoscope.  Turbulance