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2013-03-30 05:48:15
215 Bowel Elimination

215 Bowel Elimination
Show Answers:

  1. are interventions done on the GI tract sterile?
    • No
    • you do not need to use sterile technique
  2. where does most of the nutrient abosorbtion happen
    the small intestine
  3. what happens in large intestine
    the absorption of water and sodium
  4. Chyme =
    the waste products of digestion
  5. cecum =
    the first part of the large intestine
  6. ileocecal valve
    the valve between the small and large intestine
  7. resident bacteria acts on food products as it passes through the large intestine producing
    vitamin K which is important for clotting
  8. what is a stimulus for defecation
    distention of the rectal walls
  9. can it be normal for a patient to go every other day
    yes maybe even going every 3 days
  10. ascites =
    • excess fluid in the peritoneal cavity in the abdomen
    • edema in the abdomen
  11. normal bowel sounds =
    audible every 5 - 20 seconds
  12. absent bowel sounds =
    absent bowel sounds for a full 5 minutes
  13. hyperactive bowel sounds =
    • loud growling bowel sounds 
    • diarrhea or vomiting
  14. hypoactive bowel sounds =
    more than 15 seconds apart
  15. clay or white stool
    barium or bile obstruction
  16. black tarry stool =
    • iron ingestion, food (beets)
    • upper GI bleed
  17. Red stool =
    • lower GI bleed 
    • hemrrhoids
  18. pale or frothy stool =
    colitis or fat malabsorption
  19. yellow stool =
    normal for infants
  20. adult stool elimination frequency =
    • 1 to 3 day or 
    • 1 every 3 days
  21. amount of stool =
    100-400 g described as small, moderate or large amount
  22. EGD =
  23. colonoscopy =
    large intestine from nus to illeocecal valve
  24. sigmoidoscopy =
    sigoid coon, rectum and anal canal
  25. BArium can casue what
  26. what is important to assess after a patient has had an EGD
    gag reflex because tube passed down the throat
  27. nursing interventions for constipation =
    • promote comfort and relaxation
    • teach about nutrition (fluids and fiber)
    • promote regular exercise
    • promote regular bowel habits
    • teach about laxatives
  28. overuse of laxatives =
    • large intestine loses muscle tone and creates dependency
    • use laxative as a last resort
  29. bulk forming laxative =
    • metamucil 
    • increase water aborption and peristalsis
    • can interfer with absorption of nutrients
  30. stool softener
    • lowers surface tension of feces to allow water and fat to penetrate and lubricate stool
    • colace
  31. lubricant laxative =
    • mineral oil
    • softenes stool onset within 8 hours
    • can interfer with absorption of nutrients
  32. stimulant laxative =
    • dulcolax, exlax, castor oil
    • direst irritant effect on mucosa
    • faster onset an longer duration
    • can result in dependence
  33. hypotonic enema =
    • tap water
    • water moves from the bowel into the interstitial tissue
    • distends intestine and increases peristalsis
    • can cause electrolyte imbalance, water toxicity, circulatry overload if repeated
  34. hypertonic enema =
    • fleet
    • water moves from the interstitial tissue into bowel
    • distends intestine and irritates mucosa to promote defecation 
    • smaller volume, but can cause sodium retention
  35. what is the type of enema bet tolerated by infants?
    the isotonic enema
  36. soap suds enema =
    • large volume enema
    • distends intestine, irritates mucosa, softens stool
    • may cause rectal mucosal irritation or injury
  37. oil-retention enema =
    • retention enema
    • lubricates stool and intestinal mucosa to ease defecation
    • Hold as long as they can
  38. Carminative enemas
    relieve gas distention
  39. Kayexalate enemas
    reduce amount of potassium
  40. Neomycin enema =
    used to reduce normal microbes in bowel  before surgery
  41. If nurse is able to break up impaction but cannot remove it what should you do
    give an oil retention enema and have the patient hold it as long as possible
  42. what indicates an impaction
    seepage of small amounts of fluid with no passage of normal feces
  43. what should you be careful of when digitally removing impaction?
    vagal nerve stimulation
  44. Interventions for treating Diarrhea
    • remove causative agent if able
    • slow peristalsis
    • fluid replacement if dehydrated (PO or IV)
    • acute stage: Only liquids = low bulk foods; no milk or dairy
  45. Immodium, Lomotil, Paregoric =
    • increases smooth muscle tone and decreases GI motility
    • can be addictive and cause drowsiness
  46. Kaopectate = a
    • antidiarrheal
    • can interfere with absorbtion of other meds
    • non-drowsy
  47. Pepto-Bismol
    • anti-diarrheal
    • decreaces GI secretions
    • has antimicrobial effect
    • contains salicylates - use caution in children, ASA allergy, blood thinners
  48. What happens when person becomes incontinent
    loos o voluntary control of the external anal sphincter
  49. Flatus =
    gas in intestinal tract
  50. interventions of Flatus
    • ambulate
    • repositioning
    • no ice water to post op patients
    • no sodas
    • give carminative enema
  51. Ileostomy =
    liquid fecal content eliminated from the ileum of the small intestine through the stoma
  52. Colostomy =
    • formed feces in the colon exit through the stoma
    • classified by origination site in colon
    • sigmoid, descending, transverse, ascending
  53. what is most important thing to do in ostomy care
    maintain skin integrity around stoma
  54. teaching for ostomy care
    • encourage patients to avoid high fiber foods
    • drink 2 quarts liquid daily
    • teach about odor control
    • resume normal activity asap
  55. what color is most important to report in stoma care post op
    bluish color
  56. what reduces the risk of cancer related to the bowel
    dietary fiber