organ responsible for completing absorption
secretion of bicarbonates
formation/expulsion of feces
protectiong of lining with mucus
the large intestine
What are the 7 sections of the large intestine?
waste products of digestion
Factors that affect elimination
food and fluids
activity and muscle tone
surgery and anesthesia
Why does psychological variables affect elimination?
emotional stress increases GI motility
depression may cause constipation
How do medications affect elimination?
narcotic analgesics and tranqulizers, iron supplements increase constipation
antibiotics - diarrhea
What are pathological conditions that affect elimination and why?
diverticulitis- Crohns disease cause diarrhea leading to malabsorption
spinal cord injuries/ head injuries decreased sensory stimulation.
What ares some common bowel elimination problems?
fewer bowel movements than normal with the difficult passage of hard dry feces.
What are common causes of constipation?
changes in diet/lack of fiber
continued laxative use
What are some complications/consequences of constipation
stimulates vagus nerve, may decrease HR
straining is contraindicated
results from unrelieved constipation
collection of hardened feces, wedged in the rectum and can't be expelled
increased passage of loose stools
most common causes include food intolerance, colon disease, and meds.
fatigua, weakness,abdominal cramping
fluid and electrolyte imbalance and skin breakdown
defined as involuntary passage of stool
caused by any condition that impairs anal sphincter control and conditions creating diarrhea
skin break down and feelings of shame or guilt
defined as sensation of bloating and abdominal distention that is acoompanied by excess gas
complications include shame, embarrassment, discomfort due to distention
caused by increased venous pressure resulting from straining at defecation, pregnancy, CHF, chronic liver disease.
manifested by itching, burning, mass
defined as masses of dilated vessels that lie beneath the lining of the skin of the anal mucosa
creating an opening into the abdominal wall for fecal elimination
may result in temporary or permanent artificial opening in the abdominal wall
allow intestine to repair itself after inflammatory disease
as a result of cancer
surgical openings with the ends of the intestine brought through the abdominal wall
What does stool color signify?
black/tarry: upper GI bleeding, iron, diet high in red meat
red: lower GI bleeding, hemorrhoids
clay/white: absence of bile, barium ingestion
orange or green: intestinal infection
how often does slow peristaltic contractions occur?
every 3-12 minutes.
how often does mass peristalsis occur?
3-4 times within 24 hours. being strongest after meals
What is the first stool called?
age group where water is not absorbed so there is an increase in BM
age group that has decreased motility, decreased peristalsis and therefore decreased BM
gas producing foods?
onions, cabbage, and beans
foods with laxative effects
prunes, bran, alcohol, coffee, spicy foods
what does narcotic analgesics, tranquilizers, and iron supplements cause?
what do antibiotics cause
what does a bowel prep and barium cause
manifest by inability to pass stool for several days despite a repeated oozing of diarrheal stool plus abdominal distention, anorexia, or rectal pain.
symptoms of diarrhea
fatigue, weakness, and abdominal cramping
what is usual bowel frequency?
daily to 2-3x a week
what should you find during a bowel inspection?
abdomen symmetical and soft
no visible peristaltic waves
waht do you find during a bowel auscultation
due to surgery= paralytic ileus
what should you find during a bowel palpation
non-tender , no masses/nodules
What should you hear during a bowel percussion?
dull over sold masses (impaction)
why is stool brown?
due to the break down of bilirubin by bacteria
what does it signify when stool odor is pungent or noxious?
blood or infection
what is the normal amount of daily stool
150g but can very between 100-400
What causes false positives in stool exam tests?
Certain foods such as red meat, raw fruits and vegetables and medications that irritate the GI tract like Aspirin, NSAIDS, and iron or when patient has taken more than 250 mg of Vitamin C in the 3 days prior to the test.
direct visualizatoin of the of the large intestine with a flexible endoscope
viewing the rectum with a protoscope
examination of the sigmoid using a flexible instrument/tube
what are diet/fluid recommendations for ostomies?
low fiber diet to start- gradually introduce hi fiber
avoid food that may cause blockage(popcorn)
general rule is eat as tolerated
what are ways to promote healthy defecation?
its most likely to occur 1 hours aftermeals so do not ignore the urge
take time to do your tthangg
assume squatting position, use elevated seat, lean forward
stimulate laxative that causes local irritation to the intestinal mucosa, stimulates peristalsis and work relatively fast but can cause cramps and loss of fluid in stools. can cause fluid and electrolyte imbalance with prolonged use.
describe saline or osmotic laxatives
draw water into the fecal mass by osmosis, stimulate peristalsis. MOM and citrate of magnesia and Sodium phosphate or a fleets enema, are osmotic laxatives. These are rapid acting and can cause fluid and electrolyte imbalance. They should not be used by the elderly.
stool softener that inhibits reabsorption of water. it may take several days to work.
bulk forming laxatives absorb water and increase bulk. can take up to 12 hours
describe mineral oil
lubricant that softens fecal mass. but it interferes with absorption of fat soluble vitamins (A,D,E,K) if aspirated it can cause pneumonia.