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How does age influence the process of bowel elimination
- Infants have small stomachs and less secretion of digestive enzymes and are unable to control defecation due to lack of neuromuscular control
- Older adults lose muscle tone in the perineal floor and anal sphincter
How does diet influence the process of bowel elimination?
- Regular intake of food increases peristalsis
- Fiber increases peristalsis
- Gas producing foods increases peristalsis
How does fluid intake influence the process of bowel elimination
increase in fluid intake=softened stool
How does psychological factors influence bowel elimination
during emotional stress peristalsis increases and digestive process quickens. Diarrhea and gaseous distention.
How can personal habits influence bowel elimination?
- A busy work schedule sometimes prevents the individual from responding appropriately to the urge to defecate, disrupting regular habits and causing possible alterations such as constipation.
- Hospitalized clients are not always able to maintain privacy during defecation. embarrassment may prompt clients to ignore the urge to defecate, which begins a vicious cycle of constipation and discomfort.
How can pregnancy influence the process of bowel elimination
- Fetus gets bigger and increases pressure on rectum.
- Fetus can create a temporary obstruction which impairs passage of feces.
- Constant straining = permanent hemorrhoids
- The temporary cessation of peristalsis... usually after surgery.
- lasts 24-48 hours
What can cause constipation?
Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. ignoring urge to defecate
dilated, engorged veins in the lining of the rectum. They are either external or internal. External hemorrhoids are clearly visible as protrusions of skin. If the underlying vein is hardened, there is usually a purplish discoloration
What kind of stool is produced from a colostomy, ileostomy, and a sigmoid colostomy?
- An ileostomy bypasses the entire large intestine. As a result, stools are frequent and liquid. The same is true for a colostomy of the ascending colon.
- A colostomy of the transverse colon generally results in a more solid, formed stool.
- The sigmoid colostomy releases near-normal stool.
What is a loop colostomy?
Two large temporary stomas constructed in the transverse colon. Proximal end drains stool while distal end drains mucus. usually performed in a medical emegency
What is an end colostomy?
- consists of one stoma formed from the proximal end of the bowel with the distal portion of the GI tract either removed or sewn closed (called Hartmann's pouch) and left in the abdominal cavity.
- usually for pts with colorectal cancer
What is a double barrel colostomy?
Unlike the loop colostomy, the bowel is surgically severed and the 2 ends are brought out through the abdomen. The proximal stoma is functioning and the distal is non-functioning.
High bilirubin levels may indicate...
liver disease, obstructions in bile duct, certain anemias, and could indicate that pt just had blood transfusion
Elevated alkaline phosphatase may indicate...
obstructive liver disease, liver or biliary carcinomas, bone tumors, healing fractures
elevated amylase indicates...
- abnormalities in the pancreas
- cholecystitis (inflammation of gall bladder)
- necrotic bowel (death of tissue in bowel)
- diabetic ketoacidosis
elevated levels of carcinoembryonic antigen (CEA) indicates
- cancer of GI tract
- inflamation of GI tract
- inflamation of liver or biliary tract
A colonoscopy views
the entire colon through endoscopy
Flexible sigmoidoscopy views
views sigmoid colon
Computerized tomogrophy scan views...
many angles of the body using a scanner analyzed by a computer
small intestine to be studied
What are some bowel training techniques that can be used
regular meals, hot drinks, fiber, increasing exercise, or in severe case give them suppository 30 min b4 the time they want to have a bowel mvmt.
- tap water
- large volume (500-1000 mL)
- distends the colon and encourages peristalsis
- Disadvantage: can cause electrolyte imbalance
- 9% normal saline
- distends colon and stimulates peristalsis
- *not as big of a electrolyte imbalance as hypotonic
Hypertonic Solution enemas
a very strong solution pulls fluid out of tissues and into bowels (sodium phosphate)
Soap Suds enema
- soap irritates mucosa and distends colon
- use only castile soap
Oil retention enema
- Oily like substance seeps into stool and provides lubrication to move
- you want the pt to hold it for 1-3 hours
- can also be used for pts with parasites
- also used for impaction
provide relief from gaseous distention
- draws potassium out of cells and into bowels
- used with pt who has a high K+ level