Bowl Elimination

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Bowl Elimination
2011-02-13 05:02:17
Bowl Elimination

Bowl Elimination
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  1. Maintaining/Assessing enemas
    • •Explain procedure – make sure pt knows what they have to do
    • •Caution to giving more than 3 – get okay from physician before giving more than 3
    • •“Give till clear” enema is repeated until the client passes fluid that is clear and contains no fecal material
    • •Gather quipment
  2. What equipment is needed for giving an enema?
    • –Clean gloves
    • –Water soluble lubricant
    • –Absorbent pads
    • –Bath blanket
    • –Good to have bedside commode ready just in case client wouldn’t make it in time
  3. What do you do if client has pain, bleeding, or abdomen becomes rigid during an enema?
    • Pain: slow down enema
    • Bleeding/abdom becomes rigid: stop enema immediately and call the physician (happens rarely, but something it means that intestinal wall could have become perforated)
  4. Interventions for constipation
    • Encourage fluid intake or appropriate fluids, fruit juice, and water
    • Encourage activity within the limits of client’s mobility regimen
    • Provide laxitives/stool softeners as ordered
    • Provide privacy
  5. Interventions for diarrhea
    • Use of OTC anti-diarrheals like immodium
    • MOST EFFECTIVE = prescriptive opiates such as codeine phosphate, opium tincture (paregoric) and diphenoxylate (Lomotil) these decrease muscle tone to slow passage of feces
    • Recommend foods low in fiber content
    • Discourage foods that typically cause gastricupset or abdominal cramping
    • If client can’t tolerate foods po, IV therapy (with potassium supplements) may be necessary
    • At times, it is also necessary to administer IV therapy to ensure proper electrolyte balance
  6. How can antibiotics affect the GI tract?
    antibiotics can case diarrhea
  7. Normal bowl sounds occur...
    • Normal bowl sounds occur every 5 -15 seconds and last 1 to several seconds
    • Normal sounds also occur 5 to 35 times/minute
  8. bowl sounds: increase in pitch/tinkling
    • abdominal distention
    • hyperactive bowl sounds and small intestine obstruction or inflammatory disorders
  9. bowl sounds: tympanic sound
  10. borborygmi
    • Hyperactive sounds are often loud, growling, called borborygmi, indicates increased GI motility.
    • Could be caused by inflammation of bowel, anxiety, diarrhea,m bleeding, excessive ingestion of laxatives, and reaction of intestines to certain foods
  11. 35 sounds or more/minute
  12. Less than 5 sounds/minute
  13. Absence of bowl sounds
    • You must listen for at least 5 minutes continuously before declaring absent bowl sounds
    • called paralytic ileus, due to recent abdominal surgery or abdominal obstruction