ADN 140 Exam 5 Bowel Elimination

Infrequent difficult stool
hard and dry

Constipation

increased number, loose liquid stools

Diarrhea

Breast milk stools

Watery, yellow/brown

Formula stools

pasty and brown

When do toddlers gain bowel control

2-3 years old

Daily fiber requirements

25-30g/day

Lactose intolerance

difficulty digesting milk products

fluid intake requirements

2000-3000mL per day

effect of emotional distress on the bowels

increases peristalsis and exacerbates chronic conditions

effect of depression on the bowels

Decreases peristalsis and can lead to constipation

Laxatives

Soften stools

Cathartics

promote peristalsis

Laxative overuse

Weakens bowels
results in chronic constipation

Fecal incontinence

inability to control defecation

Hemorrhoids

Engorged, dilated blood vessels in the rectal wall

Causes of hemorrhoids

difficult defecation, pregnancy, liver disease, heart failure

Colostomies

End in the colon

Ileostomies

end in the ilium

Loop colostomies

temporary, help resolve medical emergency
usually in the transverse colon

Double-barrel colostomies

two abdominal stomas
can be reversed by reattaching the 2 ends

Paralytic illus

Peristalsis has stopped
intestinal obstruction caused by...
reduced motility following bowel manipulation during surgery
electrolyte imbalance
wound infection
medication

Causes of constipation

laxative overuse/other medication effects
advanced age
inadequate fluid or fiber intake
immobility/sedentary lifestyle
pregnancy

Diarrhea Causes

viral or bacterial gastroenteritis
antibiotic therapy
inflammatory bowel disease
irritable bowel syndrome

Fecal occult blood test (Guaiac test) should be done how many times?

three times from three different stool samples

What foods could cause a false positive on a Guaiac test?

Red meat, fish, poultry, raw veggies

Nursing care for constipation

Increase fiber and water intake
give bulk forming products
Stool softeners, stimulants, suppositories
Enemas

Complications of constipation

Fecal impaction
hemorrhoids and rectal fissures
bradycardia, hypotension, syncope

Fecal impaction

Stool becomes wedged in the rectum
Diarrhea can leak around the mass

Complications of Diarrhea

Dehydration
Fluid and electrolyte imbalance
skin breakdown

Major role of the colon

absorb water

What controls our GI system?

The nervous system

Bowel elimination requires

Presence of something to pass
passage

What happens if passage doesn't happen?

Waste builds up in the body

Food important to elimination

Fiber

How do fatty foods effect elimination

...

What slows down bowels?

Foods high in calcium and fats
(Cheese)

What gender is prone to bowel problems?

Females

Common problem for pregnant women?

Hemorrhoids

How does mobility effect the bowels?

Helps increase peristalsis
people who exercise a lot may get diarrhea

Common medications that cause diarrhea

Antibiotics

Common medications that cause constipation

Opioids

How long without a bowel movement is too long?

about a week

Disease processes that can cause really smelly stool

GI bleed
C. Diff
Some parasites

How long do you listen to the bowels in each quadrant?

at least 30 seconds
if sounds aren't present 2 min

Stool specimen (What are we looking for)

Bacteria
Blood
Parasites

Bowel/abdominal xray

Shows presence of stool/where stool is present

Barium Test

shows how the bowels are moving

Bowel training

Can be done, but should take them if they have the urge

Bowel obstruction

Can be caused by...
Stool
polyps
object
tumor
adhesions

Most common cause of bowel obstruction?

Adhestions

How many stools per day to be considered diarrhea?

at least 3

Irritable bowel sydrome

diagnosed by symptoms along
change in the function of the bowels, constant change from constipation/diarrhea

Ulcerative Colitis

Ulcers formed in the bowel

3 types of iritable bowel syndrom

IBSD (diarrhea)
IBSC (Constipation)
IBSA (altering between the 2)

Patients with ulcerative colitis can develop what condition related to blood loss?

Anemia

Foods to avoid with ulcerative colitis

Seeds, foods with kernels

Diet with ulcerative colitis

Low fiber