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Bowel Elimination
NUR101
| Question | Answer |
|---|---|
| Normal bowel elimination depends on | A balance diet, fluid intake, activity, muscle tone and peristalsis |
| The stomach breaks down food into | chyme |
| Melena is | dark, sticky, tarry looking feces containing partially digested blood |
| causes of white, gray, clay-like stools | antacids, barium intake, undigested fat, absence of bile |
| Cause of black, tarry, coffee ground looking stools | partially digested blood |
| Simple test that is done to detect blood in the stool | Guaiac-based test |
| Signs and symptoms of fecal impaction | decreased or absent bowel sounds, possibly small amounts of watery diarrhea |
| how does activity affect bowel elimination | physical activity stimulates peristalsis |
| how does stress affect bowel elimination | can cause diarrhea |
| How does the aging process affect elimination | peristalsis slows and can lead to constipation |
| Causes of constipation | decrease in activity, poor fluid intake, iron supplements, pregnancy, depression, hypercalcemia, antacids, aging, laxative abuse |
| causes of diarrhea | infection, steroids, anti-inflammatory meds, antacids with magnesium, food allergies, lactose intolerance, stress, diverticulitis, gastroenteritis |
| Reason the elderly have poor fluid intake | decreased thirst |
| Identify nursing interventions that promote bowel function | encourage increased physical activity, increase fluid intake, increase fiber intake, provide privacy, position patient upright, provide stimulants that "cue" bowel function at home |
| How far should the enema be inserted into the rectum for an adult | 3-4 inches |
| What should the nurse do if resistance is met while inserting an enema, why? | STOP, perforation can occur |
| How many times can a cleansing enema be given | 3 times with 1000mL |
| What are cleansing enemas used for | relieve constipation or can be given prior to surgery or testing |
| What volume of fluid can be used for an adult with a cleansing enema | 500-1000mL |
| What volume of fluid can be used with children with a cleansing enema? | usually less than 250mL but on average 90-120mL. healthcare provider to prescribe amount |
| What electrolyte disorder can occur if too many tap water enemas are given? | Hyponatremia |
| What are oil retention enemas used for | to soften the hard stool of impaction |
| What volume of fluid is used for oil retention enemas? | 90-120mL an hour prior to removing the impaction |
| Prior to administering a Kayexalate enema, what electrolyte should be checked? | potassium make sure it is high |
| What should be reviewed prior to giving a medicating enema? | Facility's policy and procedure |
| What is the purpose of a return flow enema? | Removes flatus |
| What volume of fluid is used in a return siphon enema | 100-200mL |
| What are the contraindications for receiving an enema | rectal surgery, severely bleeding hemorrhoids, ulcerative colitis, Crohn's disease, rectal fissure, rectal cancer, potential for excessive bleeding, heart conditions |
| What are potential complications from enemas | F & E imbalances, vagal response, bowel rupture, perforation of the intestinal wall, hemorrhage, infection/peritonitis |
| Signs and symptoms of a vagal response | chest pain or heaviness, shortness of breath, dizziness, feeling faint, nausea, pallor, clamminess, bradycardia |
| how many symptoms of a vagal response are needed before stopping an enema | one (any of them) |
| Why might a patient need a bowel diversion? | cancerous tumor, bowel infarction, disease process such as Crohn's, ruptured diverticulum, ulcerative colitis, traumatic abdominal injury |
| Describe a single barrelled ostomy | distal portion of the intestine is removed. it has one stoma |
| What is a double barrelled ostomy and when is it used? | it has two stomas and is used when the bowel is being allowed to rest such as with Crohn's Disease. |
| What type of stool would you expect from an ostomy placed in the left transverse colon | semi formed to soft stool |
| What type of stool would you expect from an ostomy placed in the ascending colon? | liquid to mushy with a foul odor |
| What type of stool would you expect from an ostomy placed in the descending colon or sigmoid? | soft to hard formed stool |
| What type of stool would you expect from an ostomy placed in the right transverse colon | mushy to semi-formed |
| How long can an NG tube remain in place before running the risk of necrosis of the nasal septum | 10-14 days |
| Describe how to measure the appropriate length of the NG to to be inserted | measure from the tip of the nose to the earlobes to the xiphoid process |
| How does the patient help with NG tube insertion? | By drinking small sips of water wheil the tube is being inserted |
| What should the nurse do when the patient begins to gag? | Pull back on the NG tube just a little, have the patient take some deep breaths and then have them take small sips of water while you advance the tube |
| What should the nurse do if the patient continues to gag or cough? | Take a tongue blade and light to see if the tube has curled up in the back of the throat. |
| What should the nurse do if the patient becomes cyanotic or cannot speak? | Remove the tube immediately. it may be in the lungs. |
| What is important for the nurse to remember once the tube is placed but not secured? | Don't let go of it! |
| How does the nurse determine if the tube is placed correctly? | Aspirate stomach contents, inject a small amount of air into the tube and listen with the stethoscope of the stomach to see any gurgling can be heard, obtain and xray |
| What is the gold standard for checking NG tube placement? | X-ray visualization |
| What electrolyte should be closely monitored if your patient is on NG suction? | potassium |
| What is lactobacillus acidophilus and what is it used for? | it is a supplement that replaces normal flora in the gut. it can be given along with antibiotics to prevent the loss of normal flora. it can also be used to treat diarrhea caused by the rotovirus. It can also be found in yogurt |
Created by:
Ms. A LPNI
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