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Elimination 102
LU Kozier Notes
| Question | Answer |
|---|---|
| Normal feces | 100-400g per day, brown, soft, cylindrical, about 75% water and 25% solids |
| flatus | largely air and the by products of digestion of carbs, normal adult 7-10 L per day |
| peristalsis | wave like movement of intestinal walls |
| hemorrhoids | distended veins in the rectum due to repeated pressure |
| defecation | expulsion of feces from the body |
| constipation | fewer than 3 bm per week most common bowel management problem in the elder population causes: reduced activity level, inadequate amount of fluid and fiber, muscle weakness, use of opiods |
| laxatives | medication used to stimulate bowel activity caution: overuse can cause constipation |
| fecal impaction | mass or collection of hardened feces in the folds of the rectum, often give an oil retention enema, then a cleansing enema. If this fail manual removal may be required |
| diarrhea | passage of liquid feces and an increased frequency of defecation |
| bowel incontinence | loss of voluntary abiity to control feces or gas through the anal sphincter |
| flatulence | presence of excessive flatus in the intestines |
| ostomy | opening into gastrointestinal, urinary or respiratory tract onto the skin |
| intestinal ostomy | gastrostomy (stomach), jejunostomy (abdomen into jejunum) both for feeding: , ileostomy (ileum or small bowel), colostomy (colon or large bowel): fecal matter |
| stoma | opening created in the abdominal wall, generally red and moist |
| Ways to promote regular defecation | privacy, timing, nutrition, exercise, positioning |
| Nursing interventions for diarrhea | encourage fluids and bland foods, small amounts of food, avoid extreme temps, high fiber and highly spiced foods, increase sodium and potassium intake, avoid alcohol and caffeine, increase intake of yogurt when diarrhea stops |
| Nursing interventions for constipation | increase fluids, encourage hot fluids and fruit juices, increase fiber intake |
| Nursing interventions for flatulance | limit carbonated beverages, the use of straws and chewing gum. Avoid cabbage, beans, onions and cauliflower because the create gas |
| cathartics | drugs that induce defecation, strong purgative effect (think laxative on steroids) |
| suppositiories | medication given rectally |
| carminatives | herbal oils known to act as agents that can help expel gas |
| enema | solution introduced into the rectum and large intestine (distends the intestine, increase peristalsis) Four types (cleansing, carminative, retention, return flow) |
| Cleansing enema | intended to remove feces (5 to 10 min) |
| carminative enema | intended to expal flatus |
| retention enema | introduces oil or meds into colon, retained for 1-3 hours, softens feces, and lubes the rectum |
| return flow enema | used to expel flatus, 100-200 mL fluid into and out of the rectum, stimulate peristalsis (repeat 5-6 times till flatus removed) |
| administering enema | lube 5 cm of tube, expel air and clamp, pt lie on left lateral side, right leg flexed, insert tube 7-10 cm, ask clinet to retain enema as long as required, assist client to defecate |
| ostomy appliances | should protect skin, collect stool and control odor. Applied for up to 7 days. Emptied when 1/3 to 1/2 full |
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