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SOPN FON BOWEL
| Question | Answer |
|---|---|
| Process of digestion begins here | Mouth |
| Located at base of esophagus into the stomach, where it prevents reflux of stomach contents | Cardiac Sphincter |
| A secretion of the stomach, helps to digest proteins | HCL (Hydrochloric Acid) |
| Digestive enzyme that acts as a catalyst in chemical breakdown of protein | Pepsin |
| A secretion of the stomach needed for the absorption of B12 | Intrinsic Factor |
| A secretion of the stomach that protects the stomach from HLC and enzyme activity | Mucous |
| Contraction of circular muscular fibers | Segmentation |
| Part of the small intestine -2 ft. long, processes the chyme from the stomach | Duodenum |
| The amount of liquid chyme that moves thru the digestive system every day | 7 to 10 liters of liquid chyme |
| Part of the small intestine, 9 ft. long, absorbs carbohydrates and proteins | Jejunum |
| Part of the small intestine, 12 ft. long, it absorbs fats, bile salts, some water, some vitamins and iron | Ileum |
| Most nutrients and electrolytes are absorbed in these two small intestines | Duodenum And Jejunum |
| 5-6 ft. long, primary organ of bowel elimination | Large Intestine (colon) |
| Section of large intestine, a pouch where ileum meets large intestine | Cecum |
| Section of large intestine on the right side of the body | Ascending Colon |
| Section of large intestine that is across the abdomen | Transverse Colon |
| Section of large intestine that is on the left side of the abdominal cavity | Sigmoid |
| Section of the large intestine, that is on the left side of the abdomen | Descending Colon |
| Functions of the colon (large intestine) | Absorption, secretion and elimination |
| Final portion of large intestine, normally is empty until just before defecation | Rectum |
| Permanent dilation, engorgement of veins within lining of rectum | Hemorrhoids |
| Where feces and flatus (gas) are expelled from rectum by contracting of internal and external sphincters | Anus |
| In the GI tract, supplied with sensory nerves that help maintain continence | Anus |
| Normal defecation requires: | Normal GI tract function, Sensory awareness of rectal distention, Voluntary sphincter control, Adequate rectal capacity & compliance. |
| Straining of stool with forced expiration against closed airway - assist in stool passage. | Valsalva Maneuver |
| Lack of enzyme lactose, needed to digest sugars in milk. May lead to diarrhea and cramping | Lactose intolerance |
| Diagnostic test which requires the ingestion of barium | Barium Enema |
| What should the nurse do after the patient has a Barium Enema? | Patient should be ordered a laxative, & should increase PO fluid. Nurse watches stool to be sure barium is eliminated. Watch for lightly colored stool. |
| Liquefies intestinal contents for easier passage | Fluid Intake |
| Soften stool and promote peristalsis | Laxatives |
| Medications that decrease peristalsis | Narcotics, Opiates, and Anticholinergics |
| Medications that may cause diarrhea because they alter the normal bacteria found in the bowels | Antibiotics |
| Medication that inhibit peristalsis | Antidiarrheal Agents |
| Medication that cause stool to turn black, tarry and or green | Iron Preparations |
| Medication that may result in frank blood or occult blood in stool | Anticoagulants |
| Blood that can be seen with the naked eye (see red) | Frank blood |
| Blood is hidden (may smell foul) need to take test for blood in lab | Occult blood |
| Medication that causes white discoloration | Antacids |
| Halts peristalsis (temporarily) | Anesthesia |
| Bowel surgery that may cause halt in peristalis | Paralytic Ileus |
| A condition with fewer bowel movements (BM's) than normal, with difficult passage of hard, dry feces | Constipation |
| Occurs as a result of unrelieved constipation. A collection of hardened stool, becomes wedged in rectum, cannot be expelled | Impaction |
| Increased frequency of passage of loose stool. Fluid & electrolyte imbalances can occur. Also, dehydration & rectal soreness | Diarrhea |
| Age groups that are at risk for diarrhea | Elderly and very young |
| Both of these diseases cause inflammation & ulceration of intestinal walls, decreasing absorption of fluids with increased intestinal mobility. | Crohn's disease or Colitis |
| Removal of all or part of the stomach | Gastrectomy |
| Surgical alteration which decreases the size of the colon | Colon Resection |
| Involuntary passage of stool | Bowel Incontinence |
| Sensation of bloating, abdominal distention, accompanied by excess gas (forces the diaphragm up and decreases lung expansion) | Flatulence |
| Masses of dilated blood vessels lying beneath the lining of the skin fold in the anal mucosa | Hemorrhoids |
| A temporary or permanent artificial opening from the intestine, to the abdominal wall | Stoma |
| An incontinent ostomy which produces a frequent, liquid stool, it bypasses the colon | Ileostomy |
| An incontinent ostomy which almost produces a normal stool | Sigmoid colostomy |
| Incontinent ostomie - usually temporary, large stomas, made in the transverse colon:surgeon pulls a loop of bowel on to the abdomen | Loop colostomy |
| Incontinent ostomie: just the proximal end drains stool- the distal end is either removed, or sewn closed & left in abdomen | End Colostomy |
| Incontinent ostomie: 2 distinct stoma's with separate portions of intestine brought out onto the abdomen | Double Barrel colostomy |
| Continent ostomie: colon is removed: pouch is created & ileum is connected to an intact anal sphincter - there is no ostomy | Ileoanal Pull Through |
| Continent ostomie: restorative proctocolectomy: an internal puch with no external stoma - internal pouch created from ileum | Ileoanal Reservoir |
| Continent ostomie: uses small intestine to create a pouch, there is an ostomy on abdomen, but a one way valve opens with fecal matter | Kock Continent Ileostomy |
| Blood test: a by product of Hemoglobin (HgB) excreted in bile- obstruction of the biliary tract - an increase in direct values | Total Bilirubin |
| Blood test: an enzyme found in many tissues, obstruction of biliary tract | Alkaline Phosphatase |
| Blood loss in stool > 50 mls | Melena |
| Measures microscopic amounts of blood in stool- one positive result does not confirm - should be repeated 3X to be considered positive | Guiac Test |
| Stool analysis to check for bacteria, also test for fecal fat, patient collects stool over 3-5 day period - all stool must be saved | Culture and Sensitivity |
| Adult: normal daily amount of fecal matter eliminated | 150 g daily adult |
| Diagnostic Exam: kidney, ureter, and bladder - is also a plain abdominal x-ray - used for detection of fecal impaction - no prep | KUB |
| Diagnostic Exam: x-ray using opaque contrast dye which patient must drink barium. examines structure & upper GI tract | Upper GI (UGI) - Barium Swallow |
| Diagnostic exam: a lighted, flexible scope which can allow for direct visualization or upper GI tract - can obtain biopsy also | Upper Endoscopy |
| Diagnostic exam: opaque contrast used for exam of lower GI tract - prep NPO after midnight & bowel prep to empty out remaining stool | Barium Enema |
| Diagnostic test: sound waves echo off body organs, creating a picture - prep: depends on organ to be examined | Ultrasound |
| Diagnostic test: endoscopy of colon with colonoscope inserted via rectum - prep: Golytely (drink) | Colonoscopy |
| Diagnostic test; endoscope used to examine the sigmoid colon prep: similar to Barium enema - light sedation may be used | Flexible Sigmoidoscopy |
| Diagnostic test: may be NPO or no prep, patient lies very still, light sedation may be used | Cat Scan |
| Diagnostic test: uses magnetic & radio waves to produce a picture of inside the body, prep NPO 4-6 hrs before test - no metal or jewelry | MRI (Magnetic Resonance Imaging) |
| Medication: empty the bowel, are stronger than laxatives, more rapid | Cathartics |
| Medication: can cause local irritation to intestinal mucosa, and decrease water re-absorption of the large intestine | Stimulant Cathartics |
| Medication; cause water to be reabsorbed by the fecal mass (salt prep not absorbed by intestines) | Saline or Osmotic Agents |
| Medication: examples of Saline or Osmotic Agents | MOM (Magnesium Hydroxide) & Sodium Phosphate |
| Medication: also called stool softeners - are detergents which decrease the surface tension of feces | Wetting Agents |
| Medication: a stool softener which the nurse has to watch if on sodium restriction | Docusate Sodium |
| Medication: a stool softener which renal patients can not take | Dioctyl Calcium Sulfosuccinate |
| Medication: SAFEST OF ALL CATHARTICS - nurse should encourage plenty of fluid intake if used | Bulk Laxatives |
| Medication: example of bulk agent (laxative) | Metamucil |
| Medication: soften fecal mass, decrease strain of defecation. Good for patients with hemmorrhoids | Lubricants |
| Medication: will cause lipid soluble pneumonia if aspirated. Difficult to treat - be sure patient can swallow well | Mineral oil |
| Anti-Diarrheals: most effective: decreases intestinal muscle tone to slow passage of feces | Opiates |
| Enema: promote complete evacuation of feces from the colon | Cleansing Enemas |
| Enema: use only castile soap | SSE Soap Suds Enema |
| Enema: is the safest, same osmotic pressure as fluids in interstitial space around bowel | Normal Saline Enema |
| Enema: low volume hypertonic saline | Fleets |
| Enema: lubricate rectum and colon. Oil is absorbed by feces, to become soft and easy to pass - patient must hold at least 30 min | Oil Retention Enema |
| Enema: used to treat patients with dangerously high potassium levels (K+) | Kayexolate |
| Enema: position of patient when administering | Patient lies on left side lying, or semi prone or Sims position. Semi prone with right knee flexed |
| Medications: absorb water, adding size to fecal mass. | Bulk Forming Laxatives: (Metamucil) |
| Medications: irritate bowel to increase peritalsis | Stimulant: (Dulcolax, Exlax, Correctol, Castor Oil) |
| Medications: cause water to be retained in fecal mass, to cause more watery stool | Saline/Osmotic/Surfactant: (Colace, Surfak) |
| Lubricates stool | Mineral oil |
| Medications: absorb water, adding size to fecal mass. | Bulk Forming Laxatives: (Metamucil) |
| Medications: irritate bowel to increase peritalsis | Stimulant: (Dulcolax, Exlax, Correctol, Castor Oil) |
| Medications: cause water to be retained in fecal mass, to cause more watery stool | Saline/Osmotic/Surfactant: (Colace, Surfak) |
| Lubricates stool | Mineral oil |
| Valsalva Maneuver can be dangeros - due to increased pressure for patients with: | Cardiovascular disease, Glaucoma, increased intracranial pressure. new surgical wounds, can cause cardiac irregularity I increased BP |
| Diet: increased peristalsis | High Fiber Foods: raw vegetables, cabbage, spinach, whole grains |
| Diet: decrease peristalsis | Low fiber foods: pasta, lean meats, milk |
| Diet:Gas producing foods increase peristalis | Broccoli, cauliflower, onions, and dried beans |
| Decreases colon motility | Immoblization |
| Increases peristalis | Exercise |
| Bowel Surgery: in all Post -Op Patients: Nurses are constantly assessing | BOWEL SOUNDS - Keep patient NPO until bowel sounds return (12-24 hours) |
| Fecal Frequency: Normal | 1 x daily or 2-3 x a week |
| Fecal Frequency: Abnormal | more than 3X a day, HYPER MOTILITY |
| Fecal constituents: Normal | Undigested food, dead bacteria, fat, bile pigment, mucous cells |
| Fecal constituents: Abnormal | Excess fat, due to malabsorption, enteritis, pancreatic disease, surgery resection of intestine |
| Full of stool | FOS |
| Instillation of a preparation into the rectum or sigmoid colon causes: | Breaks up fecal mass, stimulates peritalis, streches rectal wall, initiates the defecation reflux |
Created by:
betty boop
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