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Bowel Elimination
Ch. 34
| Question | Answer |
|---|---|
| Anatomy of the GI tract | mouth, esophagus, sm. intestine, lg. intestine, anus |
| what is peristalsis? | contractions that propel food through GI tract. Pushes |
| Where does digestion begin and end? | begins in mouth and ends in sm. intestine |
| What three tasks does the stomach perform? | 1. storage of swallowed food/liquid 2. mixing of food/liquid/dig. juices 3. emptying into sm. intestine |
| What is the movement within the sm. intestine? | Segmentation and peristalsis |
| What is Chyme? | semifluid material that mixes with digestive juices. What comes out of stomach into sm. intestine |
| The sm. intestine is divided into three sections: | duodenum- process chyme jejunum- absorbs carbs/proteins ileum- absorbs h2o,fats,bile salts |
| Which sections absorb most nutrients and electrolytes in sm. intestine? | Duodenum & jejunum |
| Which section of sm. intestine absorbs vitamins, iron, and bile salts? | ileum |
| How long is the sm. intestine? | approx. 23 feet |
| what three sections of the lg. intestine divided into? | cecum, colon, rectum |
| The colon is divided into? | ascending, transverse, descending, sigmoid |
| What is the colon's three functions? | absorption, secretion, elimination |
| In lg. intestine, bicarbonate is secreted in exchange for? | chloride |
| what physiological factors are critical to bowel function? | Normal GI tract function, sensory awareness of rectal distention and rectal contents, voluntary sphincter control, adequate rectal capacity and compliance |
| Which sphincter relaxes to allow awareness to defecate? | internal sphincter |
| Which spincter relaxes to force stool out? | external sphincter |
| What is the Valsalva maneuver? | pressure exerted to expel feces while straining and holding breath. Blood is trapped in veins and is released quickly possible causing problems with pxts w/ glaucoma, cardio disease, intracranial pressure |
| What are common causes of constipation? | diet, meds, inflammation, env. factors(not able to get to toilet), lack of knowledge bout bowel habits |
| What kinds of foods stimulate peristalsis? What slows peristalsis? | high fiber(raw fruits, veggies, greens, whole grains), gas-producing foods(brocolli, cauliflower, onions, dried beans) Low-fiber foods slow(pasta, milk, lean meats) |
| What psychological factors incr peristalsis? What ones decr it? | stress, fear, anxiety depression |
| What is impaction? | unrelieved constipation |
| What is fecal incontinence? | inability to control the passage of feces and gas from the anus. |
| What are hemorrhoids? | dilated, engorged veins in the lining of the rectum. |
| What is a stoma? | temp. or permanent artificial opening in the abd wall. |
| What is the most common bowell diversion reconstruction surgery? | ileoanal pouch anastomosis, pouch connected to anus |
| When an ostomy has more intestine remaining, what kind of stool is present? | more formed and normal stool. I.e. ileostomy creates more liquid stools and bypasses entire lg. intestine |
| Where are loop colostomies usually found and when are they usually performed? | In emergencies and found in the transverse colon. It has two openings thru stoma. Proximal end drains stool and distal portion drains mucus |
| An end colostomy has 1 or 2 stomas? Why would one tend to have an end colostomy? | 1 stoma and usually a surgical treatment for colorectal cancer pxts and diverticulitis. |
| Describe a double barrel colostomy | 2 stomas and bowel is surgicall severed and both ends brought thru abd. |
| How often should you change an ostomy bag? | About 3-5 days |
| What does the Kock continent ileostomy create a pouch out of? | sm. intestine, usually for the treatment of ulcerative colitis |
| what is the most common complaint of pxts who seek health care? | abdominal pain |
| what physiological changes occur with aging in the GI system? | loss of teeth, taste bud atrophy, decr secretion of gastric acid, slight decr. in sm. intestine motility. |
| What does the Bristol Stool Form Scale measure? | types of stool, i.e. types 1-7 hard lumps - watery |
| what do normal bowel sounds sound like? How long do you listen if no sounds? | 5-30 high-pitched gurgling sounds. Listen for 5 min. before deciding whether sounds are absent |
| Name 4 lab tests to diagnose problems in GI tract | total bilirubin, alkaline phosphatase, amylase, carcinoembryonic antigen (CEA) |
| What is Melena? | blood loss of over 50 mL in stool, looks black |
| How much stool should you collect for specimen, solid and liquid? | 15-30mL of liquid, about inch of formed stool |
| What is the fecal occult blood test? | also known guaiac test, measures blood in stool and screens for colon cancer. |
| what foods cause a false positive test in a fecal occult blood test? | red meat, poultry, fish, some raw veggies, vit. C, aspirin |
| Which race has highest colon cancer rates? | african americans |
| Where are bowel diversions located? | ileum(ileostomy) and colon(colostomy) |
| What health promotion activities help with bowel elmination? | excercise, diet (high fiber, low fat, fluids), timing and privacy, promotion of normal deficacy |
| Pxt will pass a soft, formed stool within 48 hours is a goal or outcome? | outcome |
| Pxt will establish a normal defication pattern by incr fluids and bulk to diet is goal or outcome? | goal |
| Outcomes provide measurable _______ or physiological ___________ that indicate progress toward goal of a normal bowel elimination pattern | behaviors, responses |
| The location of the ostomy determines type of diet | initially, pxt on low fiber diets, slowly adding high fiber foods over weeks. High fluid intake. Avoid blockage foods: oranges,apples w/ tough skins,corn, popcorn |
| What position promotes defecation best | squatting incr pressure on rectum and uses abd muscles |
| What are cathartics? | laxatives that have short term action of emptying bowel |
| What are 5 types of cathartics | stimulants- invr intestinal motility, inhibit reabsorp. h2o saline-intestines don't absorb salt, h2o drawn into fecal matter wetting/stool softeners- bulk forming- absorb h2o, incr solid intestinal bulk lubricants- soften fecal mass, mineral oil (dang |
| What is the most effective antidiarrheal agent? | opiods |
| What is an enema? | instillation of a preparation into rectum and sigmoid colon |
| What do enemas do? | stimulate peristalsis |
| tap water, normal saline, low volume hypertonic saline, and soapsuds solutions are what kind of enemas? | Cleansing enemas |
| What do cleansing enemas promote | complete evacuation of feces from colon |
| tap water enemas are hypotonic or hypertonic? | hypotonic and water escapes into interstitial spaces with a low mvmt of water. Do not repeat, causes water toxicity |
| Which cleansing enema is safest and for children? | normal saline becasue exerts same osmotic pressure as interstitial fluid spaces. No danger of excess fluids |
| What kind of soap do you add to soap enemas | pure castille |
| What kind of enema is the Fleet enema | hypertonic exerts osmotic pressure that pulls fluids out of interstiital spaces. |
| High enemas clease what? | entire colon |
| low enemas cleanse what? | rectum and sigmoid colon |
| what two complications accompany digital impactions? | irritation to the mucosa adn bleeding and vagal nerve stimulation which can slow heart rate. |
| What are the two types of NG tubings? | Levin and Salem pumps, most common for stomach decompression |
| Is nasogastric tube insertions sterile or clean technique | clean |
| what is good treatment for hemmorroids? | excercise, proper diet, fluids, heat, sitz bath |
| How much volume of enema solution should be administered for an adult? child? infant? toddler? | adult: 750-1000mL infant:150-250 toddler: 250-350 |
| How far should you lubricate tube of enema bag? | 21/2 -3 inches |
| How far should you insert tip of enema bag in adult/adol., child, infant? | adult/adol: 3-4 in child: 2-3 in infant: 1-1 1/2 in |
| How far should enema bag be above anus and mattress? | 12 inches above anus, 18 in. above mattress |
| how measure distance for ng tube insertion? | traditional method: distance from tip of nose to earlobe to xiphoid process |
Created by:
palmerag
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