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3802 Bowel Eliminat
Bowel Elimination
| Question | Answer |
|---|---|
| Constipation | include infrequent bowel movements, difficult evacuation of feces, inability to defecate at will, and hard feces. |
| Fecal impaction | It is a collection of hardened feces, wedged in the rectum that cannot be expelled. |
| ________ is a symptom, not a disease. | Constipation |
| Diarrhea | Is an increase in the number of stools and the passage of liquid, unformed feces. |
| Anorexia Nervosa | Characterized by self-imposed weight loss, endocrine dysfunction, and a distorted psychopathologic attitude toward weight and eating. |
| What factors affect normal bowel elimination? | Age, mouth, esophagus, stomach, small intestine, large intestine and liver |
| How does age affect normal bowel elimination? | Systemic changes occur in the function of digestion and absorption of nutrients in older adults. |
| How does the mouth affect normal bowel elimination? | decreased chewing and decreased salivation, including oral dryness. |
| How does the esophagus affect normal bowel elimination? | Reduced mobility. |
| How does the stomach affect normal bowel elimination? | Decrease in acid secretions; motor activity; mucosal thickness |
| How does a decrease in motor activity affect normal bowel elimination? | delayed gastric emptying |
| How does mucosal thickness affect normal bowel elimination? | loss of parietal cells leads to loss of intrinsic factor, which is needed for vitamin B12 absorption. |
| How does the small intestine affect normal bowel elimination? | Decreased nutrient absorption. |
| How does the large intestine affect normal bowel elimination? | Increase in pouches on the weakened intestinal wall called diverticulosis; constipation. |
| Diverticulosis | pouches that bulge from the large intestine wall |
| How does the liver affect normal bowel elimination? | reduces in size; reduced storage capacity and ability to synthesized proteins and metabolized medications. |
| Why is fluid intake important? | Reduced fluid intake slows the passage of food through the intestine and can result in hardening of stool content. |
| How much fluid intake should a normal adult have? | An adult should drink at least six to eight glasses (1400 to 2000 mL) of non-caffeinated fluid per day. |
| What is the role of fiber? | Fiber provides the bulk of fecal material. Bulk-forming foods such as, grains, fruits and vegetables, absorbs fluids and increase stool mass. |
| What types of foods are going to stimulate peristalsis? | Gas-producing foods such as, onions, cauliflower, and beans. |
| How does physical activity effect peristalsis? | Physical activity promotes peristalsis; immobilization depresses peristalsis. |
| How can prolonged stress affect peristalsis? | The digestive process is accelerated, and peristalsis is increased. Side effects of increased peristalsis are diarrhea, and gaseous distention. |
| If a person is experiencing pain during defecation, is the considered normal? | no, and if the person avoids defecation then constipation may be the end result. |
| What are some conditions that make defecating painful? | hemorrhoids, rectal surgery, rectal fistulas and abdominal surgery. |
| What are some effects of surgery on peristalsis? | Any surgery that involves direct manipulation of the bowel temporarily stops peristalsis, Inhaled anesthetic agents block parasympathetic impulses to the intestinal musculature. The anesthetic’s action slows or stops peristaltic waves. |
| How does this drug affect the digestive system? Narcotic Analgesics | Suppresses peristalsis and can decrease gastric emptying. |
| How does this drug affect the digestive system? Anticholinergic Drugs | Inhibits gastric acid secretion and depresses gastrointestinal mobility. |
| How does this drug affect the digestive system? Antibiotics | May produce diarrhea by disrupting the normal bacterial flora in the gastrointestinal tract. |
| How does this drug affect the digestive system? Nonsteroidal Anti-inflammatory Drugs (NSAID) | Causes gastrointestinal irritation that increases the incident of bleeding. |
| How does this drug affect the digestive system? Aspirin | It can interfere with the formation and production of protective mucus and causes gastrointestinal bleeding. |
| How does this drug affect the digestive system? Histamine (H2) Antagonists | Suppress the secretion of hydrochloric acid and interferes with the digestion of some foods. |
| How does this drug affect the digestive system? Iron | Can cause discoloration of the stool (black) and can lead to constipation. |
| How does this drug affect the digestive system? Bulk forming laxative | Agents stretch intestinal wall to stimulate peristalsis. |
| How does this drug affect the digestive system? Emollient or Wetting | Stool softeners that lower surface tension of feces, allowing water and fat to penetrate. |
| What is the name of the bulk forming laxative? | Psyllium (Metamucil) |
| What is the name of the emollient or wetting laxative? | Docusate sodium (Colace, Disonate); Docusate calcium (Surfak); Docusate potassium (Dialose) |
| What is the drug of choice for chronic constipation? | Metamucil (bulk forming laxative) |
| What is the drug of choice for short-term therapy use to relieve straining on defecation? | docusate sodium (emollient or wetting laxative) |
| What is a key point to keep in mind when using a bulk-forming laxative? | Agents can cause obstruction if agent not mixed with at least 240 mL of water or juice or swallowed quickly. |
| What is a key point to keep in mind when using an emollient or wetting laxative? | this drug is of little value for treating chronic constipation. |
| What is the name of the saline laxatives? | Magnesium citrate or Citrate of Magnesium (Citroma); Magnesium hydroxide (Milk of Magnesium); Sodium phosphate (Fleet Phospho-Soda; Fleet Enema) |
| How do saline laxatives work? | Osmotic effect increases pressure in bowel to act as a stimulant for peristalsis. |
| When would you use a saline laxative? | Agents used only for acute emptying of bowel. |
| What are the key points of saline laxatives? | Agents are not used for long-term management of constipation. |
| What is the name of the stimulant cathartics? | Bisacodyl (Ducolax) |
| How do the stimulant cathartics work? | Agents irritate intestinal mucosa to increase mobility. |
| When would you use a stimulant cathartics? | Agents may be used to prepare bowel for diagnostic procedures. |
| What is the key point of the stimulant cathartics? | Agents may cause severe cramping; agents are not used for long-term use. |
| What is the name of a lubricant? | Mineral oil (Haley’s M-O) |
| How does a lubricant work? | Agents coat fecal contents, allowing easier passage of stool. |
| When would you use a lubricant? | Agents used to prevent straining on defecation. |
| What is the key point of using a lubricant? | Mineral oil when taken with emollients can increase risk for fat emboli. |
| What are common causes of constipation? | Irregular bowels,ignoring the urge to defecate,Chronic illnesses,Low-fiber diet, lack of exercise,Heavy laxative use, Older adults experience slowed peristalsis, loss of abdominal muscle elasticity,reduced intestinal mucus,Neurological conditions |