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BM Elimination
| Question | Answer |
|---|---|
| Normal feces | 75% H2O and 25% solids; soft, but formed |
| Adult produces | 7-10 L of flatus a day. Includes CO2, methane, H+, O2, and Nitrogen. |
| Bulk-forming foods- | grains (bran, oats), fruits (prunes, figs) and vegetables- absorb fluids and increase stool mass-stimulating peristalsis |
| Gas-producing foods- | onions, cauliflower, cabbage, beans, bananas, apples--stimulate peristalsis |
| Spicy foods & Sugar- | cause diarrhea and gas |
| Lactose intolerance- | is seen with patients that can’t digest foods like milk and milk products. Can be cause of diarrhea |
| should drink | 6-8 glasses of fluid a day (non caffeinated)—preferably 2000-3000 mL/day, especially if constipation problems |
| Chocolate & alcohol | can have a laxative effect. |
| Cheese, pasta (better to use whole grain), eggs, lean meat | can cause constipation |
| Activity | Activity-stimulate peristalsis- Bedridden clients risk for constipation, as well as clients with muscle weakness |
| Psychological factors- | anxiety increases peristalsis-depression causes constipation (↓ peristalsis) |
| Defecation habits- | most people go after breakfast-if client ignores urge, H20 is absorbed, eventually making stool hard-When |
| Medications- | some cause diarrhea- laxatives help with elimination |
| Diagnostic procedures | may have enemas before, or laxative prep (colonoscopy) |
| Anesthesia/Surgery | if involves intestines, no bowel sounds for 24-48 hours-ileus; general anesthesia slows or blocks peristalsis |
| Pathologic conditions | spinal and head injuries decrease elimination-immobility decreases elimination , poorly functioning anal sphincters |
| Pain-suppresses urge to defecate | hemorrhoids, episiotomy, excoriation, fungal infection, etc. |
| Blood in the stool | (melena or hematochezia): Very important that your remember that black stool is indicative of UPPER and Red blood lower |
| Black, tarry stool | can result from aspirin, Pepto Bismol, GI bleed. |
| Gray-green stool | can result from antibiotics |
| Chalky-flecked stools | antacids, barium enema, barium swallow. |
| Brown | Normally adults |
| Yellow | Infants Newborns may also be green, black |
| Red | Bleeding from Lower GI eating beets |
| Pale | diet high in milk low in meats not absorbing fats |
| Orange or green | intestinal infection |
| Amount | varies with diet- ~100-400g/day |
| Odor | Aromatic—affected by diet & individual’s own bacterial flora |
| “bad” odor- | infection or blood |
| Constituents | undigested roughage, sloughed dead bacteria & epithelial cells, fats, protein, bile pigments, inorganic matter |
| pus | infection |
| mucus | inflammatory |
| parasites | (worms, ova), blood |
| Eructation | burping, belching, mostly from swallowed air |
| Sources of Flatus | Action of bacteria on chyme in large intestine (also source of odor of flatus) Swallowed air Gas that diffuses between the bloodstream & intestine |
| Distention | stretches intestines, causing bloating, usually from foods, abdominal surgery, or narcotics. |
| Direct Visualization | —”Going in with the light”; requires clear liquids, laxative prep day before, and NPO day of test. |
| Indirect Visualization | X-rays, barium enemas |
| Lab tests | parasites (may look like rice in stool), organisms, incomplete digestion |
| Simethicone | used to coalesce gas (Gaviscon, Gas-Ex, Mylicon) |
| meds promote defecation | (Metamucil, Fiber-Con, MOM, docusate, senna, mineral oil, Epsom salts) |
| control diarrhea | by promoting absorption of excess fluid and/or slowing motility (Imodium, Lomotil, Paregoric) |
| Laxatives & Cathartics | soften stool & promote peristalsis & can assist in return of normal pattern if used correctly—if chronic use, client can become laxative dependent, & normal signals no longer present for defecation without meds. |
| Bulemics | use laxatives to purge to lose weight. Can cause ↓ absorption of nutrients, diarrhea, dehydration, electrolyte imbalance, and even death. |
| Constipation: | Less than 3 stools per week Dry Hard stool Is this a change???? One of the most important questions |
| Symptom not disease | infrequent BM’s, difficulty or inability to defecate; hard stool. |
| Straining | Little water is left to soften the stool because of the absorption leading to hard dry stool |
| Hemorrhoids | (swollen & inflamed veins in anus & rectum) can develop during late pregnancy d/t to ↑ abd pressure & straining from constipation, causing discomfort with defecation. Can also occur in children & adults with frequent or chronic constipation |
| Acute constipation | often caused by organic process (tumor or bowel obstruction, as from surgical adhesions in abd) |
| Chronic constipation | has functional causes that impede normal passage of stool |
| Retention | Introduces oil or medication into the rectum & sigmoid colon for lubrication of stool |
| Carminative and return-flow | Used primarily to expel flatus |
| Cleansing | Prevents escape of feces during surgery Prepare intestines for certain diagnostic tests Removes feces in instances of constipation or impaction |
| Partial | loss of control of flatus & minor soiling |
| Major | lack of control of feces of normal consistency |
Created by:
ED.
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