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Theory Test IV

Unit X Bowel Elimination

Normal Bowel Elimination Highly individual, varying from several times a day to two or three times per week.
Normal Feces Made up of about 75% water and 25% solid materials. Soft but formed, brown,
The reason feces is brown Stercobilin and urobilin are derived from bilirubin (a red pigment in bile) and are present in normal conditions.
Reason for abnormal clay-colored or white feces Lack of bile or obstructed bile flow.
Reason for pale colored feces Malabsorption of fats
Reason for tarry, black feces Iron or -UPPER- GI bleeding
Reason for bright red blood in feces Hemorrhoids or -LOWER- GI bleeding
Melena Blood in feces
Bristol Stool Chart Describes 7 different forms of stool
Reason for normal odor of stool Action of microorganisms on the chyme. Also related to foods that are eaten
Reason for pungent odor of stool Infection or blood in stool
Normal amount of stool passed Varies from person to person and depends of the amount of dietary intake and amount of fiber (100-400 g/day)
Factors related to stool consistency Diet and fluid intake. Normal feces require a normal fluid intake. Feces that contain less water may be hard and difficult to pass.
Decreased peristalsis leads to...? Leads to small, hard, dry stools and constipation.
Increased peristalsis leads to...? Leads to liquid, unformed stools.
Normal shape of feces Cylindrical. Should match the shape of the rectum.
Reason for abnormal or pencil shaped feces Intestinal obstruction or rapid motility
Size of pin worms 1/8 - 1/4 inch
Size of tape worms 5 - 20 feet
Influence of Diet for fecal elimination Adequate amount of fiber (with water, works best when fiber absorbs water). Having regularly timed meals every day. Having balanced meals (know your gas-producing, laxative producing, constipation producing foods)
Adequate amount of fluid for healthy fecal elimination 2,000 - 3,000 mL (8 glasses) of fluid daily
Influence of Activity for fecal elimination This stimulates peristalsis, thus facilitating the movement of chyme along the colon.
Physiological factors affecting fecal elimination Anxiety or anger will lead to increased peristalsis. Depression will lead to slowed intestinal motility.
Influence of bad defecation habits for fecal elimination Ignoring defecation reflexes = progressively weakened response.
Influence of different medications for fecal elimination Tranquilizers and narcotics cause constipation because their action on the CNS decreases GI activity. Iron can cause constipation or diarrhea (acts locally on bowel mucosa). Laxatives directly effect fecal elimination by stimulating bowel movement.
General anesthesia affects for fecal elimination Causes normal colonic movement to cease or slow by blocking parasympathetic stimulation to the muscles of the colon.
ileus condition Surgery that involves direct handling of the intestines can cause temporary cessation of intestinal movement. Usually last 24-48 hours.
Influence of pain for fecal elimination Clients will sometimes suppress the urge because of this which causes constipation.
Alterations in Bowel Elimination Constipation, Diarrhea, Bowel Incontinence, Flatulence
Constipation Fewer than 3 bowel movements per week. Passage of dry, hard stool, or no stool. Movement of feces is slow through large intestine allowing more time for fluid absorption.
Fecal Impaction Mass or collection of hardened feces in the folds of the rectum resulting from prolonged retention and accumulation of fecal material. Client will experience liquid fecal seepage, but no normal stool.
Diarrhea Passage of liquid feces and an increased frequency of defecation. Resulting from rapid movement of fecal contents through the large intestine reducing amount of time for liquid absorption.
Bowel/Fecal Incontinence Loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter. 2 categories: Minor (no control of flatulence or minor soiling) and Major (no control of feces of normal consistency).
Flatulence Presence of excessive flatus in the intestines and leads to intestinal distention. Gas is propelled by increased colon activity before it can be absorbed and is expelled through the anus.
Type of enema for fecal impaction Oil retention enema followed by a cleansing enema 2-4 hours later, and daily cleansing enemas, suppositories or stool softeners.
Normal daily amount of flatus 10L per 24 hours (13-21 times per day)
Hypertonic solution enema Sodium Phosphate (Fleet). Draws water into the colon. The increased volume in the colon stimulates peristalsis.
Hypotonic solution enema Tap water. Causes water to leave the colon, but stimulates peristalsis first. Distends the colon and softens feces.
Isotonic solution enema Normal saline. Distends colon, stimulates peristalsis, and soften feces.
Soapsuds enema Irritates mucosa and distends the colon.
Oil/retention enema Lubricates the feces and the colonic mucosa.
Ostomy Opening for the GI, urinary, or respiratory tract into the skin.
Stoma Opening created in the abdominal wall by the ostomy. Generally red in color and moist.
Gastrostomy Opening through the abdominal wall into the stomach. Generally to provide an alternate feeding route.
Jejunostomy Opens through the abdominal wall into the jejunum. Generally to provide an alternate feeding route.
Ileostomy Opens into the ileum (small bowel). To divert and drain fecal material.
Colostomy Opens into the colon (large bowel). To diver and drain fecal matter.
The 2 ostomy classifications Permanent (P) or Temporary (T)
Reason for a temporary ostomy Traumatic injury/inflammation of the bowel
Reason for permanent ostomy Anus and rectum are nonfunctional
Created by: Jnford15
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