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Module 8 Funds
Bowel elimination and nutrition
| Question | Answer |
|---|---|
| A normal fluid intake is? | 2000-2400mL a day |
| what in the diet provides the bulk in the fecal material. | fiber |
| abdominal assessment | inspection, auscultation, percussion, palpation |
| Muscle tone in the perineal floor and anal sphincter weakens, and may cause difficulty in controlling what? | defecation. |
| This increases peristalsis and promotes movement of stool through the colon. | liquid |
| stress can cause | liquid stools |
| If a pt is bedbound and needs to have a BM | raise the head of the bed to assist the patient to a more normal sitting position on a bedpan, enhancing the ability to defecate. |
| What subjective finding could cause a pt not to want to go to the bathroom | pain |
| intestinal motility decreases-->constipation. Also, uterus puts pressure on the Anal veins and increases risk for hemorrhoids' | pregnancy |
| Any surgery that involves direct manipulation of the bowel temporarily stops peristalsis. | ileus |
| what highly addictive type of medication that slows peristalsis | Opioids slow peristalsis |
| red flag for bowel incontinence? | skin breakdown |
| green flag to prevent bowel incontinence skin breakdown | clean with a no-rinse cleanser and apply moisture barrier at changing time |
| red flag for an indwelling drainage system | necrosis |
| what device would you use on a patient with high volume diarrhea | fecal management system |
| bowel diarrhea could lead the pt to | dehydration and fluid and electrolyte or acid base imbalances |
| constipation is a (blank) and not a (blank) | symptom, disease |
| constipation could lead to | fecal impaction |
| what is the GS FIRST for fecal impaction removal? | enema |
| use this if enemas dont work to remo0ve the fecal impaction | digital removal |
| who is at risk for fecal impaction? | debilitated, confused, or unconscious are most at risk for impaction. |
| when a continuous oozing of liquid stool occurs. suspect that the pt has a | fecal impaction |
| true or false: Poor dentition or poorly fitting dentures influence the ability to chew. | true |
| bulk forming laxative. adds fiber, best for chronic constipation. no dependence | methylcellulose |
| docusate sodium | stool softener |
| (pulls water from the large intestiknes into the fecal) and no dependance | osmotic..like milk of magnesium, miralax |
| harsh stimulating laxatives. can lead to dependence . may cause cramping | Bisacodyl, senna |
| what position should pt be to receive and enema | left lateral sims |
| can digital removal be delegated? | NO |
| Do you give an enema to a pt that is on a toilet? | no because the position of the rectal tubing could damage the intestinal wall . |
| give the enema with the pt positioned on the | bedpan |
| the last resort of disimpaction | digital removal |
| true or false: Excess rectal manipulation causes irritation to the mucosa, bleeding, and stimulation of the vagus nerve, which could result in a reflex slowing of the heart rate/ b. | could result in a reflex slowing of the heart rate/ b/p true |
| types of cleansing enemas? | tap water, normal saline, soapsuds solution, and low-volume hypertonic saline. |
| red flag with tap water enema | (hypotonic solution). Use with caution. Can cause water toxicity & fluid volume overload. |
| green flag with tap water enema | Check, shortness of breath, lungs sounds, edema ect…(signs of fluid overload) |
| create the effect of intestinal irritation to stimulate peristalsis | soapsuds |
| red flag with soapsuds enema ? | Use soapsuds enemas with caution in older adults because they could cause electrolyte imbalance or damage to the intestinal mucosa. |
| true or false: Use only pure castile soap that comes in a liquid form that is included in most soapsuds enema kits. | true |
| what is the safest enema? | normal saline. Because it doesn't cause any shift of fluids. |
| T or F : internal fecal Cath should not be used for children? | T |
| T or F: hang collection bag below pt because of gravity | t |
| hypertonic solution is one that you dont need to use in dehydrated pts | fleets enema |
| cleanse most of the colon when instructed to turn turn from the left lateral to the dorsal recumbent, over to the right lateral position | high enema |
| cleanses only the rectum and sigmoid colon. | low enema |
Created by:
thannon
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