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Foundations test 4
| Term | Definition |
|---|---|
| Name the GI system components | Throat, Trachea, - Upper esophageal sphincter, esophagus, lower esophageal sphincter, -hiatus, stomach, Diaphragm, Large intestine, small intestine |
| Defecation | Process of expelling stool, bowel elimination, bowel movement |
| Feces | stool |
| Peristalsis | rythmic contractions of intestinal smooth musce, facilitates defecation, moves fiber, water, and waste |
| Gastrocolic reflex | Increased peristalsis during eating, propels stool towards the rectum |
| Sphincter | A ring shaped band of muscle surrounding and serving to guard/close an opening or tube |
| Valsava maneuver | closing the glottis and contracting the pelvic and abdomnial muscles to increase abdomninal pressure, "bearing down:, facilitates defecation |
| Melena | Black tarry stool that contains blood, bleeding from somewhere in the upper GI (different from meconium) |
| Globin | A protein removed from heme, which is present exclusively in the lower intestine |
| Dysphagia | Difficulty swallowing, can occur when muscles or nerves in the throat are damaged or obstructed |
| Gastric reflux | The backwards flow of stomach acid and stoach contents from the stomach into the esophagus, also known as gastroesophageal refulx |
| Hematochezia | Bright red, blood stool, bleeding from the lower GI |
| How do you conduct a physical exam of the GI system? | Client supine and knees flex slightly, inspect, auscultate, palpate |
| How do you obtain a client's baseline elimination pattern? | Frequency (normal 3x daily to 3x weekly), effort to expel, elimination aids |
| Factors that affect bowel elimination: | Types of food, fluid intake, drugs, emotions, neuromuscular function, abdominal muscle tone, opportunity to defecation |
| Explain what health education the nurse will provide regarding bowel elimination | Exercise daily, eat high fiber foods, drink 8-10 glasses of liquid daily, respond to the urge to defecate, types of food, fluid intake, drugs, emotions, neuromuscular function, abdominal muscle tone, opportunity to defecation |
| Examples of hihg fiber | Wheat bran, whole grains, dried peas and beans, skins/seeds of fresh fuit/vegetables |
| Normal characteristics of feces | brown, aromatic, soft, formed, round, full, undigested fiber |
| Abnormal characteristics of feces | Black, clay collared(tan), yellow, green, white, tarry, foul, soft, bulky; hard, dry; watery; paste like, unformed, flat, pencil shpaed, stone like, worms, blood, pus, mucus |
| Different testing for colorectal disorders | FOBT, FIT, Endoscopi exams: Colonoscopy, sigmoidoscopy |
| FOBT | Fecal occult blood test - occult: blood in the stool - checking for blood in the test - no NSAIDS 7 days prior, no red meat 3 dyas prior, low vit C intake 3 days prior, no citrus fruit 3 days piro, no tunips, radishes, broccoli, beets, carrots, cauliflowe |
| FIT | Fecal immunochemical test - detects blood in stool, uses antibodies to detect globin (a protein removed from heme), more specific than FOBT for detecting colorectal cancer, FIT test may be combined with a stool DNA test |
| What are common alterations in bowel elimination | Constipation, Fecal impation, Flatulence, Diarrhea, Fecal incontinence |
| Constipation | Abdomen bloating, fullness, or distension, rectal fullness or pressure, painful defecation or inabillity to defecate, change in stool characteristic, investigate overuse of laxatives - Lifestyle factors, pathologic disorder, consequence of medical tx |
| Fecal impaction: | Desire to frequently defecate, but can't, rectal pain, may look like liquied stool - unrelieved constipation, dehydration, retained barium enema, weak abd muscles - Enema, digital disimpaction |
| Flatulence | Excessive accumulation of intestinal gas, swallowed air or sluggish perstalsis, byproduct of bacterial femrentation - commonly caused by : cabbage, cucumbers, onions, beans |
| Diarrhea | Urgent water stool, abdominal cramping, may have blood or mucous in stool, may have nausea and/or vommiting - tainted food/intestinal pathogens, emotional stress, laxative misuse, bowel disorders |
| What to do when you have diarrhea | Bowel rest: clear liquid 12-24 hrs, advance diet as tolerated (low residue) consult provider for diarrhea > 24 hours |
| Fecal incontinence | Inabillity to control the elimination of stool, stoll may be normal consistency - causes: neurologic changes, impaired cognition or movility - educate family, social and emotional impact, track bowel movments and sit on toilet before that time of day |
| Causes of Primary constipation | Lifestyle factors |
| Causes of secondary constipation | Patholocig disorder |
| causes of Iatrogenic constipation | Consequence of medical tx |
| causes of psuedo constipation | When someone thinks they are constipated but they actually arent |
| Why should the nurse assess for laxative misues in someone with chronic constiaption | Many individuals believe that a daily bowel movement is the normal and turn to laxative use to promote a daily bowel movement. If a client reports chronic constipation, investigate the clients use of laxatives. Laxatives like many medications -independenc |
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