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Concepts II
Chapter 30
| Question | Answer |
|---|---|
| BOWEL ILLIMINATION Occurs after nutrients are moved through the gastrointestinal tract known as ALIMENTARY CANAL (starts at the mouth and end at the anus) | |
| DEFICATION The process of bowel illumination (distention of intestinal walls) | |
| PERISTALSIS wavelike movement that begins at the esophagus and ends at the rectum | |
| CHYME semiliquid mass of partly digested foods and digested secretions | |
| Chyme passes through the outlet of the stomach called the PYLORIC SPHINCTER | |
| SMALL INTESTINE is composed of the duodenum, jejunum, and ileum | |
| THE SMALL INTESTINES Most nutrients are absorbed into the blood via capillaries located in the villi and microvilli of the walls of the intestinal mucosa | |
| Chyme that is unable to be broken down is passed through the ILEOCECAL VALVE into the cecum portion of the colon, or large intestine | |
| FECAL MATERIAL Moves through the sigmoid colon into the rectum (intestinal walls distend to accommodate the fecal mass | |
| Bacteria that reside in the colon are NORMAL FLORA that prevent infection and maintain health | |
| Normal flora interact with chyme and produce FLATUS (gas) | |
| Newborns have black, shiny, sticky stools called MECONIUM | |
| Breastfed newborns stools are usually bright yellow, pasty, seedy appearing | |
| Babies that drink formula stools are usually dark yellowish-brown or tan colored and much more formed | |
| FRANK BLOOD is visible to the naked eye | |
| OCCULT BLOOD is not visible to the naked eye | |
| Stool that appears fluffy, floats on water, and has a foul odor is caused by an abnormally high content of undigested fat and is called STEATORRHEA. (CROHNS DISEASE) | |
| Stool that is black and tarry with a foul odor indicates bleeding from the stomach; the blood has been partially digested, giving it the black, tarry appearance that is known as MELENA | |
| Large amounts of maroon-colored blood indicates bleeding from the small intestines. | |
| Larger amounts of bright red blood will indicate bleeding or hemorrhage from the colon. | |
| Small amounts of bright red blood in the stool may indicate hemorrhoids. | |
| Stool may contain threadlike worms and granules that are parasite eggs. | |
| Ribbon-shaped stool may indicate compression on the colon by a tumor, which may be colon cancer | |
| Stool that appears yellow and greasy and has a foul odor also may be caused by pancreatitis and pancreatic cancer. | |
| Stool that is pale or clay colored indicates a lack of bile in the intestines, which may be the result of liver or gallbladder disease. Taking antacids or drinking barium for tests can also cause stool to be white. | |
| Documentation should always include the following: Color Amount Consistency Unusual shape Unusual odor | |
| Bowel sounds should be assessed at least once per shift and more often as indicated. | |
| An absence of bowel sounds indicates a problem and should always be reported to the health-care provider. | |
| If you think that bowel sounds are absent, be certain to listen for at least 3 to 5 minutes in each of the four quadrants before declaring this. | |
| Avoid palpating the abdomen until after you have assessed the bowel sounds because palpation may stimulate bowel sounds that were not there naturally. | |
| Normal Soft gurgles, irregular clicks Between 5 and 30 per minute Indicates normal bowel function | |
| Hypoactive Fewer than 5 per minute May indicate constipation | |
| Hyperactive More than 30 per minute or continuous May be heard when the patient has diarrhea | |
| Borborygmi Excessively loud gurgling May be high-pitched and tinkling in one quadrant and absent or decreased in the lower left quadrant May indicate hunger or, if not hungry, can indicate bowel obstruction | |
| CONSTIPATION is the term used for less frequent, hard, formed stools that are difficult to expel. | |
| A patient with severe constipation may complain of loss of appetite, known as ANOREXIA, in addition to bloating, cramping, malaise, or not feeling well. | |
| FACTORS CONTRIBUTING TO CONSTIPATION Decreased activity level Changes in food intake Decreased fluid intake Medication side effects Surgery | |
| INCONTINENCE Pregnancy Depression Aging Laxative overuse/abuse Nervve damage | |
| Unless contraindicated, fluid intake should be maintained between 1,500 and 2,400 mL per day in most adults. | |
| It is important that the patient also has adequate fiber intake, generally 25 to 35 g per day | |
| Debilitated, older, or confused patients may not be able to drink more than a few sips at a time, thus making it necessary to provide a drink every 15 to 20 minutes in an attempt to provide adequate intake. | |
| Adequate fiber intake is important for healthy bowel elimination. | |
| Teach the patient to increase the fiber in their diet to a minimum of 25 to 30 g per day. | |
| The water temperature of enemas should be between 105°F and 110°F (40.5°C and 43.3°C) to avoid burning the intestinal mucosa. | |
| Water that is too cold will cause abdominal cramping and may restrict the patient’s ability to retain the water. | |
| Tap water Enema 500–1,000 mL Cleansing | |
| Soapsuds (use castile soap only) 5 mL of castile soap added to 1,000 mL of tap water or normal saline Cleansing | |
| Medicated enemas Kayexalate enema pulls potassium from the body tissues and binds with it; | |
| Return flow (also called Harris flush and siphon enema) Remove flatus | |
| Positioning the patient in the left semi-prone or left lateral side-lying position allows gravity to help pull the solution into the intestine. | |
| The normal length to insert the tip of the tubing is 3 to 4 inches for administration of a cleansing enema to an adult. | |
| When the vagus nerve is stimulated, it can drop the heart rate as low as 30 to 40 beats per minute (bpm) and cause constriction of the bronchioles of the lungs. | |
| Vagus Nerve Symptoms Complaints of: Chest pain Chest heaviness or pressure Shortness of breath or inability to breathe Dizziness Feeling faint Nausea | |
| Vagus Signs Pallor Clammy skin Pulse rate under 60 bpm | |
| An impaction is a blockage of the movement of feces through the intestine by a mass of very hard stool. Fecal impaction may occur in the rectum, the sigmoid flexure, or any part of the large colon | |
| Tenesmus is a persistent desire to empty the bowel when no feces is present, causing ineffective straining efforts. It | |
| C. difficile infection starts in a long-term care facility, it is difficult to keep it from spreading among the residents, who often have compromised immune systems. | |
| When the level of normal flora decreases, other microorganisms such as fungi are allowed to grow disproportionately, causing what is called an opportunistic infection | |
| This condition occurs when the muscular wall of the colon weakens and separates, allowing small pouches or pockets of the inner wall to protrude outward. Diverticulosis | |
| These pouches easily trap fecal material and become inflamed. Such a pouch is called a diverticulum. | |
| When they become inflamed, the condition is referred to as diverticulitis, which can cause diarrhea and severe cramping sufficient to force a visit to a health-care provider. | |
| Probiotics are microorganisms with health benefits, such as the microorganisms normally found in the intestines, which help digest food and produce vitamin K. They are useful in helping to prevent diarrhea caused by antibiotics | |
| continent ostomy because the patient has control over when the reservoir is drained. | |
| A Kock pouch is created for an ileostomy to help control the effluent. |
Created by:
Daarina Jones