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Elimination 102

LU Kozier Notes

Normal feces 100-400g per day, brown, soft, cylindrical, about 75% water and 25% solids
flatus largely air and the by products of digestion of carbs, normal adult 7-10 L per day
peristalsis wave like movement of intestinal walls
hemorrhoids distended veins in the rectum due to repeated pressure
defecation expulsion of feces from the body
constipation fewer than 3 bm per week most common bowel management problem in the elder population causes: reduced activity level, inadequate amount of fluid and fiber, muscle weakness, use of opiods
laxatives medication used to stimulate bowel activity caution: overuse can cause constipation
fecal impaction mass or collection of hardened feces in the folds of the rectum, often give an oil retention enema, then a cleansing enema. If this fail manual removal may be required
diarrhea passage of liquid feces and an increased frequency of defecation
bowel incontinence loss of voluntary abiity to control feces or gas through the anal sphincter
flatulence presence of excessive flatus in the intestines
ostomy opening into gastrointestinal, urinary or respiratory tract onto the skin
intestinal ostomy gastrostomy (stomach), jejunostomy (abdomen into jejunum) both for feeding: , ileostomy (ileum or small bowel), colostomy (colon or large bowel): fecal matter
stoma opening created in the abdominal wall, generally red and moist
Ways to promote regular defecation privacy, timing, nutrition, exercise, positioning
Nursing interventions for diarrhea encourage fluids and bland foods, small amounts of food, avoid extreme temps, high fiber and highly spiced foods, increase sodium and potassium intake, avoid alcohol and caffeine, increase intake of yogurt when diarrhea stops
Nursing interventions for constipation increase fluids, encourage hot fluids and fruit juices, increase fiber intake
Nursing interventions for flatulance limit carbonated beverages, the use of straws and chewing gum. Avoid cabbage, beans, onions and cauliflower because the create gas
cathartics drugs that induce defecation, strong purgative effect (think laxative on steroids)
suppositiories medication given rectally
carminatives herbal oils known to act as agents that can help expel gas
enema solution introduced into the rectum and large intestine (distends the intestine, increase peristalsis) Four types (cleansing, carminative, retention, return flow)
Cleansing enema intended to remove feces (5 to 10 min)
carminative enema intended to expal flatus
retention enema introduces oil or meds into colon, retained for 1-3 hours, softens feces, and lubes the rectum
return flow enema used to expel flatus, 100-200 mL fluid into and out of the rectum, stimulate peristalsis (repeat 5-6 times till flatus removed)
administering enema lube 5 cm of tube, expel air and clamp, pt lie on left lateral side, right leg flexed, insert tube 7-10 cm, ask clinet to retain enema as long as required, assist client to defecate
ostomy appliances should protect skin, collect stool and control odor. Applied for up to 7 days. Emptied when 1/3 to 1/2 full
Created by: 582303342