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Bowel Elm P&P

Potter and Perry 7th Edition Chapter 46

Purpose of the GI organs? Absorb fluid and nutrients, prepare food for absorption and use by cells, and provide temp storage.
Where does mastication take place? Mouth.
Where is the cardiac sphincter and what is its function? Between the esophagus and the stomach, prevents reflux of stomach contents into the esophagus.
Purpose of the stomach? Store food, mix food w/ gastric juices, emptying contents slowly into duodenum.
2 enzymes in the stomach facilitate the digestion of protein. Pepsin and HCl
What in stomach juice is necessary for the absorption of Vitamin B12? Intrinsic factor
What protects the stomach from digestive juices? Gastric mucus.
What moves chyme through the intestine? Segmentation and peristalsis.
What is an average amount of chyme moving through the small intestine in a day? 7-10 L
By the time 7-10 L of chyme reaches the end of the small intestine how much has it been reduced to? 600-800mL
What are the three sections of the small intestine? Duodenum, jejunum, ileum
What is 8-11 inches and continues to process chyme from the stomach. Duodenum
What is 8 feet long and has the primary function of absorbing carbohydrates. Jejunum
What is 12 feet long and specializes in the absorption of water, fats, and bile salts. Ileum
Which 2 sections of the small intestine absorb most nutrients and electrolytes? Duodenum and jejunum
Which section of the small intestine absorbs certain vitamins, iron, and bile salts? Ileum
About how long is the large intestine? 1.5-1.6 m or 5-6 ft
What names of the three parts of the large intestine? Cecum, colon, rectum
What is the valve between the small intestine to the large intestine? Ileocecal valve
What are the four segments of the COLON? Ascending, transverse, descending, sigmoid
What are the three functions of the colon? Absorption, secretion, and elimination
What does the amount of time spent in the colon have to do with a stool's consistency? The amount of water absorbed determines how fluid/firm. Fast peristalsis = watery stool. Slow = hard stool
What does the large intestine absorb? Water, sodium, and chloride.
Name some electrolytes secreted in the colon. Bicarbonate and potassium
Bicarbonate is secreted in exchange for absorbing what? Chloride.
How much water and salt is absorbed? 1 gallon water, 1 ounce salt.
What type of peristalsis moves undigested food toward the rectum? Mass peristalsis
About how many times a day do we have mass peristalsis and when is the strongest? 3-4 times a day, strongest about an hour after mealtime
What is the main stimulus for contraction? Intestinal content.
What are distended veins in the rectum caused by straining during defecation? Hemorrhoids
What is the voluntary contraction of abdominal muscles while maintaining forced expiration? against a closed airway in order to expel feces called? Valsalva maneuver.
Which patients should avoid Valsalva maneuver? Anyone w/ hypertension, abnormal cardiac rhythm or other cardiovascular diseases, glaucoma, increased intracranial pressure, or surgical wound.
Oozing diarrhea, anorexia, abdominal distention, cramping, and rectal pain are signs of what? Fecal impaction.
Infants GI tract? Smaller stomach capacity, less digestive enzymes secreted.
When does control of defectation take place? 2-3 yrs.
What is the nondigestable residue in the diet that provide bulk to feces? Fiber.
Fiber helps by? Flushing fats and waste products with more efficiency.
Gas producing foods speed peristalsis by? Distending intestinal walls causing motility. Gives the sense of intestinal fullness.
Food intolerance such as lactose intolerance is not ______? An allergy. Causes body distress.
What other factors increase GI motility? Physical activity, emotional stress.
What factors decrease GI motility? Depression, 3rd trimester of pregnancy, surgery that directly manipulates the bowel.
How does leaning forward promote defecation? by raising intra-abdominal pressure
What is the aim of treatment for diarrhea? Prevent dehydration and electrolyte balance.
What stool consistency would be formed by an ostomy of the sigmoid colon? Normal stool consistency
What stool consistency would be formed by an ostomy of the ileum? Watery stool.
What are loop colostomies and when are they performed? Loop colostomies are emergency situations. They temporary stomas of the transverse colon that is looped over a bridge to prevent it from slipping back in.
What kind of colostomy is used as surgical treatment for colorectal cancer? End colostomy.
When is a temporary end colostomy with a Hartmann’s pouch used? Patients with diverticulitis.
What advantage to a colostomy of the sigmoid colon have? Can train the bowel to empty at a certain time of day w/o always having a bag.
Portion of the ileum is used to create a new rectum and connected to the anus? Ileoanal pouch anastomosis.
A pouch of ileum that the patient catheterizes and empties several times a day? Kock continent ileostomy.
Elevated levels of amylase in feces indicate? Pancreatic disorder.
Elevated levels of carcinoembryonic antigen in feces indicate? Elevated in cancer of the GI tract or hepatobiliary organs.
Elevated levels of biliruben in feces? Hepatobiliary disease.
White or clay feces lack of? Bile.
Black or tarry stool? Upper GI bleeding or Iron ingestion.
Red in the stool? Lower GI bleeding, hemorrhoids, or foods such as beets.
Pale color with fat in it? Malabsorption of fat.
What is FOBT and FIT and how often should people over 50 have it? Fecal Occult Blood Test, Fecal Immunochemical test; Yearly
What are the tests people over 50 should have every 5 years? Flexible Sigmoidoscopy (FSIG), double contrast barium edema.
What test should people over 50 have every 10 years? Colonscopy.
Patients on what medication should be regularly screened with a FOBT? Anticoagulant for intestinal bleeding.
The American Cancer Society recommends yearly what test every 5 years. FOBT and flexible sigmoidoscopy.
Name 4 factors that affect the character of feces. Mechanical breakdown of food, GI motility, selective absorption, secretion of substances in the large intestine
2 factors that make up stool consistency? Fiber and fluid intake.
Greatest dangers from diarrhea? Fluid and electrolyte imbalance.
2 dangers during digital removal of stool Trauma to rectal mucosa and vagas nerve stimulation.
What is the best time to administer an enema? Before a patient’s normal time to defecate or immediately after a meal.
What are some harmful effects related to overuse of laxatives? Permanent bowel damage, osteomalacia, electrolyte imbalance
How are cathartics classified? Way they promote defecation.
How do stimulant cathartics cause defecation? Irritate mucosa, increase motility, inhibit reabsorption of water.
What is the time frame of action for a stimulant cathartic? 6-8 hours
What catharttics stimulate motility and lubrication by osmosis? Saline or osmotic cathartics
What is the time frame of action for saline or osmotic cathartics? 1-3 hours
What cathartic soften and lower the surface tension of the stool by allowing water and fat to penetrate and block absorption of water into the intestines? Emollient or wetting agents
What kind of laxatives are the least irritating and safest? Bulk forming laxatives.
How do bulk forming laxatives work? Fecal bulk stretches intestinal walls stimulating peristalsis.
Which patients could benefit from mineral oil laxatives? Painful hemorrhoids.
What are the problems associated with regular use of mineral oil? Interference with absorption of A, D, E, K
What is the only safe type of enema for infants and children due to potential fluid imbalance? Normal saline.
Volume of a cleansing enema? 750-1000mL
What kind of enema is for patients who cannot tolerate large amounts of fluid? Hypertonic fluid.
How many mL are included in a hypertonic solution enema? 120ml to 180ml.
Narcotic analgesics, opiates, and anticholinergics affect elimination? Decrease peristalsis and cause constipation.
Antibiotics affect elimination? Destroy normal intestinal flora and produce diarrhea.
How does general anesthesia affect elimination? Slows or stops peristalsis.
How does pregnancy affect elimination? Constipation due to extra pressure on the rectum.
What is the correct temperature for and enema and why? 105 to 110 degrees to relax muscles. Colder causes muscle spasm. Hotter injures mucosa.
How come people can have heart attacks from going to the rest room? Raised intra-thoracic pressure during straining cuts of venous return to the heart. It returns forcefully causing tachycardia and ^BP followed by reflex bradycardia
Which side should a person be lying on for an enema and why? the left side because that is where the sigmoid colon is located
What is the purpose of a rectal tube? Promote passage of flatus decreasing abdominal pressure
What is the function of soap in a soapsuds enema? to irritate the bowel resulting in peristalsis
How far in is an enema tube inserted? 3-4 inches
Excessive use of what weakens the natural response to defecation? laxatives
Irritation in the colon results in increase ____ secretion? Mucus.
What is a common bacterial cause of diarrhea? Clostridium difficile (C. diff)
How can C. diff be contracted? Overgrowth of normal flora or contact with the organism.
If diarrhea is caused by a virus, what is the main goal? Rid the GI tract of the virus instead of slowing peristalsis.
Visible peristalsis indicates? Obstruction.
What is the difference in percussion sounds of gas or a mass/tumor/fluid? Gas is tympanic, a mass/tumor/fluid are dull.
What percentage of solid stool is bacteria from the colon? 25%
What is another word for microscopic? Occult.
Stool removed from an ostomy is called? Effluent.
Which ostomy is the ONLY one that can be irrigated? Colostomy.
Why is liquid stool, such as that from an iliostomy, so damaging to skin tissue? Highly acidic and contains digestive enzymes.
Created by: Babble05