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Bowel Elm P&P
Potter and Perry 7th Edition Chapter 46
| Question | Answer |
|---|---|
| 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. |
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