Fundamentals Exam 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Route of GI tract | mouth. esophagus, stomach, duodenum, jejunum, ileum, cecum, ascending, transverse, descending, sigmoid, rectum, anus
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| Factors that affect GI elimination | nutrition status, personal habits, medications, spinal injury, surgery, pregnancy, infections, food intolerance, physical activity, illnesses, stress, position, diagnostic test
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| What is peristalsis? | contraction that propels food through the length of the GI tract
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| Diarrhea | increase in the number of stools and the passage of liquid, unformed feces
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| Impaction | results from unrelieved constipation and is unable to expel the hardened feces retained in the rectum
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| Constipation | symptom, not a disease (infrequent bowel movement - less than 3 per week)
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| Risk from diarrhea | dehydration, watch potassium, skin breakdown (keep skin clean and dry while using barrier cream)
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| Prevention for GI problems | exercise, fiber in diet, laxative use, and stool softener
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| What can laxative abuse lead to? | constipation
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| Why would a nurse need to give an enema? | constipation, medications, procedure, relieve gas
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| What is an enema? | the instillation of a solution into a the rectum and stimulates peristalsis
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| Cleansing enema | promote the complete evacuation of feces from the colon; typically for diagnostic procedures
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| Types of cleansing enemas | tap water, normal saline, hypertonic solutions
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| Tap water | hypotonic solution, do not repeat -> water toxicity (fluid overload), fill up bag with large volume of tap water to irritant and have bowel movement (very cheap)
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| Normal saline | isotonic solution- same as blood, safest enema -> use on children and won't cause electrolyte imbalance
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| Hypertonic solution | Fleets enema - can give to self, hypertonic, pulls water from the body to the gut (opposite water)
Soap suds - castile soap to water, irritant the gut and get this out of here
Oil retention -absorbed in the stool to soften and hopefully get it out
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| Kayexalate enema | potassium exiting; pulls K to stool and expels through rectum - used for patients with a high K level
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| Contrast enema | barium enema to show problem in the bowel - diagnostic
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| Carminative enema | provides relief from gas distention
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| Can a CNA give an enema?? | yup
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| Position for enema | left lateral Sim's, can do on bedpan; cannot give on toilet - can perforate the intestinal wall (DO NOT GET NEAR RECTUM WHEN ADMINISTERING)
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| Safety recap on enema | wear PPE, use IV pole to hang bag, warm temperature, adult - 3-4 inches and child - 2-3 inches, angle tubing toward belly button
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| If a nurse needs to slow down the rate of an enema, what should they do? | Lower the bag to slow down the rate of the enema because of patient complaining of discomfort
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| What type of enema should a nurse never repeat? | tap water
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| Symptoms of impaction | constipation, nausea, vomiting, abdominal pain, distention, rectal pain, abdominal distention
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| Can a CNA do a dis-impaction? Why? | No, nurse can only do this. Because of stimulation of vagal nerve that can lead to bradycardia
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| How does a nurse do a dis-impaction? | insert one finger, let sphincter relax and feeling of hard stool, insert two fingers, scissor motion to break apart big mass, mass into bedpan or something (sometimes patient can pass it)
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| Stoma | abdominal wall, beefy red color (blue - no blood flow), way for stool to come out, needs to have a really tight fit on ostomy bag
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| Ileostomy | ileum location for ostomy
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| Colostomy | colon location for ostomy
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| What is an ostomy bag called? | an appliance
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| Ascending | liquid stool
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| Transverse | semi-solid stool
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| Descending | solid stool
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