Altered Bowel Elimination

  1. What lives in the bowels?
    Bacteria ONLY...NO Enzymes!!
  2. What makes gas?
    breakdown of bacteria
  3. What happens when you suppress the urge to defecate?
    Constipation-cuz poop sits in lg intestine longer so more water is reabsorbed.  Hardens
  4. What causes diarrhea?
    • bacteria
    • increase bowel transit time (less time from mouth to anus)
    • malabsorption
  5. Subjective assessment data pertinent to bowel elimination
    Tell me what your normal BM practice is like? Diet? Exercise? Weight history? Narcotics? Gas? Pain, amount, shape and color of BM? Pruritis? Hemmorhoids? Pyrosis (heartburn)? odynophagia (painful swallowing) Travel history?
  6. pyrosis
  7. odynophagia
    painful swallowing
  8. Objective assessment data pertinent to bowel elimination
    • What I see, hear, touch or smell.
    • Pt. height and weight
    • Oral cavity, condition, sores, thrush, halitosis
    • Inspect and measure abdominal girth, stool observation, AUSCULATE, PERCUSS
  9. If I dont hear bowel sounds what do I do?
    spend 5 min. at each quadrant
  10. Where will I find largest fecal mass?
  11. Labs for stools
    • Occult Blood
    • Ova and Parasite
  12. Barium Swallow and Small bowel series...

    What does it look at?
    • pt. drinks white chalky substance
    • pics taken of pharynx, esophagus, stomach, duodenum.
  13. Prep and Post care for Barium Swallow and Small Bowel series
    • NPO 8-12 hours before
    • Post care....lots of liquids to prevent constipation
  14. Lower GI Series or Barium Enema look at...
    Looks at large intestine
  15. Prep and Post care for Lower GI Series and Barium Enema
    • Pre-Laxatives
    • Post-Laxatives and a ride home
  16. CT scan Prep and Post
    • Pre-drink a litre of water
    • Post-check BUN & Creatinine
  17. Direct visualization diagnostic studies
    • ENDO
    • EGD
    • ERCP
  18. Endoscopy looks for
    Looks for bleeding, inflammation, masses and polyps
  19. Prep and Post for Endo
    • Prep NPO for 8 hrs. before
    • Post NPO till gag reflex returns
  20. EGD looks at
    Looks at the stomach, duodenum and upper GI problems
  21. ERCP looks at...

    Looks at the gallbladder, liver, pancrease, stones in GB

    Uses dyes
  22. Nursing care after endoscopy
    NPO till gag reflex returns
  23. Why do babies have a hard time with bowel elimination?
    lack of development of nervous system so cant control the sphincter
  24. Why do the elderly have problems with bowel movements?
    • Decreased motility so slower peristalsis
    • Dryer feces cuz drink less water
    • More water absorbed cuz of slower peristalsis
    • Decreased abd tone so harder to bear down
    • Decreased anal sphincter tone
    • Medications
  25. What are cultural issues with bowel elimination?
    • Muslims eat with their right hand and wipe with their left
    • African Americans/Asians are lactose intolerant
  26. Constipation is
    infrequent bowel movements that are hard to pass
  27. perceived constipation is
    think constipated cuz have BM's every other day or 3 days.  But it is soft and not hard to pass, so it isnt constipation.
  28. What dont you give a person with any sort of a perforation?
  29. Bulk forming laxative does what....

    • increases absorption of water in to stool
    • Doesnt require RX

    • Examples:  Metamucil, Citrucel
    • Bran and Prunes
  30. Emollient/Fecal Softeners does what....

    Lower surface tension of feces allowing water to be absorbed by fecal mass make a soft stool

    Examples:  Docusate Sodium, Colace
  31. Osmotic Cathartics do what...

    Increase fluid bulk in feces by pulling H2O thru the intestinal wall by osmosis

    Example:  Milk of Magnesia, Miralax, Fleet Enema
  32. Stimulants do what....

    Increase peristalsis by chemical irritation to the bowel nerve endings

    Examples:  Castor oil, Dulcolax, Ex Lax
  33. Complications of altered bowel elimination
    • fecal impaction
    • constipation
    • hemorrhoids
    • anal fissures
    • mega colon
  34. Complications of diarrhea
    • Fluid volume deficit
    • risk for injury
    • impaired skin integrity
  35. What causes diarrhea
    high fiber foods, spicy foods, sugar and sugar substitutes, food poisoning, allergies and antibiotics, and bacteria
  36. What causes constipation
    • eggs
    • lean meat
    • past
    • bananas
    • decrease in fluids
    • sedentary life style
    • opioids
    • narcotics
  37. What is Gastrocolic and Duodenocolic Reflex?
    Bowel evacuation that is stimulated by peristalsis in the colon.  Usually happens after the first meal of the day.
  38. Bruit
    Humming or swishing sound heard with the stethoscope.  Turbulance
Card Set
Altered Bowel Elimination
Altered Bowel...test 3