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Nursing 135 > Bowel Elimination > Flashcards

Bowel Elimination Flashcards

1
Q

What is an Hypoactive bowel?

A

Less than 5 per minute, must listen for 5 minutes Someone must verify

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2
Q

True or False: Does the stomach secretes HCL, Mucus, pepsin, and intrinsic factor (needed for vitamin B12 absorption)?

A

True

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3
Q

Dilated, engorged veins in the lining of the rectum?

A

Hemorrhoids

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4
Q

What is the action, advantage, caution of diphenoxylate and atropine?

A

● ACTION: Slows motility through local effect on GI wall. ● ADVANTAGES: Effective. ● CAUTIONS: Chemically related to morphin. Atropine added to prevent addiction but high in doses can be addictive. May cause dorwsiness.

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5
Q

What is the process for Stool Collection test?

A

● medical aseptic technique is imperative. ● hand hygiene, before and after glove use is essential. ● wear disposable gloves. ● do not contaminate outside of container with stool. ● obtain stool and package, label, and transport according to agency policy.

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6
Q

Which Peristalsis occurs every 3-12 minutes

A

Segmentation

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7
Q

Inability to control passage of feces and gas from anus.

A

fecal incontinence?

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8
Q

Breaks down fatty acid, glycerol, and alcohol

A

Lipase

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9
Q

What is Bowel incontinence?

A

State in which a person experiences a change in normal bowel habits characterized by INVOLUNTARY PASSAGE OF STOOL.

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10
Q

What is considered to be normal bowel pattern?

A

● individualized 1/day to 2-3 day. ● influenced by what’s eaten. High cellulose (fiber) more stool produced. ● many individuals defecate after breakfast due to mass peristalsis.

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11
Q

What is a hypertonic enema?

A

Draws fluid from colon mucosa. Increases peristalsis. Stimulates defecation reflex.

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12
Q

Surgical removal or resection of the large intestine?

A

Colostomy

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13
Q

State in which a person experiences a change in normal bowel habits characterized by INVOLUNTARY PASSAGE OF STOOL.

A

Bowel incontinence

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14
Q

What does the Pyloric Sphincter control?

A

The release of chyme from stomach to small intestine via peristalsis

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15
Q

What are the 2 sphincters in the anus

A

Internal = involuntary External = voluntary

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16
Q

What are the benefits oral laxatives?

A

● easy to administer, gradual effect, less side effects.

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17
Q

Normal fecal matter consist of what characteristics?

A

● water 75%, solids 25%. ● color. ● soft: formed consistency. ● cylindrical: 1inch and 100-300g/day. ● odor. ● Consistency

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18
Q

What is the action, advantage, caution of imodium?

A

● ACTION: Inhibits peristalsis via direct effect on GI wall muscles. ● ADVANTAGES: Not addictive, longer duration than lomotil. ● CAUTION: Must be discharged if not effective in 48 hours with acute cases.

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19
Q

What is the primary where bowel elimination takes place?

A

Large instestine

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20
Q

Bile does what?

A

a bitter greenish-brown alkaline fluid that aids digestion and is secreted by the liver and stored in the gallbladder.

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21
Q

How can you collect pinworms?

A

● collect first thing in the morning. No stool or urine. ● primary symptom: perianal itching. ● needs to be completed on consecutive days.

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22
Q

Rectum and sigmoid colon. patient may receive conscious sedation. outpatient procedure.

A

Sigmoidoscopy

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23
Q

Who age group of people typically abuse laxatives?

A

Elderly

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24
Q

Having a pink to red to black stool is associated with what?

A

Aspirin, anticoagulants

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25
Q

What is the cause of odor from stool?

A

bacteria decomposition of protein= pungent, influenced by food eaten.

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26
Q

glycerin base, melt and absorbed into system. patient may administer by self.

A

Suppositories

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27
Q

Miralax is bulk forming, osmotic, lubricant, oil, osmotic?

A

Osmotic

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28
Q

What is the primary purpose of the large intestine?

A

Absorption of water, protection, secretion and elimination of stool

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29
Q

What preparation is needed to perform a Barium enema the day before?

A

Usually. ● clear liquid diet diet day before. ● 2pm bottle of magnesium citrate or x-prep golytly. Over 4 hours. ● 7pm dulcolax tablets. ● NPO after midnight.

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30
Q

A hollow muscular tube where food pass to the stomach?

A

Esophagus

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31
Q

When should an toddler be able to voluntarily control defection?

A

30 months

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32
Q

Protease

A

an enzyme that breaks down proteins and peptides.

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33
Q

an enzyme that breaks down proteins and peptides.

A

Protease

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34
Q

What is the action, advantage, caution of miralax?

A

● ACTION: draws water into the intestine, resulting in a softer stool and more frequent bowel movements. ● ADVANTAGES: is used when rapid cleansing is desired. ● CAUTION: May cause floating and or diarrhea. Can produce dehydration. Not recommended for patients with kidney problems.

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35
Q

True or False: Stool sampling for testing can be sent to lab 24 hours after defecation?

A

False. Needs to be sent immediately for testing. must be warm.

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36
Q

A nurse is performing colostomy care. What does colostomy care consist of?

A

patient as free of odors as possible. Empty the appliance frequently. ● inspect the patients stoma regularly. ● note the size, which should stabilize within 6 to 8 weeks. ● keep the skin around the stoma site clean and dry. ● measure the patients fluid intake and output. ● explain each aspect of care to the patient and self care role. ● encourage patient to care for and look at ostomy.

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37
Q

What process involves involuntary and voluntary control?

A

Rectum-Anus

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38
Q

Mastication is the process of what?

A

Chewing, is the process by which food is crushed and ground by teeth

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39
Q

What foods are associated with specific effects on bowel elimination?

A

● constipating foods: chees, lean meat, eggs, pasta. ● laxative effect: certain fruits and vegs: prunes, bran, chocolate, spicy foods, alcohol and coffee. ● gas producing foods: onions, cabbage, beans, cauliflower, turkey

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40
Q

When should you palpate the painful area?

A

Palpate at end of assessment

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41
Q

Nutrients such as electrolytes are absorbed where?

A

Duodenum and Jejunum

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42
Q

Esophagus

A

A hollow muscular tube where food pass to the stomach

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43
Q

What are the patient guidelines for stool collection?

A

● void first so that urine is not in stool sample. ● defecate into the container rather than toilet bowl. ● do not place toilet tissue in the bed pan or specimen container. ● notify nurse when specimen is available.

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44
Q

Where does the absorption of water occur?

A

Large intestine

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45
Q

What is needed for a toddler to be able to voluntarily be able to control defecation?

A

myelinozation of sacral spinal core 18-24 monts, needed for control. cue=walking.

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46
Q

Hyper active bowel is what?

A

Continous or 5 secs or less or 35 sounds per minute

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47
Q

Accumulation of gas in the intestinal tract

A

flatulence?

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48
Q

What is the action, advantage, caution of mineral oil?

A

● ACTION: lubricates intestinal tract, and retards colonic absorption of water, softening the stool making it easier to pass. ● ADVANTAGES: Usually effective within 8 hours. ● CAUTION: May interfere with fat soluble vitamin absorption. Can be aspirated, possibly resulting in a lipid pneumonia.

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49
Q

During fecal diversion consistency of stool is different for each section. What is the difference in stool and location?

A

● ascending colon= liquid loss of electrolytes. ● transverse colon= mushy; semi solid. ● descending colon (becomes storage)= more water removed: solid. ● illeocecal valve= liquid diarrhea.

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50
Q

What is the next process of transferring chyme from the stomach to where?

A

Small intestine

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51
Q

What factors affect bowel elimination?

A

● normal bowel pattern. ● food and fluid. ● foods associated with specific effects on bowel elimination. ● food and fluid intake. ● activity and exercise. ● body position. ● ignoring urge to defecate. ● lifestyle.

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52
Q

Is Metamucil bulk forming, lubricant, stool softener?

A

Bulk forming

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53
Q

Normal route altered. Manipulate the bowel. temporary or permanent colostomy. no need for all or part of the bowel. proximal segment to the removed area forms the stoma.

A

Fecal diversion?

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54
Q

Chemical substances that act to facilitate passage of bowel contents.

A

Laxatives

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55
Q

Lipase is what?

A

Breaks down fatty acid, glycerol, and alcohol

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56
Q

Having a brown stool is influenced by what?

A

● Bilirubin to stercobilin by intestinal bacteria. ● food: dairy = light brown. ● green leafy vegetables; spinach= almost black.

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57
Q

True or False: Colon secretion consist of acidic mucus solution.

A

False: The colon secretion of mucous is alkaline.

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58
Q

Vitamins, iron, fluid and bile salts are nutrients mainly absorbed where?

A

ileum

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59
Q

What does a Barium enema do?

A

Fill cavity to see structure. ● visualizes the colon, distal small bowel and appendix. ● series of x-ray films taken after barium is instilled into the colon via an enema. ● may use gastrografin if possibility of perforation. ● bowel prep, must be free of stool.

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60
Q

What are the 3 sections of the small intestine?

A

Duodenum Jejunum ileum

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61
Q

Suppositories

A

● glycerin base, melt and absorbed into system. ● patient may administer by self.

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62
Q

What part of the large intestine has 2 sphincters?

A

Anus

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63
Q

Having a sedentary life does what for your bowel movement?

A

Constipation

64
Q

Hemorrhoids are located where?

A

External (clearly visible) or internal

65
Q

What is sigmoidoscopy?

A

Rectum and sigmoid colon. ● patient may receive conscious sedation. ● outpatient procedure.

66
Q

When physically assessing the patient abdomen what would you be looking for?

A

● four abdominal quadrants (umbilicus midline). ● contour, shape, symmetry, skin, color, scars, any masses. ● distention: drum, taut skin. (Should be soft; excess fluid or flatus) ● abdominal circumference (mark it). ● localize pain. ● pannus.

67
Q

Colonoscopy examination?

A

Colon up to the ileal cecal. ● patient may revive sedation. ● outpatient procedure.

68
Q

What is Bowel Retraining?

A

● long term approach to control bowel elimination. ● used for chronic constipation, incontinence, or impaction. ● neuro genie bowel. Paralysis, stroke. ● GOAL: soft consistency stool and develop stool evacuation routine.

69
Q

There are 2 types of motility which takes place in the intestine. What are they?

A

Segmentation (Colon peristalsis) Mass peristalsis

70
Q

What are 3 types of laxatives used for constipation?

A

Oral Suppositories enema

71
Q

What are the different consistencies of stool and where can they be located at?

A

● ascending colon= liquid. ● transverse colon= mushy; semi-solid now. ● descending colon= more water removed: solid.

72
Q

What is bearing down?

A

Valsalva Maneuver

73
Q

Ascending colon receives approximately _______ of chime and ____________ of liquid.

A

● 1500ml ● 1000-8000ml

74
Q

The external sphincter remains contracted until decision to defecate is made. This urge to defecate will subside and return hours later? What is this?

A

Voluntary control

75
Q

The large intestine is broken into 3 sections what are they?

A

Cecum Colon Rectum

76
Q

Cathartics is defined as what?

A

A purgative action of the bowels, action is stronger and generally produces elimination of liquid stools

77
Q

True or False: A toddler can control their urine before bowel movement?

A

False. Toddler will have better control over bowel defecation before urination

78
Q

What is fecal Impaction?

A

● collection of hardened feces in rectum. ● results from unresolved constipation.

79
Q

what is P.O.O.P.E.R S.C.O.OP ?

A

P= position (sitting, upright). O= output (adequate hydration). O= offer fluids. P= privacy. E= execise. R= report results. S= size (amount). C= consistency. O= occult blood. O= odor. P= peristalsis.

80
Q

How does a persons lifestyle affect bowel elimination?

A

● habits: interruption may lead to decreased defecation. ● stress= increase in mucus production and motility. ● Chronic stress: decrease motility. ● vacation privacy.

81
Q

During infancy what color should the first stool be, and what is it often referred too?

A

Meconium, black stool, occurs with 28 hours

82
Q

Where does digestion begin?

A

Mouth

83
Q

What is amylase?

A

an enzyme, found chiefly in saliva and pancreatic fluid, that converts starch and glycogen into simple sugars.

84
Q

Ignoring the urge to defecate does what to our body?

A

● voluntary control may suppress defecation reflex. ● stool remains in rectum, water reabsorbed =hard pebble stool. ● if frequent, urge to defecate weakens= stimulants to defecate. ● pain: hemorrhoids. ● analysis fissure.

85
Q

What is fecal incontinence?

A

Inability to control passage of feces and gas from anus.

86
Q

Do you need an Order for Removal of Fecal Impaction?

A

Yes order is required from MD?

87
Q

What organ is located in the upper right quadrant of the abdomen?

A

Stomach

88
Q

Chyme enters the illeocecal valve to what part of the large intestine?

A

Cecum ( Ascending colon)

89
Q

Breakdown of nutrients via mechanical take place where

A

Mouth

90
Q

Storage of Feces?

A

Rectum

91
Q

Where is food temporarily stored and broken down?

A

Stomach

92
Q

What is the action, advantage, caution of colace?

A

● ACTION: Agents with detergent activity that allows water to penetrated and lubricate the stool. ● ADVANTAGES: recommended for those who must avoid straining. Patients on bedrest/immobile. ● CAUTION: Has lubricant component of drug that may interfere with absorption of certain vitamins.

93
Q

What are 3 types of endoscopic examination

A

● sigmoidoscopy. ● colonoscopy. ● ephagogastroduodenoscopy

94
Q

Being constipated and producing black stool is associated with what?

A

Iron Salts

95
Q

This valve prevents digested food from entering the small intestine but allow food to enter the large intestine?

A

Ileocecal valve

96
Q

The rectum is connected to what?

A

Sigmoid colon

97
Q

What consist of indigestible food and provides bulk?

A

Ascending colon

98
Q

How long should you listen to bowel movement sounds?

A

5 mins

99
Q

What is the action, advantage, caution of Duculax?

A

● ACTION: Drug promotes peristaltic by irritating the intestinal mucosa or stimulating nerve endings in intestinal wall. ● ADVANTAGES: Works more quickly than bulking agents. ● CAUTION: Are the most abused laxatives on the market. Causes lazy bowel syndrome, may affect absorption of vitamin D and calcium

100
Q

What are the different physical characteristics of the abdomen?

A

● Normal: Convex or flat, symmetric. ● Abnormal: Hollow or scaphoids: distended, asymetric.

101
Q

sitting during defection increases pressure?

A

Downward rectal pressure

102
Q

Breast fed infant would have what color stool?

A

Yellow-golden and loose stool, more frequently

103
Q

What extends from the ileocecal valve to the anus?

A

Large intestine

104
Q

Distension is defined as?

A

● accumulation of excessive amounts of flats or liquid or solid intestinal contents. ● abdominal fullness, discomfort, inability to pass flatus. ● abdomen may be slightly distended to rigid.

105
Q

What provides lubrication for food to flow through the small and large intestine?

A

Secretion of alkaline mucus

106
Q

What are the 5 structures of the large intestine?

A

Ascending colon Transverse colon descending colon sigmoid colon rectum Anus

107
Q

layer of fat covered by skin on the anterior abdominal wall of obese or formerly obese patients.

A

Pannus?

108
Q

Pregnancy affects bowel elimination how?

A

● hormone changes= decrease muscle tone= constipation. ● infant position. ● iron supplements.

109
Q

What are the measurements of the small intestine?

A

1in in diameter and 20 feet long

110
Q

Majority of absorption of nutrients occur where?

A

Small intestine

111
Q

Having a green-grayish tinge in stool along with C.Diff and diarrhea is in relation to what?

A

Antibiotics

112
Q

What are the uses for Laxatives and cathartics?

A

● reduce cholesterol. ● obtain stool sample. ● accelerate excretion of parasites after anthelminthics (antiparasitic drug) started. ● accelerate elimination of potentially toxic substances (kayexalate). ● pre op or pre procedure. ● prevent straining at stool w/ CAD, hemorrhoids. ● relieve constipation in pregnancy, in the elderly. In children with megacolon, and in those with decreased motility.

113
Q

What is fecal diversion?

A

● Normal route altered. Manipulate the bowel. ● temporary or permanent colostomy. ● no need for all or part of the bowel. ● proximal segment to the removed area forms the stoma.

114
Q

What part of the large intestine allows for defecation of bowel?

A

Anus

115
Q

Where does the salivary secretion of enzymes take place?

A

Mouth

116
Q

Thigh Flexion does what during defection

A

Increases abdominal pressure

117
Q

Where is Chyme located at?

A

Stomach

118
Q

How does the autonomic NS affect the rate of peristalsis?●

A

● sympathetic slows peristalsis. ● parasympathetic increases peristalsis and emptying.

119
Q

Contraction and relaxation of smooth muscles via esophagus and intestine is referred to as?

A

Peristalsis

120
Q

While auscultating a patient what would you note in your finding?

A

Listen for bowel sounds in all quadrants. ● note frequency and character, audible clicks, and flatus. ● describe bowel sounds as hypoactive, hyperactive, absent or infrequent.

121
Q

How will antacids affect stool color and consistency?

A

White or speckling in stool Constipation or diarrhea

122
Q

What is constipation?

A

● infrequent sometimes painful passage of hard, dry stool. ● stool moves slowly through the large intestine. ● or remains in large intestine too long. ● defined in relation to persons normal defecation pattern. ● more of a symptom than a disorder.

123
Q

When 1500ml of chime and 1000-8000ml of liquid is absorbed it turns into

A

Stool

124
Q

What is a endoscopic examination?

A

● Visualization or the internal structures of the GI tract via a fiber optic scope. ● used for visualization, biopsy, polyp removal, cauterize, bleeding vessels.

125
Q

What is flatulence?

A

Accumulation of gas in the intestinal tract

126
Q

What is the action, advantage, caution of Bismuth subsalicylate (pep-bismal)?

A

● ACTION: Absorbs and soothes. ● ADVANTAGES: No drowsiness. ● CAUTION: May interfere with absorption of other medications and nutrients.

127
Q

What is a hem occult test, and where should it be performed?

A

may be done on unit instruct client to refrain (1-3 days) from 2 different parts of stool

128
Q

What is the action, advantage, caution of paregoric?

A

● CATEGORY: Acts on GI smooth muscle. ● ACTION: Increase smooth muscle tone. Decrease GI motility. Diminishes GI secretion. ● ADVANTAGES: Effective. ● CAUTIONS: May be addictive, morphine component. May cause light headedness and drowsiness. Discontinue as soon as possible.

129
Q

Powerful muscle contractions, move over large area, propel food through the small and large intestines especially after eating.

A

Mass peristalsis

130
Q

How long is the rectum?

A

Varies based on age

131
Q

How often should a infant defecate?

A

After every meal

132
Q

What are some type of therapeutics for better bowel elimination?

A

Laxatives, stool softeners, enemas

133
Q

This occurs 1-4 times a day, and only 1/3-1/2 of indigested food is excreted in 24 hours, and the rest 28-72 hours?

A

Mass peristalsis

134
Q

What does antidiarrheal agents do?

A

● act to slow motility or absorb excess fluid into the bowel. ● absorbants and bulk forming agents change the consistency of the stool. ● cure the underlying cause- antibiotics.

135
Q

Absent bowel sounds beyond 72 hours post op

A

Paralytic ileus

136
Q

Laxatives is what?

A

Chemical substances that act to facilitate passage of bowel contents.

137
Q

When physically assess anus and rectum of patient. What would you be checking for?

A

● lesions, ulcers, fissures inflammation, and external hemorrhoids. ● ask the patient to bear down as though having a bowel movement. ●appearance of internal hemorrhoids or fissures and fecal masses. ● inspect perineal area for skin irritation secondary to diarrhea or fecal incontinence.

138
Q

What is the process of performing the Valsalva Maneuver (Bearing Down)?

A

Deep Breathing Closed Glottis Moving diaphragm toward Contract abdominal Muscles contract pelvic floor muscles

139
Q

Less than 5 per minute, must listen for 5 minutes Someone must verify

A

Hypoactive bowel

140
Q

What is Diarrhea

A

State in which a person experiences a passage of loose unformed stools at least 3 LOOSE LIQUID STOOLS PER DAY; abdominal pain, cramping, hyperactive, bowel sounds; urgency.

141
Q

What is one of problems that plague school-aged children for defecation?

A

Constipation

142
Q

What is Pannus?

A

● layer of fat covered by skin on the anterior abdominal wall of obese or formerly obese patients.

143
Q

What should a person consume daily for fluid intake?

A

2000-3000ml

144
Q

What are some examples of Implementation?

A

Health promotion: ● diet. ● fluids. ● activity and exercise. ● bowel habits. ● colorectal screening.

145
Q

State in which a person experiences a passage of loose unformed stools at least 3 LOOSE LIQUID STOOLS PER DAY; abdominal pain, cramping, hyperactive, bowel sounds; urgency.

A

Diarrhea

146
Q

Surgical openings are most commonly formed in the ileum (ileostomy) or the colon (colostomy).

A

Osotomy

147
Q

Neutralizes irritating acids from local bacteria fermentation.

A

Alkaline mucus

148
Q

What are the measurements of the large intestine?

A

5-6 feet in length, 1-3in in diameter, decreases in size from cecum to anus

149
Q

Continous or 5 secs or less or 35 sounds per minute

A

Hyper active

150
Q

What vitamin is produced in the small intestine?

A

Vitamin K

151
Q

What is an EGD (Esophagogastroduodenoscopy)?

A

Esophagus, stomach, duodenum. ● patient may receive conscious sedation. ● outpatient procedure.

152
Q

What is the action, advantage, caution of metamucil?

A

● ACTION: psyllium grain or synthetic product that causes stool to absorb water and swell stimulating peristalsis. ● ADVANTAGES: usually acts withing 24 hours. ● CAUTION: may interfere with absorption of calcium and iron and certain drugs. Should not be given to bedridden patients or those with intestinal stricture.

153
Q

Having an active lifestyle with daily exercising does what for the small and large intestine?

A

Increase peristaltic through improved muscle tone especially abdominal, diaphragm and perineum muscles.

154
Q

What enzymes breaks down fats, proteins, and carbs into basic elements?

A

Amylase, lipase, bile, protease

155
Q

Formula fed Infant stool would consist of what color?

A

Yellow to brown pasty stool, stronger odor than breast fed

156
Q

What is an ostomy?

A

Surgical openings are most commonly formed in the ileum (ileostomy) or the colon (colostomy).

Nursing 135 (8 decks)

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