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88 Cards in this Set

  • Front
  • Back
What is stool or feces?
The excreted waste products.
How long is the colon (large intestine) in the adult?
in the adult, it is generaloly about 50 to 60 inches long. (125-150cm).
What are the seven parts of the colon (large intestine)?
the cecum, ascending, transverse, and descending colons; sigmoid colon; rectum; and anus.
What is haustra?
pouches in the large intestines.
What are the colons main functions?
the absorption of water and nutrients, the mucal protection of the intestine wall, and fecal elimination.
What does the contents in the colon represent?
represents food ingested over the previous 4 days.
When is most of the food excreted through the colon?
most of the waste products are excreted within 48 hours of ingestion.
What is ingestion?
the act of taking in food.
the waste products leaving the stomach through the small intestine and then passing through the ileocecal valve.
How much chyme passes into the large intestine daily?
As much as 1500 ml of chyme pass into the large intestine daily and all but 100 ml is reabsorbed in the proximal half of the colon.The 100 ml of fluid is excreted in the feces.
How does the colon serve as a protection function?
by secreting mucus.
What is the mucus secretion stimulated by?
stimultaed by excitation of the parasympathetic nerves.
How does the mucus protect the colon?
mucus protects the walls of the large intestine from trauma by the acids formed in the feces, and it holds the fecal material together, alos protects the intestinal wall from bacterial activity.
largely air and the by-products of the digestion of carbs.
3 types of movements that occur in the large intestine?
haustral churning, colon peristalis, and mass peristalis.
haustral churning involves what?
movement of the chyme back and forth within the haustra.
wavelike movement produced by the circular and longitudinal muscle fibers of the intestinal walls: it propels the intestinal contents forward. (very sluggish, moves chyme very little along)
mass peristalis
the third type of colonic movement, involves a wave of powerful muscular contraction that moves over large areas of the colon (usually occurs after eating)only a few times a day
How long is the rectum?
4-6 inches.long (10-15 cm)
how long is the anal canal?
1-2 inches (2.5-5cm long.
when the veins become distended with repeated pressure
The internal sphinter muscle is innervated by?
the autonomic nervous system.
external sphincter muscle is innervated by?
the somatic nervous system.
expulsion of feces from the anus and rectum.
What are normal feces m,ade up of?
about 75% water and 25% solid materials.
Normal color of feces is caused by what?
the presence of stercobilin and urobilin.(derived from bilirubun)
How much flatus is usually formed in the large intestine in24 hrs.
7-10 L of flatus.
What is flatus consisted of?
carbon dioxide, methane, hydrogen, oxygen, and nitrogen.
Normal characteristics of feces.
brown in color; infants yellow; formed, soft, semisolid, moist, cylindrical in shape, 100-400 g/day, aromatic, small amounts of roughage, sloughed dead bacteria and epithelial cells, fat, protein, bile
Abnormal characteristics of feces.(color)
clay or white in color(adult) black and tarry (infant) red, pale. may be due to barium-white; red;bleeding-hemorroid; iron diet, malabsorption of fat.
Abnormal characteristics of feces (consistency)
hard, dry, diarrhea; may be due to intestinal infection, dehydration, lack of fiber, lack of exercise, laxative abuse, amotional upset.
Abnormal characteristics of feces (shape)
narrow, pencil shaped, stringlike; causes- obstructive condition of the rectum
Abnormal characteristics of feces (odor)
pungent-b/c of infection or blood
Abnormal characteristics of feces (Constitents)
pus, mucus, parasites, blood, large quantities of fat, foreign objects- due to bacterial infection/inflammatory condition/gastrointestinal bleeding/malabsorption/accidental ingestion
Factors that affect defication
circumstances of diet, fluid intake and output, activity, psychologic factors, lifestyle, meds, and medical procedures, disease.
toddler have some control of defication at what age?
starts at 1 1/2-2 yrs of age.
daytime control for defication is normally attained by?
2 1/2 after a process of toilet training.
t/f some school age children may delay defication b/c of an activity such as play.
What are some reasons for constipation in elders?
reduced activity levels, inadequate amounts of fluid and fiber intake, and muscle weakness.
essential preventive measures for constipation.
roughage in the diet, adequate exercise, and 6-8 glasses of fluid daily
gastrocolic reflex
incresed peristalsis of the colon after food has entered the stomach
T/F A change in the bowel habits over several weeks should be referred to a physician for a complete medical evaluation.
healthy elimination usually requires fluid intake of?
people who are anxious or angry experience-
increased peristaltic activity-subsequent nausea and diarrhea.
depressed peopl experience-
slower intestinal motility, resulting in constipation.
How does medications interfere w/ elimination?
side effects may cause diarrhea, constipation.
meds that stimulate bowel activity and so assist fecal elimination.
meds can also affect the appearance of the feces. for example-
aspirin- look red/black- iron salts lead to black stool b/c of the oxidation of the iron- antibiotic may cause gray-green discoloration-antacids-whitish discoloration or white specks in stool-pepto- cause stools to be black.
general anesthetics cause?
normal movements to slow by blocking parasympathetic stimaulation to the muscles of the colon.
surgery involving the direct handling of the intestines can cause?
temporary cessation of intestinal movement-called ileus lasts 24-48 hrs.
fewer than 3 bowel movements per week.
many causes of constipation
insufficient fiber intake
" fluid intake
" actiivity or immobility
irregular defecation habits
change in daily routine, lack of privacy
chronic use of laxatives or enemas
emotional disturbances such as depression or mental confusion
meds such as apiates or iron salts
Holding the breath increases the ?
intrathoracic and the intracranial pressures
fecal impaction
mass or collection of hardened feces in the folds of the rectum.
fecal impaction can be recognized by what?
the passage of liquid fecal seepage (diarrhea) and no normal stool.
causes of fecal impaction
poor defecation habits and constipation; barium
What is often given for fecal impaction
given an oil retention enema, a cleansing enema 2-4 hrs later, and daily additional cleansing enemas, suppositories, or stool softeners
passage of liquid feces and an increased frequency of defecation.
diarrhea results from?
rapid movement of fecal contents through the large intestine.
what are results from prolonged diarrhea
weakness, fatigue, malaise, and emaciation are the results of prolonged diarrhea.
assessment of the client w/ a bowel elimination need.
assess pattern, any changes in description of feces, problems such as constipation and diarrhea, diet, fluid, stress, meds.
physical assessment data that might indicate that a client may have bowel elimination need.
bowel sounds, abdominal distention, characteristics of stool.
common symptoms of bowel elimination problems
incontinence, constipation, diarrhea, flatus, impaction
fewer than 3 bowel movements per week.
causes and factors that contribute to constipation
insufficent fiber intake, insufficient fluid intake, insufficient activity or immobilty. irregular defecation habits, change in daily routine, lack of privacy
nursing diagnoses for client with a bowel elimination need.
constipation, diarrhea, self care deficit, knowledge deficit, risk for constipation, bowel incontinence, perceived constipation.
goals for client with fecal elimination problems
maintain or restore normal stool consistency, maintain or restore normal bowel elimination pattern, prevent associated risks such as fluid and electrolyte imbalance, skin breakdown, abdominal distention, and pain.
promoting regular defecation (implementing)
provide privacy, encourage to defecate (timing), nutrition and fluids, exercise.
intervention for constipation
increase daily fluid intake, instruct client to drink hot liquids and fruit juices, especially prune juice, include fiber in the diet (raw fruit, bran products, whole grain cereals and bread.
intervention for diarrhea
encourage oral intake of fluids and bland food. eat small amounts b/c it is more easily absorbed. avoid hot and cold fluids, spicy or high fiber foods. may aggravate diarrhea.
intervention for flatulence
limit carbonated beverages, drinking straws, and chewing gum-increase the ingestion of air. also avoid gas forming food, such as cabbage, beans, onions, and cauliflower.
teaching healthy defecation
regular exercise, high fiber foods in diet, fluid intake of 2000-3000, dont ignore the urge, allow enough time, avoid over the counter meds to treat constipation and diarrhea.
types of enemas
cleansing, carminative, retention, and return-flow enemas.
action of a enema
to distend the intestine and sometimes to irritate the intestinal mucosa, thereby increasing peristalsis and the excretion of feces and flatus.
cleansing enemas
intended to remove feces-prevent escape of feces during surgery, prepare intestine for diagnostic tests such as X-ray or colonoscopy, remove feces in instances of constipation or impaction.
retention enema
introduces oil or medication into the rectum, liquid is held for 1-3 hrs, acts as a softener
an opening for the gastrointestinal, urinary, or respiratory tract onto the skin.
an opening through the abdomen wall into the stomach.
opens through the abdominal wall into the jejunum
opens into the ileum (small bowel)
opens into the colon (large bowel)
opening created into the abdomen wall by the ostomy
types of bowel incontinence
partial and major.
partial incontinence
inability to control flatus or to prevent minor soiling.
major incontinence
inability to control feces of normal consisteny
surgical procedures for fecal incontinence
repair of the sphincter and fecal diversion or colostomy.
factors that could be potential problems for bowel elimination in elders
poor fluid intake, low fiber intake, medications, impaired mobility.
single stoma
created when one end of bowel is brought out through an opening onto the anterior abdominal wall.