Altered Bowel Elimination

Front 1

What is the result of unrecognized constipation?

Back 1

Fecal impaction (stool blocks small intestine)

Front 2

effluent

Back 2

the fecal drainage from a stoma

Front 3

How much should the client drink per day, if not contraindicated, to reduce risk of constipation?

Back 3

2000-3000 ml of fluid

Front 4

Name some factors that can lead to constipation:

Back 4

1) dehydration
2) decreased activity
3) postsurgical ileus
4) opioid use
5) inadequate dietary fiber

Front 5

When is fecal impaction utilized?

Back 5

When administration of enemas and suppositories has been unsuccessful.

Front 6

What may happen if the vagus nerve is stimulated while performing digital removal?

Back 6

The heart rate may slow

Front 7

constipation

Back 7

infrequent stools

Front 8

Name two of the three criteria that must be present for at least 3 months for a dx of functional constipation to be made:

Back 8

1) straining c defecation at least 1/4 of the time
2) lumpy or hard stools 1/4 of the time
3) sensation of incomplete evacuation at least 1/4 of the time
4) two or fewer bowel movements/week

Front 9

When might digital fecal removal be contraindicated?

Back 9

If client is on anticoagulant therapy (may cause bleeding of the mucosa)

Front 10

What is needed in order for a digital fecal removal to be performed?

Back 10

A physicians order (d/t possible vagus nerve stimulation)

Front 11

Which position should the client be in when performing DFR?

Back 11

left side-lying w/ knees flexed

Front 12

How should fingers be advanced in the rectum?

Back 12

along rectal wall toward the umbilicus.

Front 13

How are the fingers moved to loosen/fragment fecal mass?

Back 13

Scissor-like movement or hooking movement (if using one finger)

Front 14

What should be assessed periodically while performing DFR?

Back 14

heart rate, sx's of fatigue

Front 15

How long after DFR should the client be monitored for bradycardia?

Back 15

1 hour