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14 Cards in this Set
- Front
- Back
What are factors that affect bowel elimination?
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* Developmental
• Diet ⁃ 25-30g of fiber ⁃ Types of Food ⁃ Food intolerance • Lactose • Glutin • Fluid Intake ⁃ 2500 mL - 3000 mL/day ⁃ – Depends on type |
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What are factors that affect defecation?
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• Activity and Exercise
• Body position • Ignoring the urge to defecate • Lifestyle • Pregnancy • Medications – antacids slow peristalsis, antibiotics decrease normal flora (can cause diarrhea), opoid pain meds & iron cause constipation, laxatives • Surgery/Anesthesia – Paralytic ileus (cessation of bowel peristalsis) • Pathologic conditions – Neurological disorders, food allergies, diverticulosis |
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What are the signs and symptoms and causes of constipation?
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S & S
– Low frequency of stools – Hard, dry – Straining to deficate – Feeling of rectal fullness – Pain, cramps, distension – ↓ Appetitie – headache Causes • Insufficient fluid, fiber, exercise • Poor habits, chg in routine, no privacy |
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What are factors that affect fecal/bowel elimination in an older adult?
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Constipation most common
Reduced activity levels Inadequate fluid & fiber intake Muscle weakness Malignancy Laxative abuse Inhibits natural defecation reflex Thought to cause vs cure prob. Interferes w/ electrolyte and vit absorption |
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What are some of the common fecal elimination problems?
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Fecal Impaction
⁃ Unrelieved constipation, ⁃ Seeping of liquid stool • Diarrhea ⁃ Liquid with ↑ frequency • Fecal Incontinence ⁃ Loss of voluntary ability to control • Flatulence ⁃ Action of bacteria on chime ⁃ Swallowed air ⁃ Diffused air from bloodstream • Distention |
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What information is obtained during the nursing history regarding fecal elimination?
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• Nursing history
⁃ Subjective • Normal Pattern • Risk Identification • Dysfunction Identification Physical assessment • Objective ⁃ Inspection, auscultation, Percussion,Palpation ⁃ Inspecting feces – Abdominal girth , Perirectal |
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What are some common nursing diagnosis statements regarding bowel elimination problems?
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• Diagnostic Statements
– Constipation r/t abdominal muscle weakness, insufficient fiber intake, ignoring urge to defecate • Risk for r/t insufficient fluid intake, opoid use – Perceived constipation r/t cultural or family health beliefs (Uses laxatives to ensure daily BM) – Diarrhea (3 liquid stools/day) – Bowel Incontinence r/t chronic diarrhea, inability to get to bathroom – Others: Risk for FVD, Risk for impaired skin integrity |
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What are goals and outcomes expected regarding bowel elimination?
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• Goal
⁃ Normal bowel elimination ⁃ No complications from altered bowel elimination ⁃ Acceptable pattern of bower elimination Possible outcome criteria ⁃ Soft formed bowel movement in 24 hours ⁃ Consistency changing from liquid to form within 48 hours ⁃ Perianal skin remains intact ⁃ Drinks 2500 mL – 3000 mL /day ⁃ – Correct ostomy bag application with minimal leakage |
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What can be taught to client to alleviate common elimination problems?
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Nutrition and fluids:
Constipation ⁃ Increase fluids esp hot liquids and fruit juices ⁃ Fiber in diet Diarrhea ⁃ Increase fluids intake ⁃ Eat bland foods in small amts ⁃ Avoid excessively hot or cold fluids ⁃ Avoid highly spiced and high fiber foods Flatulence ⁃ Limit carbonated beverages, use of straws and chewing gum ⁃ Avoid gas-forming foods (cabbage, beans, onions) |
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What are some interventions to manage diarrhea?
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⁃ Drink @ least 8 glasses of water a day
⁃ Eat foods w/ sodium & potassium ⁃ Increase foods containing soluble fiber (rice, oatmeal, skinless fruits & potatoes) ⁃ Avoid alcohol and caffeine ⁃ Limit foods w/ insoluble fiber ⁃ Limit fatty foods ⁃ D/C meds that cause diarrhea ⁃ Seek medical treatment if lasts more than 48 hours ⁃ When stopped, reestablish bowel flora by taking fermented dairy products such as yogurt or buttermilk. |
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What habits can promote regular defecation?
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Privacy
⁃ Extremely important for some Timing ⁃ Go when urge is recognized Exercise ⁃ Strengthen abdominal & pelvic muscles Position ⁃ Squatting best (not practical) ⁃ Sitting leaning forward on toilet |
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What is a bowel ostomy and what is it’s purpose?
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To divert and drain fecal material.
Types are: • Colostomy • Ileostomy • Ascending colostomy • Transverse colostomy • Descending colostomy |
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What is the difference between and temporary or permanent colostomy?
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Temporary:
⁃ Traumatic injuries ⁃ Inflammatory condition ⁃ Allow the distal diseased portion of bowel to rest & heal Permanent ⁃ To proved a means of elimination when the rectum or anus is nonfunctional as a result of birth defect or disease. |
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What is a paralytic ileus and who is at risk for this condition?
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Causes S & S of intestinal obstruction, but there is no blockage.
⁃ Crampy, intermittent pain ⁃ N & V, diarrhea ⁃ Inability to have BM or gas ⁃ Abdominal distention ⁃ Abdominal tenderness ⁃ Fever Common causes: abdominal surgery |