Term
Bowel Elimination Factors
AGE |
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Definition
| As age increases the ability to chew decreases, digestion decreases, peristalsis decreases, esophageal emptying decreases and muscle tone in the perineal floor and anal sphincter decrease which impairs the absorption of intestinal mucosa. |
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Term
Bowel Elimination Factors
DIET |
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Definition
| Maintaining a regular eating schedule helps promote normal peristalsis. High fiber, whole grains, fresh fruits and vegetables promote normal elimination. Foods and veggies that promote gas, distend the intestinal wall and increase colonic motility. |
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Term
Bowel Elimination Factor
FLUID INTAKE |
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Definition
| Required fluid intake for males is 3L/day and for females is 2.2L/day. Increase in fluid intake helps the body to absorb fiber and increase stool size, softens the stool and increases peristalsis. Decreased fluid intake cause the stool to harden. |
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Term
Bowel Elimination Factor
PHYSICAL ACTIVITY |
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Definition
| Physical activity promotes peristalsis and normal elimination. P.A. helps maintain good muscle tone which helps deification. Decreased muscle tone can be due to long term illness, spinal cord injury or neurological disease that causes nerve transmission damage and impairs the abdominal and pelvic floor muscles which affects the intraabdominal pressure and sphincter control. These issues can all lead to increased constipation. |
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Term
Bowel Elimination Factors
PSYCHOLOGICAL |
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Definition
| Emotional stress can increase digestion, increase peristalsis and can cause diseases of the GI tract such as; ulcerative colitis, IBS, gastric/duodenal ulcers or Crohn's. Depression can trigger the autonomic nervous system and slow peristalsis and cause constipation. |
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Term
Bowel Elimination Factors
PERSONAL HABITS |
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Definition
| Work schedule can effect one's elimination schedule. Having a busy job can interrupt or distract someone from going to the bathroom when they need to. |
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Term
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Definition
| Squatting is the best position for elimination. Laying down or supine causes impaired elimination. Nurses should elevate the head of the patient's bed to at least a 45 degree position. |
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Term
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Definition
| Normal elimination is not painful but impaired bowel elimination can cause hemorrhoids, cause rectal surgery or anal fissures. These can all lead to constipation. |
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Term
Bowel Elimination Factor
PREGNANCY |
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Definition
| The larger the fetus the more pressure is on the rectum. The fetus can cause obstruction which impairs passage of the feces. |
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Term
Bowel Elimination Factor
SURGERY/ANESTHESIA |
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Definition
| Gen. anesthesia can cause temporary cessation of peristalsis. Local or regional is better because it has lower risk for elimination altercations. Temporary stopping of peristalsis for 24-48 hours is called ileus. |
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Term
Bowel Elimination Factor
MEDS |
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Definition
| Meds cause secondary effects like decrease peristalsis and contractions, which lead to constipation. Opioids cause constipation. Antibiotics decrease intestinal flora and cause diarrhea. Laxatives and cathartics control diarrhea. Fiber and osmotic laxatives are better to use then stimulant laxatives because of risk for dependence. |
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Term
Bowel Elimination Factor
DIAGNOSTIC TESTS |
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Definition
| Testing often requires an enema for preparation and elmination of stool. Many require restricted food and liquid intake prior to test. |
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Term
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Definition
| when a patient has unrelieved constipation and is unable to expel the hardened feces retained in the rectum |
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Term
FECAL IMPACTION:
DEF and RISKS |
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Definition
| Inability to pass stool for several days, despite urge to go. If not resolved it will cause intestinal obstruction. People who are debilitated, confused or unconscious are more at risk for impaction due to dehydration, being too weak or unaware. |
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Term
| Fecal Impaction: Symptoms ; Treatment |
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Definition
Decrease appetite, nausea, vomiting, abdominal distention, cramping and rectal pain.
Digit exam, palpate |
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Term
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Definition
| infrequent bowel movement. Hard, dry stools leads to difficulty to pass. |
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Term
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Definition
Improper diet, decreased fluid intake, decreased exercise or medications
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Term
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Definition
Increase number of stool, liquid or unformed feces
Associated with digestive, absorption and secretion disorders of GI. Irritation within colon increases mucous secretion and makes feces watery, which makes it difficult for the patient to control the urge to go. Increase the loss of colonic fluid. Often cause meticulous skin care so containment is needed to prevent skin breakdown. |
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Term
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Definition
| Inability to control/ pass feces or gas from anus |
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Term
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Definition
| Leads to body images and social isolation. Impaired sphincter function or large volume liquid stool. Impaired cognitive impairment. Clostridium difficile, which is caused by antibiotic therapy or direct contact. Communicable food borne pathogens. Surgery or diagnostic test of lower GI. Enteral nutrition and food intolerances. |
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Term
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Definition
| gas accumulates in lumen of intestines stretches and distends wall. Cause abdominal fullness, pain and cramping. Abdominal distention and severe, sharp pain. |
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Term
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Definition
| Dilated, engorged veins in lining of rectum. Can be both external and internal. Thrombosis is external and cause pain and require exertion. Internal occur in the anal canal. |
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Term
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Definition
| Increase venous pressure from straining, pregnancy, heart failure and chronic liver disease. |
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Term
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Definition
Teeth, tongue, gums
Poor dentition and poor denture fitting influence the ability to chew |
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Term
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Definition
Four Quadrants
Contour, shape, symmetry and skin color
Note masses, peristalsis waves, scars, venous patterns, stoma and lesions
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Term
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Definition
escalate abdomen with a stethoscope for bowel sounds in each quadrant.
Normal sounds every 5 to 15 seconds/ sec to several secs
Hypoactive- absent with ileus or maybe did not capture bowel sounds
hyperactive-small intestine obstruction and inflammatory disorders |
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Term
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Definition
identifying underlying abdominal structures
detects lesions, fluid and gas in abdomen |
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Term
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Definition
| palpate for masses and tenderness |
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Term
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Definition
| Inspect around anus for lesions, discolonization, inflammation and hemorrhoids |
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Term
Bowel:
Lab Tests
Fecal Specimens |
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Definition
When collecting specimens make sure to properly label specimens, aim for specimen accurately and specimen transport
Use of chemical preservatives, refrigeration and putting on ice
Medical aseptic technique and use of proper hand hygene
Teach patient to avoid mixing feces with water and urine
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Term
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Definition
measure microscopic blood in feces
scan for colon cancer ( American Cancer Society)
2 Types
Guaic (gFOBT); avoid red meat for 3 days, avoid aspirin, ibuprofen and NSAIDS
Fecal immunochemical (FIT); 3x, from 3 separate bowel movements
Follow up with colonoscopy |
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Term
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Definition
| temporary or permanent opening created surgically by brining part of intestine through abdominal wall |
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Term
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Definition
| surgical techniques allow more patients to have part of small or large intestine removed and remaining part reconnected |
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Term
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Definition
| Location determines on stool inconsistency, surgically performed as a temporary means to divert stool from area of trauma or perineal wounds |
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Term
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Definition
Illeoanal Pouch Anastomosis
surgical procedure for patients that need to have a colectomy for treatment of ulcerative colitis or familial adenopolyposis
Collection of fecal material stimulates the rectum |
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