Term
| Clients should be taught that repeatedly ignoring the sensation of needing to defecate could result in which of the following? |
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Definition
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Term
| Which statement provides evidence that an older adult who is prone to constipation is in need of further teaching? |
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Definition
“I need to take a laxative such as Milk of Magnesia if I don’t have a BM every day.”
The standard of practice in assisting older adults to maintain normal function of the gastrointestinal tract is regular ingestion of a well-balanced diet, adequate fluid intake, and regular exercise. If the bowel pattern is not regular with these activities, this abnormality should be reported. Stimulant laxatives can be very irritating and are not the preferred treatment for occasional constipation in older adults (option 2). In addition, a normal stool pattern for an older adult may not be daily elimination. |
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Term
| A client is scheduled for a colonoscopy. The nurse will provide information to the client about which type of enema? |
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Definition
Low, small volume
Small-volume enemas along with other preparations are used to prepare the client for this procedure. An oil retention enema is used to soften hard stool. Return flow enemas help expel flatus. Because of the risk of loss of fluid and electrolytes, high, large-volume enemas are seldom used . |
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Term
| The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy? |
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Definition
The stoma color is a deep red-purple.
An established stoma should be dark pink like the color of the buccal mucosa and is slightly raised above the abdomen. The skin under the appliance may remain pink/red for a while after the adhesive is pulled off. Feces from an ascending ostomy are very liquid, less so from a transverse ostomy, and more solid from a descending or sigmoid stoma. |
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Term
| Which goal is the most appropriate for clients with diarrhea related to ingestion of an antibiotic for an upper respiratory infection? |
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Definition
| The client will return to his or her previous fecal elimination pattern. |
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Term
| A client with a new stoma who has not had a bowel movement since surgery last week reports feeling nauseous. What is the appropriate nursing action? |
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Definition
| After assessing the stoma and surrounding skin, notify the surgeon. |
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Term
| The nurse assesses a client’s abdomen several days after abdominal surgery. It is firm, distended, and painful to palpate. The client reports feeling “bloated.” The nurse consults with the surgeon, who orders an enema. The nurse prepares to give what kind of enema? |
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Definition
Return flow
This provides relief of postoperative flatus, stimulating bowel motility. |
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Term
| Which of the following is most likely to validate that a client is experiencing intestinal bleeding? |
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Definition
| Semisoft tar-colored stools |
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Term
| Which nursing diagnoses is/are most applicable to a client with fecal incontinence? Select all that apply. |
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Definition
-Bowel Incontinence
-Disturbed Body Image
-Social Isolation
-Risk for Impaired Skin Integrity |
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Term
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Definition
| a receptacle for urine and feces |
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Term
| Bowel (fecal) incontinence |
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Definition
| loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter |
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Term
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Definition
| an agent that promotes the passage of flatus from the colon |
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Term
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Definition
| drugs that induce defecation |
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Term
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Definition
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Term
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Definition
| a temporary or permanent opening into the colon (large bowel) to divert and drain fecal material |
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Term
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Definition
| a portable chair with a toilet seat and a receptacle underneath that can be emptied; often used for the adult client who is able to get out of bed but is unable to walk to the bathroom |
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Term
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Definition
| passage of small, dry, hard stool or passage of no stool for a period of time |
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Term
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Definition
| expulsion of feces from the anus and rectum |
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Term
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Definition
| defecation of liquid feces and increased frequency of defecation |
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Term
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Definition
| used most often as a treatment for constipation, it distends the intestine and sometimes irritates the intestinal mucosa, thereby increasing peristalsis and the excretion of feces and flatus |
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Term
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Definition
| a mass or collection of hardened, putty-like feces in the folds of the rectum |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| the presence of excessive amounts of gas in the stomach or intestines |
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Term
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Definition
| gas or air normally present in the stomach or intestines |
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Term
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Definition
| increased peristalsis of the colon after food has entered the stomach |
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Term
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Definition
| an opening through the abdominal wall into the stomach |
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Term
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Definition
| pouches that form in the large intestine when the longitudinal muscles are shorter than the colon |
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Term
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Definition
| (shuffling) movement of the chyme back and forth within the haustra in the large intestine |
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Term
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Definition
| distended veins in the rectum |
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Term
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Definition
| a colostomy that generally empties from the distal end of the small intestine |
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Term
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Definition
| the act of taking in food or medication |
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Term
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Definition
| a tube that is placed surgically or by laparoscopy through the abdominal wall into the jejunum for long-term nutritional support |
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Term
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Definition
| medications that stimulate bowel activity and assist fecal elimination |
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Term
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Definition
| involves a wave of powerful muscular contraction that moves over large areas of the colon; usually occurs after eating |
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Term
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Definition
| the first fecal material passed by the newborn, normally up to 24 hours after birth |
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Term
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Definition
| an opening on the abdominal wall for the elimination of feces or urine |
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Term
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Definition
| wavelike movements produced by circular and longitudinal muscle fibers of the intestinal walls; the movement propels the intestinal contents onward |
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Term
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Definition
| an opening created in the abdominal wall by an ostomy |
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Term
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Definition
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Term
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Definition
| solid, cone-shaped, medicated substances inserted into the rectum, vagina, or urethra |
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Term
| A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following should the nurse include when explaining the procedure to the client? |
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Definition
-The specimen cannot be contaminated with urine.
-Three Specimens from three different bowel movements are required
- some proteins such as red meat, fish, & poultry can alter the test results
- a blue color indicates blood in the stool |
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Term
| A nurse is caring for a client for whom a tap water enema is prescribed, to be repeated until the return is clear. Which of the following actions should the nurse take? |
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Definition
Clarify the order with the provider.
Tap water is a hypotonic solution that can cause water toxicity. It should never be repeated. No other actions matter if the prescription is wrong. |
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Term
| Which of the following foods should a nurse encourage for a client who is experiencing constipation? |
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Definition
| fresh fruit and whole wheat toast |
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Term
| A nurse is caring for a client who has had diarrhea for the past 4 days, when assessing the client, the nurse should expect which of the following findings? Select all that apply |
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Definition
-hypotension
-fever
-poor skin turgor
-abdominal cramping |
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Term
| True or false: Normal feces are about 25% water and 75% solid materials |
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Definition
| false: The reverse is true. Normal feces are 75% water and 25% solid material. |
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Term
| What is the significance of stool that is clay or white in color? |
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Definition
| absence of bile pigment, bile obstruction likely. |
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Term
| What is the significance of stool that is black or tarry in color? |
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Definition
| drugs, bleeding from upper G.I. tract, diet high in red meat and dark green vegetables |
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Term
| What is the significance of stool that is red in color? |
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Definition
| bleeding from lower G.I. tract, some foods (i.e. beets) |
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Term
| What is the significance of stool that is pale in color? |
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Definition
| malabsorption of fats, diet high in milk/ milk products and low in meat |
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Term
| What is the significance of stool that is orange or green in color? |
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Definition
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Term
| What is the significance of stool that is hard or dry in formation? |
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Definition
| dehydration, decreased intestional motility resulting from lack of fiber, lack of exercise, emotional upset, laxative abuse |
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Term
| What is the significance of diarrhea? |
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Definition
| increased intestinal motility (due to irritation of colon by bacteria) |
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Term
| What is the significance of stool that is narrow, pencil shaped, or string-like? |
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Definition
| obstructive condition of the rectum |
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Term
| What is the significance of stool that is pungent in odor? |
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Definition
| infection, presence of blood |
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Term
| What is the significance of stool that contains pus? |
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Definition
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Term
| What is the significance of stool that contains mucus? |
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Definition
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Term
| What is the significance of stool that contains parasites? |
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Definition
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Term
| What is the significance of stool that contains blood? |
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Definition
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Term
| What is the significance of stool that contains large quantities of fat? |
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Definition
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Term
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Definition
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Term
| What are some of the major causes of diarrhea? |
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Definition
-psychological stress
-medications
-antibiotics
-iron
-cathartics
-allergies (to food, fluid, drugs)
-intolerance of food or fluid
-diseases of the colon |
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Term
| what are characteristics of bulk forming laxatives? |
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Definition
-Increases amount of: fluid, gaseous, or solid bulk
-i.e. metamucil, citrucel
-takes 12+ hours
-sufficient fluid must be taken
-safe for long term |
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Term
| what are characteristics of emollient/stool softener laxatives? |
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Definition
-softens and delays drying of feces
-allows fat and water to penetrate feces
- i.e. colace, Surfak
- slow acting, can take days |
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Term
| what are characteristics of stimulant/irritant laxatives? |
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Definition
-irritates intestional mucosa OR stimulates nerve endings
-rapid propulsion of contents
-i.e. exlax, dulcolax, correctal, castro oil
-acts quickly
-fluid passed with feces
-may cause cramps
-prolonged use can cause fluid and electrolyte imbalance |
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Term
| what are characteristics of lubricant laxatives? |
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Definition
-lubricates feces in colon
-i.e. mineral oil
-prolonged use inhibits vitamin absorption |
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Term
| what are characteristics of saline/osmotic laxatives? |
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Definition
-draws water into intestines by osmosis
-distends bowels and stimulate peristalsis
-i.e. epsom salts, miralax
-can be rapid
-SHOULD NOT BE USED WITH OLDER CLIENTS
-prolonged use inhibits vitamin absorption |
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Term
| Characteristics of Hypertonic enemas: |
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Definition
-90-120 ml solution
-draws water into colon
-5-10 minutes for effect
-adverse- retention of sodium |
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Term
| Characteristics of Hypotonic enemas: |
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Definition
-500-1000 ml solution
-distends colon, stimulates peristalsis, softens feces
- 15-20 min for effect
- -adverse- fluid and electrolyte imbalance, water intoxication |
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Term
| Characteristics of isotonic enemas: |
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Definition
-500-1000 ml normal saline
-distends colon, stimulates peristalsis, softens feces
- 15-20 min for effect
-adverse- possible retention of sodium |
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Term
| Characteristics of soapsud enemas: |
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Definition
-500-1000 ml soap to 1000 ml water
-irritates mucosa, distends colon
-10-15 min for effect
-irritates and may damage mucosa |
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Term
| Characteristics of oil(mineral, olive, cottonseed) enemas: |
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Definition
90-120 ml solution
-lubricates feces and colonic mucosa
-1/2 -3 hours
-no adverse effects listed |
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Term
| what type of enema is primarily given to expel flatus? |
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Definition
Carminative
(occasionally return flow enemas used) |
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Term
| cleansing enemas are used when? |
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Definition
-prevent feces escape during surgery
-prepare for certain diagnostic tests (i.e. colonoscopy)
-remove feces in instances of constipation or impaction |
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Term
| how long can ostomy appliances be applied? |
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Definition
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