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Questions and Answers
A patient reports infrequent bowel movements, difficulty in passing stools, and a feeling of incomplete evacuation. Which condition is the patient most likely experiencing?
A patient reports infrequent bowel movements, difficulty in passing stools, and a feeling of incomplete evacuation. Which condition is the patient most likely experiencing?
- Constipation (correct)
- Fecal incontinence
- Diarrhea
- Fecal impaction
A nurse is assessing a patient's bowel elimination patterns. Which question would be most appropriate to gather relevant information?
A nurse is assessing a patient's bowel elimination patterns. Which question would be most appropriate to gather relevant information?
- Do you have a family history of gastrointestinal diseases?
- How often do you consume caffeinated beverages?
- What is your preferred method of stress management?
- Can you describe the usual color and consistency of your stools? (correct)
A patient is undergoing an assessment of their bowel elimination. Which of the following assessment techniques should the nurse perform?
A patient is undergoing an assessment of their bowel elimination. Which of the following assessment techniques should the nurse perform?
- Auscultation of bowel sounds in all four quadrants. (correct)
- Deep palpation of the liver to assess for enlargement.
- Percussion of the abdomen to identify masses.
- Inspection of oral mucosa for signs of dehydration.
A client has been experiencing frequent episodes of watery stools. Which nursing intervention is most appropriate for managing this condition?
A client has been experiencing frequent episodes of watery stools. Which nursing intervention is most appropriate for managing this condition?
A patient is scheduled for a colonoscopy. Which type of enema would the nurse anticipate being prescribed?
A patient is scheduled for a colonoscopy. Which type of enema would the nurse anticipate being prescribed?
A nurse is caring for a patient who reports excessive flatulence. Which dietary modification is most likely to alleviate this symptom?
A nurse is caring for a patient who reports excessive flatulence. Which dietary modification is most likely to alleviate this symptom?
A patient with a history of cardiac disease is constipated. Which type of enema is contraindicated for this patient?
A patient with a history of cardiac disease is constipated. Which type of enema is contraindicated for this patient?
A patient reports having black, tarry stools. What condition should the nurse suspect?
A patient reports having black, tarry stools. What condition should the nurse suspect?
A patient is scheduled for an ostomy surgery due to ulcerative colitis. Where is the most likely location for the ostomy placement?
A patient is scheduled for an ostomy surgery due to ulcerative colitis. Where is the most likely location for the ostomy placement?
A nurse is preparing to administer an enema to a patient. Which position will facilitate the procedure and promote optimal results?
A nurse is preparing to administer an enema to a patient. Which position will facilitate the procedure and promote optimal results?
A nurse is teaching a patient how to manage their new colostomy. What should the nurse emphasize regarding skin care around the stoma?
A nurse is teaching a patient how to manage their new colostomy. What should the nurse emphasize regarding skin care around the stoma?
A patient with a new ileostomy is concerned about maintaining adequate hydration. What should the nurse advise this patient?
A patient with a new ileostomy is concerned about maintaining adequate hydration. What should the nurse advise this patient?
A nurse is reviewing the fecal occult blood test (FOBT) results for a patient. Which statement accurately describes this diagnostic test?
A nurse is reviewing the fecal occult blood test (FOBT) results for a patient. Which statement accurately describes this diagnostic test?
A patient with a sigmoid colostomy reports constipation. What initial intervention should the nurse recommend?
A patient with a sigmoid colostomy reports constipation. What initial intervention should the nurse recommend?
A patient with an ileostomy is experiencing a blockage. Which dietary instruction is most crucial for the nurse to provide?
A patient with an ileostomy is experiencing a blockage. Which dietary instruction is most crucial for the nurse to provide?
A nurse assesses a patient who has not had a bowel movement in 4 days. The patient reports abdominal discomfort and distention. Which condition is most consistent with these findings?
A nurse assesses a patient who has not had a bowel movement in 4 days. The patient reports abdominal discomfort and distention. Which condition is most consistent with these findings?
A patient who has been taking antibiotics for an extended period develops diarrhea. Which intervention is most appropriate in this case?
A patient who has been taking antibiotics for an extended period develops diarrhea. Which intervention is most appropriate in this case?
A nurse is caring for a patient with fecal incontinence. What is the priority nursing intervention?
A nurse is caring for a patient with fecal incontinence. What is the priority nursing intervention?
A patient complains of abdominal cramping and frequent, urgent bowel movements containing mucus and blood. Which condition should the nurse suspect?
A patient complains of abdominal cramping and frequent, urgent bowel movements containing mucus and blood. Which condition should the nurse suspect?
A patient with a colostomy is preparing to travel by air. What advice should the nurse provide to help manage their bowel elimination needs during the flight?
A patient with a colostomy is preparing to travel by air. What advice should the nurse provide to help manage their bowel elimination needs during the flight?
A nurse is providing education to a patient with chronic constipation. Which of the following lifestyle modifications is most effective?
A nurse is providing education to a patient with chronic constipation. Which of the following lifestyle modifications is most effective?
A patient reports experiencing a vagal response during the administration of an enema. Which of the following is the most appropriate initial action by the nurse?
A patient reports experiencing a vagal response during the administration of an enema. Which of the following is the most appropriate initial action by the nurse?
A nurse is caring for a patient with a history of Crohn's disease who reports frequent episodes of steatorrhea. Which dietary modification should the nurse suggest?
A nurse is caring for a patient with a history of Crohn's disease who reports frequent episodes of steatorrhea. Which dietary modification should the nurse suggest?
A patient with a new ileostomy is being discharged. What teaching point should the nurse emphasize regarding medication administration?
A patient with a new ileostomy is being discharged. What teaching point should the nurse emphasize regarding medication administration?
A nurse is assessing a patient with a colostomy. What characteristic of the stool would be expected from an ascending colostomy?
A nurse is assessing a patient with a colostomy. What characteristic of the stool would be expected from an ascending colostomy?
A patient who is recovering from surgery is prescribed opioid pain medication and has not had a bowel movement in three days. What intervention should the nurse implement first?
A patient who is recovering from surgery is prescribed opioid pain medication and has not had a bowel movement in three days. What intervention should the nurse implement first?
A nurse is preparing to perform digital removal of stool for a patient with a fecal impaction. What potential complication should the nurse closely monitor for?
A nurse is preparing to perform digital removal of stool for a patient with a fecal impaction. What potential complication should the nurse closely monitor for?
A patient with a history of heart failure is prescribed an enema for severe constipation. Which type of enema is safest to administer?
A patient with a history of heart failure is prescribed an enema for severe constipation. Which type of enema is safest to administer?
A nurse discovers that a patient's stoma is pale and dusky. What should the nurse do first?
A nurse discovers that a patient's stoma is pale and dusky. What should the nurse do first?
A nurse is teaching a patient about the BRAT diet for managing diarrhea. What foods are included in this diet?
A nurse is teaching a patient about the BRAT diet for managing diarrhea. What foods are included in this diet?
A patient awaiting ostomy surgery asks the nurse what to expect regarding the color of a healthy stoma. What's the most accurate response?
A patient awaiting ostomy surgery asks the nurse what to expect regarding the color of a healthy stoma. What's the most accurate response?
A nurse is caring for a patient with fecal incontinence due to a neurological disorder. What should be included in the nursing care plan?
A nurse is caring for a patient with fecal incontinence due to a neurological disorder. What should be included in the nursing care plan?
A nurse is teaching a patient with a new colostomy how to irrigate their colostomy at home. What should the nurse include?
A nurse is teaching a patient with a new colostomy how to irrigate their colostomy at home. What should the nurse include?
For a patient experiencing severe diarrhea, what would be the most appropriate initial dietary modification?
For a patient experiencing severe diarrhea, what would be the most appropriate initial dietary modification?
During assessment of a patient, the nurse notes an abdominal mass with palpation. What is the next best action?
During assessment of a patient, the nurse notes an abdominal mass with palpation. What is the next best action?
A patient with frequent liquid stools from an ileostomy is most at risk for what complication?
A patient with frequent liquid stools from an ileostomy is most at risk for what complication?
Which of the following is a common cause of constipation?
Which of the following is a common cause of constipation?
A patient is scheduled for a hemoccult test, and asks the nurse what it screens for. What is the best answer?
A patient is scheduled for a hemoccult test, and asks the nurse what it screens for. What is the best answer?
Flashcards
What is defecation?
What is defecation?
The process of bowel elimination, involving the contraction of intestinal muscles to move waste.
What is peristalsis?
What is peristalsis?
Rhythmic wave-like movements that propel food through the GI tract.
What is flatus?
What is flatus?
Intestinal gas.
Factors affecting bowel elimination?
Factors affecting bowel elimination?
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Components assessed during bowel assessment?
Components assessed during bowel assessment?
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Physical examination during bowel assessment?
Physical examination during bowel assessment?
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Alterations in bowel elimination?
Alterations in bowel elimination?
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What is constipation?
What is constipation?
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What is diarrhea?
What is diarrhea?
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What is a fecal impaction?
What is a fecal impaction?
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What is fecal incontinence?
What is fecal incontinence?
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Nursing interventions for diarrhea?
Nursing interventions for diarrhea?
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What is steatorrhea?
What is steatorrhea?
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What is frank blood?
What is frank blood?
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What are culture and sensitivity (C&S) tests?
What are culture and sensitivity (C&S) tests?
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What are ova and parasite (O&P) tests?
What are ova and parasite (O&P) tests?
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Nursing interventions to promote bowel function?
Nursing interventions to promote bowel function?
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What is a rectal suppository?
What is a rectal suppository?
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What are enemas?
What are enemas?
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Contraindications to an enema?
Contraindications to an enema?
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Cancerous tumor, ulcerative colitis, traumatic abdominal injury.
Cancerous tumor, ulcerative colitis, traumatic abdominal injury.
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What is an ostomy?
What is an ostomy?
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Ileostomy Stool?
Ileostomy Stool?
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Colostomy Stool?
Colostomy Stool?
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What is Stoma and Peristomal Care?
What is Stoma and Peristomal Care?
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What is ostomy irrigation?
What is ostomy irrigation?
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Study Notes
Bowel Elimination and Care
Defecation
- Defecation refers to the process of bowel elimination or bowel movement.
- Peristalsis involves rhythmic, wavelike movements that propel food boluses through the GI tract.
- These movements become more active upon eating and rely on the contraction of circular and longitudinal muscles in the GI tract walls, starting from the esophagus down to the rectum.
- Flatus is intestinal gas
- Interventions can relieve discomfort and help to "eliminate” gas.
Key Anatomy
- The small intestine is 20 feet long:
- Made up of the duodenum, jejunum, and ileum.
- The large intestine is 5 feet long:
- Composed of the cecum, colon, and rectum.
- The pathway of food materials follows:
- Mouth → Pharynx → Esophagus → Stomach → Small Intestine (duodenum, jejunum, ileum) → Large Intestine (cecum, colon- ascending, transverse, descending, sigmoid, rectum) → Anus.
Factors Affecting Bowel Elimination
- Types of food
- Fluid intake
- Drugs
- Emotions
- Neuromuscular function
- Abdominal muscle tone
- Opportunity for defecation
- Surgery
- Allergies
- Pregnancy
- Laxative abuse
- Aging
- Structural changes
- Chemical changes
Assessment of Bowel Elimination
- Elimination Patterns and Characteristics of Stool.
- Inspect the shape of the abdomen.
- Auscultate the bowel sounds.
- Palpate the abdomen.
- Ask about pain.
Alterations in Bowel Elimination
- Constipation
- Primary
- Secondary
- Iatrogenic
- Pseudo constipation
- Diarrhea
- Impaction
- Fecal incontinence
Nursing Interventions for Diarrhea
- Clear liquid diet helps rest and heal the GI tract.
- Push fluids, such as Gatorade and Pedialyte.
- BRAT Diet includes Bananas, Rice, Applesauce, and Toast.
- Yogurt and probiotics
Abnormal Conditions of Stool:
- Steatorrhea: stool containing an abnormal amount of undigested fat.
- Indicates a malabsorption disorder like Crohn's ("fluffy and floats").
- Frank blood: bright red blood in the stool.
- May indicate caused by hemorrhoids, intestinal bleeding, or hemorrhage.
- Occult blood: hidden blood in the stool.
- Guaiac test detects blood in the stool.
Laboratory Tests
- Culture and sensitivity (C&S): Identifies microorganisms infecting the stool and the antibiotics that can kill them.
- Ova and parasite test (O&P): Detects the presence of parasitic worms and their eggs.
Nursing Interventions to Promote Bowel Function
- Increase physical activity levels.
- Ensure adequate fluid intake of at least 2,500 mL/day.
- Increase fiber intake to 20 to 30 g/day gradually.
- Provide privacy.
- Position patients upright for elimination.
- Provide stimulants like a cup of hot coffee before breakfast.
Measures to Promote Bowel Elimination
- Rectal Suppository and Enemas.
- Types: Cleansing and Retention; Enemas given as a 30 min retention
Cleansing Enemas Solutions
- Tap Water
- Normal Saline
- Soapsuds
- Hypertonic Solution
Contraindications to an Enema
- Rectal surgery
- Severely bleeding hemorrhoids
- Ulcerative colitis or Crohn's disease
- Rectal fissure
- Rectal cancer
- Potential for excessive bleeding
- Heart conditions i.e. MI, unstable angina.
Enema Complications
- Vagal Response: Monitor for signs/symptoms and be prepared with interventions.
- Perforation of colon.
Conditions Related to Bowel Diversions
- Cancerous tumor
- Infarcted area with ischemic/died walls
- Disease process
- Ruptured diverticulum
- Ulcerative colitis
- Traumatic abdominal injury
Ostomies
- Ileostomy:
- Liquid stool.
- Colostomy utilizes the colon.
- Continent ostomy uses a Kock pouch.
- Requires draining every 4-6 hours and patient teaching.
Colostomy Types
- Ascending colostomy: Frequent, liquid stools.
- Transverse colostomy: Semi-solid, some form, soft stool.
- Descending colostomy: Near-normal stool.
Ostomies Care
- Focus on Stoma and Peristomal areas.
- Irrigation is necessary for solid stool.
- The process is similar to administering an enema.
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