Fundamental of Nursing II: Fecal Elimination
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Questions and Answers

What is the frequency of defecation in an individual?

  • Once a week
  • Once a day
  • Same for everyone
  • Several times a day to 2 or 3 times a week (correct)

    • What is the percentage of water in feces?

  • 75% (correct)
  • 25%
  • 90%
  • 50%

    • What is the main function of the colon?

  • production of enzymes
  • production of hormones
  • Absorption of nutrients and water (correct)
  • elimination of waste

    • What is the reason for the brown color of feces?

    <p>Presence of bile pigment</p> Signup and view all the answers

    What is the role of the internal anal sphincter?

    <p>Involuntary control of defecation</p> Signup and view all the answers

    What is the effect of thigh flexion on defecation?

    <p>Increases abdominal pressure</p> Signup and view all the answers

    What is the term for the expulsion of feces from the anus and rectum?

    <p>Defecation</p> Signup and view all the answers

    What is often palpated through the client's abdomen during the assessment of fecal impaction?

    <p>Hardened mass</p> Signup and view all the answers

    What is a common problem related to fecal elimination?

    <p>All of the above</p> Signup and view all the answers

    What is the primary function of the large intestine?

    <p>Absorption of water</p> Signup and view all the answers

    What is a common cause of fecal impaction in the elderly?

    <p>All of the above</p> Signup and view all the answers

    What is a symptom of diarrhea?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the waste products of digestion eliminated from the body?

    <p>Feces</p> Signup and view all the answers

    What can cause inflammation and infection of the intestinal mucosa?

    <p>Pathogenic intestinal microorganisms</p> Signup and view all the answers

    How many parts does the large intestine consist of?

    <p>7</p> Signup and view all the answers

    What is a client teaching strategy for managing diarrhea?

    <p>Drink at least 8 glasses of water/day</p> Signup and view all the answers

    What is the main role of the rectum and anus?

    <p>Elimination of waste products</p> Signup and view all the answers

    What is a possible complication of diarrhea?

    <p>Dehydration</p> Signup and view all the answers

    What is a treatment for fecal impaction?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of the lecture on fecal elimination?

    <p>To describe the physiology of fecal elimination</p> Signup and view all the answers

    What is characterized by the loss of voluntary control of fecal and gaseous discharges through the anal sphincter?

    <p>Fecal incontinence</p> Signup and view all the answers

    What is one of the learning outcomes of this lecture?

    <p>To describe the physiology of fecal elimination</p> Signup and view all the answers

    What is the primary organ of bowel elimination?

    <p>Large intestine</p> Signup and view all the answers

    What is partial incontinence?

    <p>The inability to control flatus or to prevent minor soiling</p> Signup and view all the answers

    What is the primary source of flatus in the large intestine?

    <p>Action of bacteria on the chyme</p> Signup and view all the answers

    What is an ostomy?

    <p>An artificial opening in the gut for elimination</p> Signup and view all the answers

    What is included in the nursing history of a client with fecal elimination problems?

    <p>Defecation pattern, description of feces, and fecal elimination problems</p> Signup and view all the answers

    What is the purpose of rectal endoscopy?

    <p>To visualize the rectum</p> Signup and view all the answers

    How much stool is usually adequate for laboratory analysis?

    <p>2.5 cm of formed stool or 15 to 30 ml of liquid stool</p> Signup and view all the answers

    Why may the client need to refrain from eating red meat before a stool test for occult blood?

    <p>Because red meat may mask the presence of occult blood in the stool</p> Signup and view all the answers

    What is a potential nursing diagnosis related to fecal elimination problems?

    <p>Risk for fluid volume deficit related to diarrhea</p> Signup and view all the answers

    What is a main goal of bowel training programs?

    <p>To restore normal bowel elimination pattern</p> Signup and view all the answers

    What is a contraindication for the use of cathartics?

    <p>Nausea, cramps, or colic</p> Signup and view all the answers

    What is the purpose of a fecal incontinence pouch?

    <p>To collect and contain large volumes of feces</p> Signup and view all the answers

    What is a way to reduce or prevent flatulence?

    <p>Not providing gas-producing foods</p> Signup and view all the answers

    What is the purpose of administering enemas?

    <p>To clean the rectum and sigmoid colon</p> Signup and view all the answers

    What is a nursing responsibility when using a fecal incontinence pouch?

    <p>Regularly assessing the perianal skin status</p> Signup and view all the answers

    What is the effect of persistent self-administration of laxatives?

    <p>Chronic constipation</p> Signup and view all the answers

    What is the purpose of digital removal of a fecal impaction?

    <p>To break up the fecal mass digitally and removing in portions</p> Signup and view all the answers

    Study Notes

    Fecal Elimination

    • Fecal elimination is the process of eliminating waste products from the body through the anus and rectum, also known as bowel movement.
    • The frequency of defecation is highly individual, varying from several times a day to 2-3 times a week.
    • The amount of defecation also varies from person to person.

    Physiology of Defecation

    • The rectum and anus are the most distal parts of the large intestine.
    • The rectum is usually 10-15 cm long in adults.
    • The internal anal sphincter is innervated by the autonomic nervous system, and the external anal sphincter is innervated by the somatic nervous system.
    • Defecation is a process that involves both involuntary and voluntary control.
    • The colon's main functions are:
      • Absorption of water and nutrients
      • Mucoid protection of the intestinal wall
      • Fecal elimination

    Characteristics of Normal and Abnormal Feces

    • Normal feces are:
      • 75% water and 25% solid materials
      • Soft, but formed
      • Brown due to the presence of sterocobilin and urobilin
      • Has a characteristic odor due to the action of bacteria
      • Contains 7-10 liters of gas in the large intestine every 24 hours
    • Abnormal feces may be:
      • Clay or white (absence of bile pigment)
      • Black or tarry (bleeding from upper GIT)
      • Red (bleeding from lower GIT)
      • Pale or orange/green (malabsorption of fats or diet-related)

    Factors that Influence Fecal Elimination

    • Age and development
    • Diet
    • Fluid intake
    • Activity
    • Psychologic factors
    • Defecation habits
    • Medications
    • Diagnostic procedures
    • Anesthesia and surgery
    • Pathologic conditions
    • Pain

    Fecal Elimination Problems

    • Constipation
      • Defined as fewer than 3 bowel movements a week
      • Characteristics: decreased frequency of defecation, hard, dry, formed stools, straining at stool, painful defecation
      • Causes: irregular defecation habits, insufficient activity, insufficient fluid or fiber intake, chronic use of laxatives, change in daily routine
    • Fecal impaction
      • A mass or collection of hardened feces in the folds of the rectum
      • Causes: poor defecation habits, constipation, certain medications
      • Treatment: oil retention enema, cleansing enema, daily additional cleansing enemas, suppositories or stool softeners, manual removal
    • Diarrhea
      • Passage of liquid feces and an increase in frequency of defecation
      • Causes: rapid movement of fecal contents through the large intestine, infection, inflammation, irritation of the intestinal mucosa
      • Treatment: client teaching (managing diarrhea), fluids, electrolytes, and medications as needed
    • Fecal incontinence
      • Loss of voluntary control of fecal and gaseous discharges through the anal sphincter
      • Types: partial incontinence, major incontinence
      • Causes: nerve damage, muscle weakness, rectal surgery
      • Treatment: bowel training program, fecal incontinence pouch

    Nursing Management

    • Assessment of fecal elimination includes:
      • Nursing history
      • Physical examination of the abdomen, rectum, and anus
      • Inspecting the feces
      • Reviewing diagnostic test data
    • Nursing diagnosis:
      • Altered bowel movement
      • Risk for fluid volume deficit
      • Self-esteem disturbance
      • Anxiety
      • Risk for impaired skin integrity
    • Planning:
      • Maintain or restore normal bowel elimination pattern
      • Maintain or regain normal stool consistency
      • Prevent associated risks
    • Implementing:
      • Promoting regular defecation
      • Client teaching for healthy habits related to bowel elimination
      • Administering prescribed medications
      • Administering enemas
      • Digital removal of a fecal impaction
      • Decreasing flatulence
      • Bowel training program
      • Fecal incontinence pouch

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    Description

    This lecture covers the physiology of fecal elimination, factors that influence it, and common causes of fecal elimination problems. It also discusses normal and abnormal characteristics of feces and nursing care planning.

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