NURS 3000: Physiology of Defecation and Elimination Needs

They increase abdominal pressure, which helps to expel feces from the body.

Expansion of the rectum to accommodate accumulated feces and eventual loss of sensitivity to the need to defecate, leading to constipation.

It provides fecal volume, promotes the movement of material through the digestive system, and increases stool bulk.

It increases the pressure within the abdomen, which facilitates defecation.

They help to move the feces through the anal canal during defecation.

The urge to defecate is ultimately lost.

Immobility can lead to weak abdominal and pelvic muscles, which are ineffective in increasing intra-abdominal pressure during defecation or in controlling defecation.

The vagal stimulation from the brain triggers individual differences in the response of the enteric nervous system to emotional states, leading to increased peristaltic activity or slowed intestinal motility.

The feces become hard and difficult to expel due to continued water reabsorption.

Embarrassment about using a bedpan, lack of privacy, or discomfort during defecation.

Short urethra and the proximity of the urinary meatus to the vagina and anus.

Smooth muscle under involuntary control.

Pregnancy and childbirth, chronic constipation, decrease in estrogen (menopause), being overweight, aging, and lack of general fitness.

Stretch receptors.

Skeletal muscle under voluntary control.

To prevent leakage and reflux of urine back towards the kidneys

Every 2 to 3 hours initially, and increasing to every 5 to 6 hours as the pouch expands

Sensory nerves in the rectum are stimulated

It relaxes to allow feces to move into the anal canal

Relaxation of the external anal sphincter

The client should be encouraged to consume oral fluids and bland food, eat small amounts, and avoid excessively hot or cold fluids and highly spiced foods. This is because small amounts are more easily absorbed, and excessively hot or cold fluids and highly spiced foods can stimulate peristalsis and exacerbate diarrhea.

Regular exercise helps clients develop a regular defecation pattern, and specific exercises such as tightening abdominal muscles and contracting thigh muscles can help strengthen weak muscles and improve defecation.

Carbonated beverages, drinking straws, and chewing gum should be avoided, as they increase the ingestion of air. Additionally, gas-forming foods such as cabbage, beans, onions, and cauliflower should be limited, as they can contribute to gas buildup and exacerbate flatulence.

Fiber plays a crucial role in maintaining healthy gut function, and a diet rich in fiber can help promote regular defecation and prevent constipation. Fiber adds bulk to stool and helps to stimulate peristalsis, promoting the movement of food through the digestive system.

A client with weak abdominal and pelvic muscles can improve their ability to use a bedpan by strengthening their thigh muscles through exercises such as contracting and relaxing the thigh muscles. This can help improve their ability to use a bedpan and promote independence.

To gradually lengthen the intervals between urination to correct the client's frequent urination, stabilize the bladder, and diminish urgency.

Delayed voiding provides larger voided volumes and longer intervals between voiding.

Inhibiting the urge-to-void sensation through deep, slow breathing until the urge diminishes or disappears.

To strengthen pelvic floor muscles and reduce or eliminate episodes of incontinence.

By tightening the anal sphincter as if to control the passing of gas, around the vagina and the urethra as if trying to stop urine mid-flow.

Avoiding contraction of the muscles of the buttocks and thighs.

PFM exercises can be performed anytime, anywhere, sitting or standing.

The nurse instructs the client on how to practice deep, slow breathing and perform pelvic floor muscle exercises correctly.

Client education is crucial for successful implementation and adherence to these techniques.

To reduce or eliminate episodes of incontinence and improve overall quality of life.

The result is a fecal impaction, which leads to the passage of liquid fecal seepage (diarrhea) around the impacted mass, with no normal stool.

Chronic use of laxatives or enemas can lead to dependence and weaken the muscles involved in defecation, resulting in poor motility and slow transit, which can contribute to the development of fecal impaction.

Digital examination of the rectum is significant in assessing fecal impaction, as it allows the healthcare provider to palpate the hardened mass of feces in the rectum.

Neurologic conditions such as Parkinson's disease or paralysis can disrupt bowel function by slowing down motility and Transit, increasing the risk of fecal impaction, and requiring specialized nursing care to manage elimination needs.

Irritable bowel syndrome (IBS) can increase the risk of fecal impaction due to altered motility and transit, and its management requires a comprehensive approach that addresses both IBS and fecal impaction.