Physiology of Defecation
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Questions and Answers

What is the primary function of the large intestine?

Absorption of water and nutrients, mucoid protection of the intestinal wall, and fecal elimination

How long is the adult colon approximately?

125 to 150 cm (50 to 60 in.)

What is the name of the valve that separates the small and large intestines?

Ileocecal valve

What is the term for the waste products leaving the stomach through the small intestine?

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

How much of the daily chyme is reabsorbed in the proximal half of the colon?

<p>About 1,400 mL (leaving 100 mL in the feces)</p> Signup and view all the answers

What is the protective function of the colon?

<p>Secreting mucus that contains bicarbonate ions</p> Signup and view all the answers

What nerves stimulate the mucous secretion in the colon?

<p>Parasympathetic nerves</p> Signup and view all the answers

How long does it take for most waste products to be excreted after ingestion?

<p>Within 48 hours</p> Signup and view all the answers

Why may hospitalized clients suppress the urge to defecate?

<p>Embarrassment about using a bedpan, lack of privacy, or discomfort</p> Signup and view all the answers

What is the effect of morphine and codeine on gastrointestinal activity?

<p>Decrease gastrointestinal activity</p> Signup and view all the answers

What is the effect of iron supplements on bowel activity?

<p>Can cause constipation or diarrhea</p> Signup and view all the answers

What happens to the stool as it moves farther along the bowel?

<p>The stool becomes more formed as the large bowel reabsorbs water from the fecal mass.</p> Signup and view all the answers

What is the purpose of laxatives in facilitating fecal elimination?

<p>Stimulate bowel activity</p> Signup and view all the answers

What is the characteristic of an ileostomy drainage?

<p>Liquid fecal drainage that is constant and cannot be regulated.</p> Signup and view all the answers

Why is odor a problem in ascending colostomy?

<p>Because more bacteria are present in the drainage.</p> Signup and view all the answers

Why may certain medications cause a change in the appearance of feces?

<p>Gastrointestinal bleeding or oxidation of iron</p> Signup and view all the answers

What is the characteristic of a transverse colostomy drainage?

<p>Malodorous, mushy drainage with some liquid reabsorbed.</p> Signup and view all the answers

Why may clients be restricted from ingesting food or fluid before certain diagnostic procedures?

<p>To prepare for visualization of the colon</p> Signup and view all the answers

What is the characteristic of a descending colostomy drainage?

<p>Increasingly solid fecal drainage.</p> Signup and view all the answers

What is the effect of general anesthetics on normal colonic movements?

<p>Cause normal colonic movements to cease or slow</p> Signup and view all the answers

What is one of the causes of constipation related to daily habits?

<p>Irregular defecation habits</p> Signup and view all the answers

What is the characteristic of a sigmoidostomy drainage?

<p>Normal or formed consistency, with regulated frequency of discharge.</p> Signup and view all the answers

What is the condition called when surgery involves direct handling of the intestines and normal intestinal movement ceases?

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

What is a common symptom of fecal impaction?

<p>Rectal pain</p> Signup and view all the answers

What is included in the assessment of fecal elimination?

<p>Nursing history, physical examination, and inspection of feces, as well as review of diagnostic test data.</p> Signup and view all the answers

What is the purpose of a nursing history for fecal elimination?

<p>To ascertain the client's normal pattern and identify any past or current problems with elimination.</p> Signup and view all the answers

What is the opposite of constipation?

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

What type of medication can increase the risk of fecal impaction?

<p>Anticholinergics and antihistamines</p> Signup and view all the answers

What is a common cause of fecal impaction?

<p>Poor defecation habits</p> Signup and view all the answers

What is a possible consequence of fecal impaction?

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

What is the term for the collection of hardened feces in the rectum?

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

What is another term for frequent but nonproductive desire to defecate?

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

What is the correct order of physical examination of the abdomen in relation to fecal elimination problems?

<p>inspection, auscultation, percussion, and palpation</p> Signup and view all the answers

What are the components of a complete examination of the rectum and anus?

<p>inspection and palpation</p> Signup and view all the answers

What are the characteristics of stool that should be observed during a physical examination?

<p>color, consistency, shape, amount, odor, and the presence of abnormal constituents</p> Signup and view all the answers

What is the NANDA diagnostic label for the inability to control bowel movements?

<p>Bowel Incontinence</p> Signup and view all the answers

What is a potential etiology of other NANDA diagnoses related to fecal elimination problems?

<p>Fecal elimination problems may affect many other areas of human functioning</p> Signup and view all the answers

What are some factors that can help clients achieve regular defecation?

<p>privacy, timing, nutrition and fluids, exercise, and positioning</p> Signup and view all the answers

What is the action of an enema in the large intestine?

<p>to distend the intestine and sometimes to irritate the intestinal mucosa, increasing peristalsis and the excretion of feces and flatus</p> Signup and view all the answers

What is a potential NANDA diagnosis related to the need for assistance with toileting?

<p>Situational Low Self-Esteem</p> Signup and view all the answers

Study Notes

Physiology of Defecation

  • The large intestine extends from the ileocecal valve to the anus and is approximately 125-150 cm (50-60 in) long in adults.
  • The large intestine has seven parts: cecum, ascending, transverse, and descending colons, sigmoid colon, rectum, and anus.
  • The colon is a muscular tube lined with mucous membrane, allowing it to enlarge and contract in both width and length.
  • The colon has three main functions: absorption of water and nutrients, mucoid protection of the intestinal wall, and fecal elimination.
  • The contents of the colon normally represent foods ingested over the previous 4 days, with most waste products excreted within 48 hours of ingestion.
  • The ileocecal valve regulates the flow of chyme into the large intestine and prevents backflow into the ileum.
  • Up to 1,500 mL of chyme passes into the large intestine daily, with all but about 100 mL reabsorbed in the proximal half of the colon.
  • The colon secretes mucus containing large amounts of bicarbonate ions, which is stimulated by parasympathetic nerves.

Factors Affecting Defecation

  • Hospitalized clients may suppress the urge to defecate due to embarrassment, lack of privacy, or discomfort.
  • Medications can interfere with normal elimination, causing diarrhea or constipation.
  • Iron supplements can cause constipation or diarrhea by acting locally on the bowel mucosa.
  • Laxatives stimulate bowel activity, while certain medications can soften stool or suppress peristaltic activity.
  • Medications can also affect the appearance of the feces, such as causing gastrointestinal bleeding or discoloration.

Diagnostic Procedures

  • Before diagnostic procedures like colonoscopy or sigmoidoscopy, clients may be restricted from ingesting food or fluid and may be given a cleansing enema.
  • Normal defecation usually resumes after eating is restarted.

Fecal Impaction

  • Fecal impaction is a mass of hardened feces in the folds of the rectum, resulting from prolonged retention and accumulation of fecal material.
  • Symptoms include fecal seepage, constipation, frequent but nonproductive desire to defecate, rectal pain, and a generalized feeling of illness.
  • Causes of fecal impaction include poor defecation habits, constipation, and certain medications like anticholinergics and antihistamines.

Diarrhea

  • Diarrhea refers to the passage of liquid feces and an increased frequency of defecation, resulting from rapid movement of fecal contents through the large intestine.
  • The type of stool produced by an ostomy depends on the location of the ostomy:
    • Ileostomy: liquid fecal drainage with little control over frequency
    • Ascending colostomy: liquid drainage with minimal control over frequency and odor
    • Transverse colostomy: malodorous, mushy drainage with little control over frequency
    • Descending colostomy: increasingly solid fecal drainage with some control over frequency
    • Sigmoidostomy: formed stools with regulatable frequency and minimal odor

Nursing Management

  • Assessment of fecal elimination includes taking a nursing history, performing a physical examination of the abdomen, rectum, and anus, and inspecting the feces.
  • The nurse should review data from relevant diagnostic tests and assess the client's normal pattern, past or current problems with elimination, and factors influencing the elimination pattern.
  • NANDA International includes diagnostic labels for fecal elimination problems, such as bowel incontinence, constipation, diarrhea, and dysfunctional gastrointestinal motility.
  • Fecal elimination problems may affect other areas of human functioning and be the etiology of other NANDA diagnoses.

Implementing

  • The nurse can promote regular defecation by attending to privacy, timing, nutrition and fluids, exercise, and positioning.
  • Enemas can be administered to distend the intestine and increase peristalsis, but should be used with caution to avoid irritating the intestinal mucosa.

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Fecal Elimination PDF

Description

Learn about the process of fecal elimination, the large intestine, and the physiology of defecation. Understand the importance of waste elimination for overall health.

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