CH30

Normal Bowel Elimination

Begins in the mouth and ends as waste products (feces/stool) are expelled from the anus.

Peristalsis

The process of wave-like muscle contractions that moves food through the digestive tract.

Constipation

Less frequent, hard, formed stools that are difficult to expel.

Feces Characteristics

Soft, formed, light yellowish-brown to dark brown, slightly odorous, and falls into a slightly curved shape.

Abnormal Stool Characteristics

Liquid or semiliquid, watery, unformed, very hard and dry, with possible blood, black, or clay color.

Assessment of Bowel Elimination

Includes color, amount, consistency, unusual shape, and unusual odor.

Hyperactive Bowel Sounds

More than 30 per minute, may indicate diarrhea.

Borborygmi

Excessively loud gurgling sounds, may indicate hunger or bowel obstruction.

Factors Contributing to Constipation

Includes decreased activity level, changes in food intake, decreased fluid intake, and medication side effects.

Nursing Interventions for Constipation

Increase activity, improve fluid and fiber intake, provide privacy, assist with positioning, administer medications.

Types of Enemas

Includes tap water, normal saline, soapsuds, and hypertonic sodium phosphate, each with specific mechanisms and purposes.

Contraindications to Enemas

Includes rectal surgery, severe hemorrhoids, ulcerative colitis, and specific heart conditions.

Complications of Enemas

Can include vagal response or perforation of the intestinal wall.

Nursing Interventions for Diarrhea

Modify food intake, increase fluids, administer medications, provide perineal care.

Bowel Training Goal

To establish regular bowel elimination.

Ostomy

Surgically creating a bowel diversion to redirect intestinal contents through an alternative exit site.

Bowel Elimination and Aging

Decreased physical activity, improperly fitting dentures, and decreasing peristalsis can lead to constipation in older adults.

Lab Tests for Diarrhea Causes

Includes guaiac test for blood, culture and sensitivity for microorganisms, and Ova and parasite test for worms.

Emotional Support for Fecal Incontinence

Offer kindness, professionalism, and compassion to patients dealing with incontinence.

Nursing Interventions for Fecal Impaction

Usually requires digital removal before administering a cleansing enema.

Milk and Molasses Enema

A hypertonic solution used to cleanse by pulling fluid into the colon to soften hard stool.

High Enema Purpose

To cleanse higher up in the colon beyond the sigmoid.

Cleansing Enema

Types include tap water, normal saline, and soapsuds, aimed at distending colon and increasing peristalsis.