Bowel Elimination and Nursing Care Flashcards

A complete set of practice flashcards covering bowel elimination, stool characteristics, constipation, diarrhea, enemas, impaction, bowel training, ostomies, and diagnostic tests based on lecture notes.

What gives normal stool its light to dark brown color?

Bile

What is the normal shape and diameter of adult stool?

Tubular, approximately $1\,\text{in}$ ($2.5\,\text{cm}$) in diameter.

What does bright red blood on the surface of stool indicate?

Fresh bleeding in the lower GI tract.

What is melena, and what type of GI bleeding does it represent?

Dark, black, tarry stool that indicates old or upper GI bleeding.

What does pale, white, or gray stool indicate?

Absence of bile, which points to a possible obstruction.

What is steatorrhea, and how is it evaluated?

Fatty stool caused by fat malabsorption that floats and has a foul smell; it is evaluated using a Lipase Test.

What is the correct order of physical assessment for bowel elimination?

Inspect, Listen, Percussion, Palpate.

What fluid intake is recommended daily for promoting normal bowel elimination?

Eight $8\,\text{oz}$ glasses of water per day.

What natural reflex should be utilized when establishing a toileting routine?

Gastrocolic reflex.

What type of laxative is preferred for older adults with constipation, and how must it be taken?

Bulk-forming laxatives (Psyllium), which must be taken with plenty of fluids.

What nursing interventions should be performed if a patient has no bowel movement in $3\,\text{days}$?

Assess first using the least invasive methods, encourage fluid intake, provide a fiber-rich diet, and encourage activity if safe.

What are the key signs of dehydration resulting from diarrhea?

Decreased skin turgor (tenting), dry mucous membranes, and increased thirst.

What bland, low-fiber foods are recommended when reintroducing food after diarrhea?

Cottage cheese, gelatin, applesauce, and bananas.

What is the standard cleansing enema volume for adults compared to infants?

Adults: $500\text{ to }1000\,\text{mL}$; Infants: $50\text{ to }150\,\text{mL}$.

What is the volume range and hold time for an oil retention enema?

Volume is $20\text{ to }180\,\text{mL}$, held for at least $20\,\text{min}$.

What position and container height should be used when administering an enema?

Sims position (modified left lateral recumbent) with the container held $12\text{ to }18\,\text{in}$ above the anus.

What sign in a patient with no bowel movement in greater than $3\,\text{days}$ indicates fecal impaction?

Passage of liquid or semi-soft stool (watery leakage).

What complication must be monitored for and reported immediately during digital removal of feces?

Vagal response.

What is the goal timing for a bowel movement during bowel training?

A bowel movement within $1\,\text{hr}$ of the scheduled time.

What is the difference in stool consistency between an ileostomy and a colostomy?

An ileostomy opens at the ileum and produces liquid stool, while a colostomy opens into the colon and produces formed stool.

What is the normal appearance of a stoma, and what abnormal colors must be reported to the MD?

Normal appearance is pink/red and well-perfused. Abnormal colors are pale or dusky black.

What organization can patients be referred to for peer support following a bowel diversion?

United Ostomy Associations of America.

What diagnostic test is used to detect hidden blood in stool?

Guaiac test (fecal occult blood test).

Mastication

The process of chewing food, breaking it down into smaller pieces to facilitate digestion.

Duodenum

The first section of the small intestine, where the majority of chemical digestion occurs.

Jejunum

The middle portion of the small intestine, where most nutrient absorption takes place.

Ileum

The final segment of the small intestine, responsible for absorbing vitamin B12 and bile salts.

Peristalsis

The wave-like muscle contractions that move food through the digestive tract.

Stomach acids

Hydrochloric acid and gastric juices produced in the stomach that aid in food digestion and kill pathogens.

Length of the intestinal tract

The overall length of the intestinal tract is approximately $25\,\text{ft}$ (about $7.5\,\text{m}$).

Function of the small intestine

The small intestine is responsible for the majority of digestion and absorption of nutrients. It consists of three parts: duodenum, jejunum, and ileum.

Function of the large intestine

The large intestine absorbs water and electrolytes from indigestible food matter, compacts it into feces, and stores it before elimination.

Factors affecting bowel elimination

Diet, fluid intake, physical activity, medications, and personal habits are key factors that can influence bowel elimination.

Constipation/hypoactive bowel

A condition characterized by infrequent bowel movements, often associated with hard, dry stools.

Constipation in the older adult

Often caused by reduced physical activity, poor diet, medications, and changes in the digestive system.

Diarrhea/hyperactive bowel

Frequent, loose, and watery stools that result from increased intestinal activity.

Fecal incontinence

The inability to control bowel movements, resulting in the unintentional passage of stool.

Types of ostomies

Colostomy and ileostomy are the main types; colostomy connects a part of the colon to the abdominal wall, while ileostomy connects the ileum to the abdominal wall.

Function of a colostomy

To divert waste material from the colon to an external pouch.

Function of an ileostomy

To divert waste from the ileum to an external pouch, allowing for the bypass of the entire colon.