Bowels

Green poop indication

Food moving through the large intestine too quickly. Bile doesn't fully break down. Could also be from green veggies or food dye

Pale or clay colored poop indication

A lack of bile may indicate a bile duct obstruction. Certain medications and anti-diarrheals can also cause this

Yellow poop indication

Excess fat in the stool, possibly due to a malabsorption disorder. Sometimes from celiac disease as well

Black poop indication

Bleeding in the upper intestinal tract. Or iron supplements, Pepto-Bismol, or black licorice

Red poop indication

Bleeding in the lower intestinal, like the large intestine or rectum. Could also be caused by red dye or beets

Fecal specimen collection tips

-May need to instruct patient about food restrictions for at least 4 days before the test

-Postpone the test with menstruating women or bleeding hemorrhoids

-Avoid urine mixing with the stool

How many drops of developing solution should be applied to the test area over occult blood smear samples?

2 drops

How long until occult blood smear results can be read?

30-60 seconds

What is the purpose of an enema?

-Promotes defecation by stimulating peristalsis

-Fluid can also break up fecal mass

-Can allow drugs to exert a local effect on rectal mucosa

-Empty bowels before diagnostic tests, surgery, childbirth, or for bowel training

Tap water or plain water enema

-Hypotonic, water moves from bowel to interstitial spaces

-Do not repeat, may cause water toxicity

Normal saline enema

-Isotonic (safest solution)

-Same action as tap water, except no adverse effects

-No water movement

Soap suds enema

Detergent irritates and breaks down stool

Low Volume (fleets) enema

-Hypertonic, water moves from interstitial spaces to bowel

Oil retention enema

-Lubricate the stool and intestinal mucosa, easing defecation

Height enemas

Can be low, regular, or high

Carminative enema

Help expel flatus from the rectum

Return flow enema (or Harris flush or Hi-Low)

-is occasionally used to expel flatus

-alternates flow of 100 - 200 mL in and out

-stimulates peristalsis

-repeated 5 or 6 times until flatus is expelled and abdominal distention is relieved

Medicated enema

Solution with drugs to reduce bacteria before bowel surgery or remove potassium

What kind of enemas can infants and children receive and why?

Only normal saline at small amounts. 150 cc (for infants) to 500 cc (for school age children) because it poses an electrolyte imbalance risk

What are the procedures for administering an enema?

-Assess vitals, bowel sounds, last BM

-Check for any rectal problems and electrolyte levels

-Read Dr. orders

-Prepare equipment

-Confirm patient

-Have patient in sims position on their left side with their right knee flexed

-Raise the bed and monitor heart rate

-Document

What position should a patient be in for an enema?

On left side in sims position with right knee flexed

Patients that receive frequent enemas should be observed for what?

Dizziness, sweating, or vomiting because these are signs of dehydration or electrolyte imbalance

Colostomy irrigation

Involves introducing water into the colon through a stoma to stimulate bowel contractions and evacuate stool. It functions similarly to an enema and can help establish a predictable bowel routine, often allowing individuals to go 24 to 48 hours without stoma output. Do not use an enema kit for this. This should be a normal daily activity just like anyone else who goes to the bathroom for a bowel movement

When is the best time to collect a sample to test for pinworms?

In the morning after waking up before bathing or pooping.

How do we collect a pinworm sample?

Applying the sticky side of tape to the anal area in the morning to collect eggs or the worms. The sample is then transferred to the laboratory