Bowel Elimination: Key Concepts, Disorders, and Care Guidelines

defecation

The act of passing feces from the large intestine out of the body through the anus.

peristalsis

Involuntary contractions that move food through the gastrointestinal tract.

constipation

The inability to eliminate stool

enema

Specific amount of water

fecal impaction

Hard stool that is stuck in the rectum and cannot be expelled.

hemorrhoids

Enlarged veins in the rectum or outside the anus that can cause rectal itching

diarrhea

Frequent elimination of liquid or semiliquid feces.

fecal incontinence

The inability to control the bowels

flatulence

Air in the intestine that is passed through the rectum

also called flatus or gas.

lactose intolerance

The inability to digest lactose

malabsorption

The inability to absorb or digest a particular nutrient properly.

gastroesophageal reflux disease (GERD)

A chronic condition in which the liquid contents of the stomach back up into the esophagus.

heartburn

A condition that results from a weakening of the sphincter muscle that joins the esophagus and the stomach and causes a burning sensation in the esophagus.

ulceration

The process of eroding away.

peptic ulcers

Raw sores in the stomach that cause pain

irritable bowel syndrome (IBS)

A condition that causes diarrhea

inflammatory bowel disease (IBD)

A condition in which the bowel is chronically inflamed.

ulcerative colitis

A chronic inflammatory disease of the large intestine that causes cramping

Crohn's disease

An inflammatory disease that can affect any part of the digestive tract

stoma

An artificial opening in the body.

colorectal cancer

Cancer of the gastrointestinal tract

also known as colon cancer.

Rectal Suppository Procedure

Identify yourself and the resident

wash hands

explain the procedure

provide privacy

adjust bed height

help resident into left-sided Sims' position

unwrap and lubricate the suppository

insert past the rectal sphincter

ask resident to take deep breaths

hold toilet paper against the anus

wash hands

document the procedure.

Types of Enemas

Tap water enema

Guidelines for Assisting with an Enema

Provide privacy

keep bedpan nearby

place resident in Sims' position

use warm enema solution

do not raise enema bag above care plan height

lubricate tubing

unclamp tube to remove air

report any pain or resistance.

Cleansing Enema Procedure

Identify yourself and the resident

wash hands

explain the procedure

provide privacy

adjust bed height

place bed protector

help resident into left-sided Sims' position

prepare warm enema solution

lubricate tubing

insert tubing gently

allow solution to flow slowly

assist resident to use bedpan or bathroom.

Symptoms of Ulcerative Colitis

Cramping

Symptoms of Crohn's Disease

Similar symptoms to ulcerative colitis

Treatment for IBD

Medications to relieve symptoms and surgical treatment options like colostomy or ileostomy.

Enema Solution Temperature

Should be warm

Enema Bag Height

Should not be more than 12 inches above the resident's anus.

Signs to Report After Enema

Resident could not tolerate enema due to cramping

Sims' Position

Left-sided position used for administering enemas and rectal suppositories.

Privacy Measures

Use curtain

Deep Breathing Technique

Encouraged to help the resident relax and retain the suppository during insertion.

Documentation of Procedures

Follow facility guidelines to document any procedures performed.

Equipment for Rectal Suppository

Gloves

Equipment for Cleansing Enema

Bath blanket

Insertion Depth for Suppository

Place the suppository past the rectal sphincter against the wall of the colon.

Post-Procedure Care

Make resident comfortable

Air Removal from Enema Tubing

Unclamp tube and allow a small amount of solution to run through before administering the enema.

Signs of Resistance During Enema

Stop immediately if the resident has pain or you feel resistance

report to the nurse.

Assisting Resident with Bedpan

Raise the head of the bed and ensure both bed rails are up before leaving the room.

Cleansing Enema Solution Volume

Fill bag with 500-1000 mL of warm water for cleansing enemas.

Cleansing enema

A procedure to cleanse the bowel using a liquid solution.

Bowel Elimination

The process of expelling waste from the digestive tract.

Call light

A device used by residents to signal for assistance.

Perineal care

Hygiene care of the genital and anal areas.

Bedpan

A receptacle used by residents who are unable to use the toilet.

Gloves

Protective hand coverings used to prevent contamination.

Lubricating jelly

A gel used to ease the insertion of medical devices.

Specimen container

A container used to collect samples for testing.

Stool specimen

A sample of stool tested for blood

Ova and parasites

Tests conducted on stool to detect the presence of eggs and parasites.

Disposable wipes

Single-use cloths for cleaning hands or surfaces.

Hamper

A container for collecting used linens or clothing.

Cleaning and disinfecting

Processes to remove dirt and kill germs on surfaces.

Documenting procedures

Recording the details of medical procedures according to guidelines.

Nonskid footwear

Shoes designed to prevent slipping.

Bed protector

A disposable or washable cover placed under a resident.

Call the nurse

To notify nursing staff about a resident's condition or needs.

Face-to-face contact

Direct communication with the resident

Hamper or bag

A container for disposing of used towels and linens.

Specimen bag

A bag used to transport collected samples.

Tongue blades

Flat sticks used to collect stool samples.

Hat for toilet

A device used to collect urine or stool in the toilet.

Warm stool

Stool that must be at body temperature for certain tests.

Resident's reach

Items placed within easy access for the resident.

Removing privacy measures

Taking down curtains or screens after a procedure.