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Defecation
Bowel elimination; passing feces from the large intestine out of the body through the anus
Feces; stool; bowel movements
Medical names for poop
Normal
Characteristics of _________ stool is brown in color, soft or formed, and tubular in shape.
Appearance
Food, medication, supplements, illness can all change the ________ of stool
Black
Stool can appear _______ if the resident is taking iron supplements or if there is old blood in the stool.
Red
Stool can appear _______ if the resident consumes red food coloring beets or tomato juice. It may also contain fresh blood like from lower intestinal bleeding.
Liver
Stool may appear _________ if the resident has issues with the liver affecting the production of bile.
Normal
Normal or report:
Stool is soft and formed
Report
Normal or report:
Whiteish, black, red, or hard stool
Report
Normal or report:
Hard stool or liquid stool
Report
Normal or report:
Diarrhea
Report
Normal or report:
Constipation
Normal
Normal or report:
Stool that is brown in color
Report
Normal or report:
Flatulence or gas in excess
Report
Normal or report:
Pain when having a bowel movement
Report
Normal or report:
Fecal incontinence
Normal
Normal or report:
Stool that is tubular in shape
Report
Normal or report:
Blood, pus, mucus, or discharge in the stool.
Peristalsis
Involuntary contractions of the smooth muscle in the organs of the digestive tract that move food through the gastrointestinal system.
Slows; longer; absorbed
Normal changes of aging in bowel elimination:
Peristalsis _______
Digestion takes ________ and is less efficient
Proteins, vitamins, and minerals are not _______ as well.
Decreased; tooth; taste; appetite
Normal changes of aging in bowel elimination:
______ saliva production
Possible _____ loss
Medication use and dulled sense of ____ may result in a poor _______.
Fluids; dentures; hands; clean; dry
Nursing Assistants can promote normal bowel elimination by:
Encouraging ________
Encouraging nutritious meals
Making meals enjoyable
Ensuring _______ fit properly and are cleaned well
Performing oral care
Helping resident wash their _____ after elimination
Keeping residents with fecal incontinence _____ and ______.
Psychological
___________ factors that affect bowel elimination:
Stress, anger, fear, depression, and a lack of privacy.
Increase
Stress, anger, anxiety, and fear can _________ peristalsis.
Decrease
Depression can ________ peristalsis
Privacy; rushing
Nursing assistants can help reduce psychological factors affecting bowel elimination by
Providing ______ and closing the bathroom door, not _______ the resident or interrupting, reporting signs of depression or anxiety, and reporting changes in frequency.
Fiber
Consuming _______ can help elimination. This can be found in fruits, whole grains, and raw vegetables.
Constipation
Meats, animal fats, cheese and foods high in processed sugars can cause ____________.
Flatulence
Gas
Help
Flatulence can _____ bowel elimination.
Flatulence
High fiber foods including the following can also cause ____________:
Beans
Fruits
Whole grains
vegetables
dairy products
carbonated drinks
Low
_______ fluid intake can cause constipation because water is reabsorbed from feces in the intestines.
Fluids; fiber
Nursing assistants can promote normal bowel elimination by offering ____ and foods high in ______.
Exercise
Physical activity and ______ promotes bowel elimination by strengthening abdominal and pelvic muscles.
Walks
Nursing assistants can promote normal bowel elimination by offering to take the resident on ______ or making exercise fun for the resident.
Pattern
A resident’s ________ of bowel elimination depends on the person, on their habits, on the amount and type of food and drink they have consumed.
After meals
When does elimination usually occur?
Squatting and leaning forward
What is the best position for bowel elimination?
Supine position
What is the worst position for bowel elimination?
Laxatives
This type of medication promotes elimination and may cause excessive elimination.
Slow
Pain relievers, antacids, and iron supplements may _______ elimination.
Antibiotics
This medication is given to fight bacterial infections but may also cause diarrhea.
Constipation
The inability to eliminate stool or infrequent difficult and painful elimination of hard dry stool.
Constipation
Factors that can cause ______:
decreased fluid intake, poor diet, lack of fiber, inactivity, medications, aging, certain disease, ignoring the urge to eliminate, and holding in stool for long periods of time.
Constipation
Signs and symptoms of ________:
Abdominal swelling, gas, irritability, and a record of no recent bowel movement.
Distention
Abdominal Swelling
Increase; suppositories
Ways to treat constipation include:
_______ the amount of fluid and fiber consumed, increase activity level, and medications including enemas and _______.
Document
It is very important to _______ bowel movements accurately. Every bowel movement should be recorded.
Enema
A specific amount of water with or without an additive introduced into the solon to stimulate the elimination of stool.
Suppository
Medication given rectally to cause a bowel movement
Fecal Impaction
Hard stool that is stuck in the rectum and cannot be expelled
Fecal Impaction
Unrelieved constipation can cause _________ ___________
Fecal Impaction
Signs and symptoms of _________ ___________:
No stool for several days, oozing of liquid stool, cramping, abdominal swelling, rectal pain.
Fingers
If a resident has a fecal impaction a nurse, doctor, or CNA must reach into the rectum with 1 or 2 gloved _____ to break up the mass so it can be passed.
Hemorrhoids
Enlarged veins in the rectum. Can be external or internal.
Hemorrhoids
Causes of _______:
Chronic constipation, obesity, pregnancy, chronic diarrhea, overuse of laxatives or enemas, straining during bowel movements, sitting for long periods on the toilet.
Hemorrhoids
Signs and symptoms of _______:
Rectal itching, rectal burning, pain, bleeding.
Sitz Baths
Treatments for hemorrhoids includes:
Increasing fiber and fluid intake, medications, cold compresses, __________ ________, surgery, and a cream called preparation H.
Diarrhea
Frequent elimination of liquid or semisolid feces
Diarrhea
Signs and symptoms that may accompany ________:
Abdominal cramps, urgency, nausea, vomiting
Diarrhea
Causes of ________:
Bacterial and viral infections, microorganisms in food or water, irritating foods, medications.
Immodium
Diarrhea can be treated with the following:
Medications like ________, increase in water and electrolytes to replace what is lost, and the BRAT diet.
Dehydrated
It is important to remember that residents with diarrhea may become _________ due to excessive loss of water in the stool.
Banana, Rice, Apple, Toast
The BRAT diet is used for patients with diarrhea. What does it stand for?
Fecal Incontinence
The inability to control the bowels leading to involuntary passage of stool. Not a normal part of aging.
No
Is fecal incontinence a normal part of aging?
Fecal Incontinence
Treatment for ___________:
Change in diet, medication, bowel training, and surgery.
Fecal Incontinence
Causes of ______ ______:
Constipation, muscle and nerve damage, loss of storage capacity in the rectum, and diarrhea.
Flatulence
Air in the intestine that is passed through the rectum. Can result in cramping or abdominal pain.
Air; fiber
The following can cause flatulence:
Swallowing ____ while eating
Eating high ______ foods
Eating foods that you can’t tolerate
Antibiotics
Malabsoprtion
Malabsorption
When the body can’t absorb or digest a particular nutrient properly.
Lactose Intolerance
The inability to digest lactase a sugar found in milk and dairy products. A deficiency in the lactase enzyme. It can cause bloating, diarrhea, and flatulence. Resolved with a dairy-free diet or lactaid pills.
Gastrointestinal Reflux Disease
What does GERD stand for?
GERD
A chronic condition where the liquid contents of the stomach come back up into the esophagus. The stomach acid causes damage to the esophagus.
GERD
If ____________ if left untreated it can cases inflammation of or damage to the esophagus, bleeding or ulcers in the esophagus, and scars and tissue damage to the esophagus. It can make swallowing difficult. It can cause ulceration of the esophagus.
Heartburn
What is the most common symptom of GERD
Heartburn
Weakening of the sphincter muscle that joins the esophagus and the stomach causes GERD and ____________.
Antacids
What medications are used to treat GERD?
Medications; 3-4; 2-3
Residents with GERD…
May take ________ like Pepsid or Prevacid
Should have their last meal ____-_____ hours before bed
Not lying down ___-____ hours after eating
Pillows; largest; fast
Residents with GERD…
May have extra _____ to keep the body upright
Have the ____ meal at lunch and eating several small meals throughout the day
Reducing _______ foods, fatty foods, and spicy foods
Smoking; alcohol; loose
Residents with GERD…
May have to stop _______ or drinking _______
May wear _______-fitting clothing
Peptic Ulcer
Raw sores in the stomach caused by excessive acid secretion
Peptic Ulcers
Signs and symptoms of _____ ___________:
Dull/burning pain 1-3 hours after eating in the upper abdomen area
Belching
Vomiting
Bleeding or black and tarry stool
Peptic Ulcer
Treatments for __________:
Antacids, antibiotics (if caused by bacteria), medications, change in diet, bland diet, no smoking, no alcohol.
Bland
What type of diet would a resident with Peptic Ulcers be on?
Irritable Bowel Syndrome
A condition of inflammation of the large intestine. AKA colitis. A condition that causes diarrhea, constipation, or both on a regular basis. It can cause bloating, abdominal pain, and gas. Stress, certain foods, and beverages can cause flare-ups. Caused by problems with communication between the nervous system and the digestive track, causing the bowel to function less efficiently.
Ulcerative Colitis
Chronic inflammatory disease of the large intestine. Caused by ulceration and sores that form in the colon. It is usually a continuous area of damage that may spread.
Ulcerative Colitis
Signs and symptoms of ________ ________:
Cramping, diarrhea, pain on one side of the lower abdomen, rectal bleeding, loss of appetite, weight loss, abdominal bleeding, and it may lead to death.
Irritable Bowel Disease
A group of conditions where the bowel is chronically inflamed and it is caused by an immune response. It includes Ulcerative Colitis and Crohn’s disease.
Intestinal Bleeding or death
What can UC cause if left untreated?
Crohn’s Disease
Inflammation in the small intestine. It usually occurs in patches of damaged tissue. Ulcers and sores in the small intestine.
Medications and surgery
Treatments for UC and Crohn’s
Colostomy
What type of surgery would be performed for UC?
Ileostomy
What type of surgery would be performed for Crohn’s disease?
Colostomy
A surgical opening created into the large intestine created to allow stool to be expelled.
Stoma
The artificial opening through the abdomen that allows for stool to be eliminated. The section of intestine that protrudes from the abdomen.
Colorectal Cancer
Cancer of the gastrointestinal tract specifically the colon and rectum.
Colorectal Cancer
Signs and Symptoms of ________ _________:
Changes in normal bowel patterns
Cramps
Abdominal Pain
Rectal Bleeding
Bowel Resection
Colorectal cancer is treated with surgery including a ______ ______ and colonostomy.
Milk of Magnesia
What is step one if a resident hasn’t had a BM in four days?
