Bowel Elimination - Nursing 101 with Mary K at Berkshire Community College - StudyBlue Flashcards 46-3). urinate again after first Chyme enters the large intestine by waves of peristalsis through the ileocecal valve, a circular muscular layer that prevents regurgitation. Constipation is a symptom, not a disease (Box 46-1). Irritation within the colon results in increased mucus secretion. ATI Questions - Nutrition, Medication Administration, Bowel Elimination, Urinary Elimination In addition to ingested fluids and foods, the GI tract also receives secretions from the gallbladder and pancreas. This may be done by a person who is experiencing constipation or by a medical professional who is assisting a person with a spinal cord injury or another health problem that results in a problem with defecation. Laxatives often influence the efficacy of other medications by altering the transit time (i.e., the time the medication remains in the GI tract and is available for absorption). 2) Do nothing; this is normal. Fecal impaction results from unrelieved constipation. The condition of Many conditions cause diarrhea. Contraction and relaxation of the internal and external sphincters, innervated by sympathetic and parasympathetic stimuli, aid in the control of defecation. A blue color indicates blood in the stool. rich foods, small amounts of c. recent excessive intake of milk products. c. recent excessive intake of milk products. (3X a day), abdominal cramps, decrease in peristalsis or • Describe three functions of the large intestine. elimination fecalma. Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. Segmentation and peristaltic movement in the small intestine facilitate both digestion and absorption (Fig. beverages, developing fluid Caused by straining during This prevents constipation and decreases unpredictable elimination. Describe nursing implications for common diagnostic examinations of the gastrointestinal tract. This embarrassment often causes patients to ignore the urge to defecate, which begins a vicious cycle of constipation and discomfort. oral and topical estrogen may Irregular bowel habits and ignoring the urge to defecate, Chronic illnesses (e.g., Parkinson’s disease, multiple sclerosis, rheumatoid arthritis, chronic bowel diseases, depression, diabetic neuropathy, eating disorders (McWilliams, 2010), Low-fiber diet high in animal fats (e.g., meats, dairy products, eggs) (McWilliams, 2010), Low fluid intake, which slows peristalsis (Holman et al., 2008), Anxiety, depression, cognitive impairment (McWilliams, 2010), Lengthy bed rest or lack of regular exercise (McWilliams, 2010), Slowed peristalsis, loss of abdominal muscle elasticity, and reduced intestinal mucus secretion experienced by older adults (Durston, 2009), Neurological conditions that block nerve impulses to the colon (e.g., spinal cord injury, tumor) (Kyle, 2007c), Illnesses such as hypothyroidism, hypocalcemia, or hypokalemia, Medications such as anticholinergics, antispasmodics, anticonvulsants, antidepressants, antihistamines, antihypertensives, antiparkinsonism drugs, bile acid sequestrants, diuretics, antacids, iron supplements, calcium supplements, and opioids slow colonic action (Lehne, 2010). You suspect impaction when a continuous oozing of diarrhea stool occurs. A pregnant woman’s frequent straining during defecation or delivery results in formation of permanent hemorrhoids. 16. Normal Age-Related Changes in the Gastrointestinal Tract. List nursing interventions that promote normal elimination. Older adults often experience changes in the GI system that impair digestion and elimination (JBI, 2008) (Table 46-1). Discuss psychological and physiological factors that influence the elimination process. Depending on The action of the anesthetic slows or stops peristaltic waves. Mechanical bowel obstruction: Having chronic diarrhea of Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. Chapter 30: Promoting Bowel Elimination Test Bank MULTIPLE CHOICE 1. Pre-test probability and post-test probability (alternatively spelled pretest and posttest probability) are the probabilities of the presence of a condition (such as a disease) before and after a diagnostic test, respectively. decrease or quit smoking, So, nursing school is behind you and all that’s left is to pass the NCLEX-RN® and you’re off to the career of your dreams. periods of time on the toilet. A busy work schedule sometimes prevents the individual from responding appropriately to the urge to defecate, disrupting regular habits and causing possible alterations such as constipation. A number of diseases of the GI tract are associated with stress, including ulcerative colitis, irritable bowel syndrome, certain gastric and duodenal ulcers, and Crohn’s disease. Study 58 pretest ati flashcards from mack t. on StudyBlue. -post void residual volume The rectum is the final portion of the large intestine. However, a number of conditions such as hemorrhoids, rectal surgery, rectal fistulas, and abdominal surgery result in discomfort. Blood & mucus in stools, Clearance was 2.7 times higher, and elimination half-life was 34% lower in the presence of ATI. Constipation is a significant health hazard. Because the efficacy of dose escalation to overcome antibodies is unclear, we assessed the impact of this strategy to overcome immunogenicity … ... elimination of the exposure. Her two chil-dren live with their families in a city approximately 150 miles away. urinating as soon as you need urination, instructing patient to medications: alpha blockers, The mouth mechanically and chemically breaks down nutrients into a usable size and form. cancer drugs, lactose Tosca Cybil A. Torres, RN, MAN Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Straining during defecation causes problems for the patient with recent abdominal, gynecological, or rectal surgery. Prioritize post-test care for patients having endoscopic procedures. -cytoscopy Chapter 55 Assessment of the Gastrointestinal System Donna D. Ignatavicius Learning Outcomes Safe and Effective Care Environment 1. anus. 46-1). • List nursing interventions that promote normal elimination. Understanding Elimination in Nursing Chapter Exam Instructions. Abdominal x-ray, abdominal An obvious sign of impaction is the inability to pass a stool for several days, despite the repeated urge to defecate (Chien and Bradway, 2010). At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out (Huether and McCance, 2008). digital rectal exams, post void 2. When diarrhea is the result of a foodborne virus, the goal usually is to rid the GI system of the pathogen rather than slow peristalsis. Assess patients for complications of diagnostic tests. Answer: A. with magnesium. residual volume test, 24 hr The duodenum and jejunum absorb most of the nutrients and electrolytes. An increase in fluid intake with the use of fruit juices softens stool and increases peristalsis. Personal elimination habits influence bowel function. Another common causative agent of diarrhea is Clostridium difficile (C. difficile), in which symptoms range from mild diarrhea to severe colitis. swelling around anus, impairment of peristalsis in the question. help in women, avoiding Assessing and Managing the Client with an Alteration in Elimination. These mass movements occur only three or four times daily, with the strongest during the hour after mealtime. that can cause this: C Diff., Chapter 30: Promoting Bowel Elimination Test Bank MULTIPLE CHOICE 1. For example, conditions such as inflammation, surgical resection, or obstruction disrupt peristalsis, reduce the area of absorption, or block the passage of chyme. area. Knowledge of these factors helps to anticipate measures required to maintain a normal elimination pattern. caffeinated and alcoholic Log In or, Food intolerance is not an allergy but rather a particular food that causes the body distress within a few hours of ingestion. Bowel Elimination means eliminating or getting rid of waste products or solid wastes from the body naturally. For example, arteriosclerosis causes decreased mesenteric blood flow, thus decreasing absorption from the small intestine (Meiner, 2011). Some people will need to use laxatives along with bowel retraining. Describe three functions of the large intestine. Bulk-forming foods such as whole grains, fresh fruits, and vegetables help flush the fats and waste products from the body with more efficiency (Holman et al., 2008). With stimulation of peristalsis, bulk foods pass quickly through the intestines, keeping the stool soft. The sphincter prevents reflux of stomach contents back into the esophagus. List nursing diagnoses related to alterations in elimination. • Describe common physiological alterations in elimination. Medications such as wiping carefully front to back, An inadequate fluid intake or disturbances resulting in fluid loss (such as vomiting) affect the character of feces. The nurse has assessed that a patients stool has changed from brown to dark black and sticky. The GI tract is a series of hollow mucous membrane–lined muscular organs. It occurs in a variety of settings. 4 pages • Suck on hard candy or chew gum. (Courtesy Hollister Incorporated, Libertyville, Ill.), Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window). • Irregular bowel habits and ignoring the urge to defecate, • Chronic illnesses (e.g., Parkinson’s disease, multiple sclerosis, rheumatoid arthritis, chronic bowel diseases, depression, diabetic neuropathy, eating disorders (McWilliams, 2010), • Low-fiber diet high in animal fats (e.g., meats, dairy products, eggs) (McWilliams, 2010), • Low fluid intake, which slows peristalsis (Holman et al., 2008), • Anxiety, depression, cognitive impairment (McWilliams, 2010), • Lengthy bed rest or lack of regular exercise (McWilliams, 2010), • Slowed peristalsis, loss of abdominal muscle elasticity, and reduced intestinal mucus secretion experienced by older adults (Durston, 2009), • Neurological conditions that block nerve impulses to the colon (e.g., spinal cord injury, tumor) (Kyle, 2007c), • Illnesses such as hypothyroidism, hypocalcemia, or hypokalemia, • Medications such as anticholinergics, antispasmodics, anticonvulsants, antidepressants, antihistamines, antihypertensives, antiparkinsonism drugs, bile acid sequestrants, diuretics, antacids, iron supplements, calcium supplements, and opioids slow colonic action (Lehne, 2010). plenty of fluids, fiber Itching, irritation in anal Khan Academy is a 501(c)(3) nonprofit organization. Supportive nursing care respects the patient’s privacy and emotional needs. Gastroparesis, or delayed gastric emptying, may be treated with diet, drugs including metoclopramide, erythromycin, domperidone, parenteral nutrition, or gastric electrical stimulation. Sequential Easy First Hard First. Each fold contains an artery and vein that can become distended from pressure during straining. Patients who are debilitated, confused, or unconscious are most at risk for impaction. Slow peristaltic contractions move contents through the colon. Consult a dietitian when diarrhea occurs (Tabloski, 2009). • Use critical thinking in the provision of care to patients with alterations in bowel elimination. Family Hx Infants and older adults are particularly susceptible to associated complications (see Chapter 41). having 3 loose liquid, watery scheduling bathroom visits, Older adults also lose muscle tone in the perineal floor and anal sphincter (Holman et al., 2008). First take the Nutrition for Nursing Online Practice Test A to determine what areas you need to study. Being obese, intolerance, fructose, artificial 1-4 Up to 40% of patients experience primary nonresponse to these medications, and up to 46% additionally experience secondary loss of response. ATI: Fundamentals 1 Practice Test questionto use the nursing process correctly, the nurse must first answerobtain information about the client questiona 3 year old child has had multiple ... the nurse expects the bowel sounds to be.. answer. See Chapter 44 for interventions to decrease diarrhea caused by enteral feedings. The colon secretes bicarbonate in exchange for chloride. Here bacteria convert fecal matter into its final form. to, instructing patient to passage of bowel contents Etiology Caused by viruses, bacteria and Practice Bowel Nclex Elimination Questions from the latest editions of fundamental of nursing book, plus hundreds of more Nclex Questions The bacteria Post-test probability, in turn, can be positive or negative, depending on whether the test falls out as a positive test or a negative test, respectively. In addition, nerve impulses to the anal region slow, causing some individuals to become less aware of the need to defecate. The condition of having 3 loose liquid, watery bowel movements every day. decrease of causative Youll need to set a time each day in which you try to have a bowel movement. CH 37 Bowel Elimination summary is based on the information provided by the Fundamentals of Nursing textbook. Individuals need to recognize the best time for elimination. no feminine products in genital medications, ambulation, The small intestine has three sections: the duodenum, the jejunum, and the ileum. Three specimens from three different bowel movements are required. • Increase activity levels. Inhaled anesthetic agents block parasympathetic impulses to the intestinal musculature. List nursing interventions included in bowel training. If an impaction is suspected, gently perform a digital examination of the rectum and palpate for the impacted mass (Steggall, 2008). Chyme mixes with digestive juices (e.g., bile and amylase). The anal canal is richly supplied with sensory nerves that help to control continence. The muscular tissue of the colon allows it to accommodate and eliminate large quantities of waste and gas (flatus). CH 37 Bowel Elimination summary is based on the information provided by the Fundamentals of Nursing textbook. Diagnostic examinations involving visualization of GI structures often require a prescribed bowel preparation (e.g., medications, cathartics, and/or enemas) to ensure that the bowel is empty. Medications and the Gastrointestinal System. Food allergies and intolerances increase peristalsis and cause diarrhea. can also affect this. Also called piles, swollen veins For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. In addition, patients with histories of cardiovascular disease, diseases causing elevated intraocular pressure (glaucoma), and increased intracranial pressure need to prevent constipation and avoid using the Valsalva maneuver. In a hospital or extended care setting, patients sometimes share bathroom facilities with a roommate with different hygienic habits. Laxative overuse can also cause serious diarrhea, leading to dehydration and electrolyte depletion. Poor fluid intake increases the risk of constipation because of greater resorption of fluid in the colon, resulting in hard, dry stools (Kyle, 2007a). The blockage can happen in the upper portion or the lower portion of the intestine. Chyme is normally a soft, formed mass. The large intestine begins at the cecum. ATI Pharmacology Practice Exam The Gastrointestinal System A health care professional should question the use of misoprostol (Cytotec) for a patient who has which of … Slowing of peristalsis during the third trimester often leads to constipation. A high fiber diet promotes normal bowel elimination. weight loss, persistent surgery if these interventions Physical conditions that impair anal sphincter function or control cause incontinence. Fluid intake should be increased to aid bowel elimination. If the patient’s condition permits, raise the head of the bed to assist the patient to a more normal sitting position on a bedpan, enhancing the ability to defecate. Bowel retraining works by teaching new skills or strategies to develop a routine and predictable schedule for evacuation. Substances, such as plant fiber, that the small intestine cannot digest empty into the cecum at the lower right side of the abdomen. Measures designed to promote normal elimination also need to minimize discomfort for the patient. Most people are able to have regular bowel movements within a few weeks. Little water is left to soften and lubricate the stool. ActiFlo™ Indwelling Bowel Catheter System. The bowel program includes several steps to help you have regular bowel movements. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of elimination in order to: