Elimination and diagnostic tests.docx - Elimination and...

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Elimination and diagnostic tests Factors affecting bowel movements o Diet High fiber o Fluid intake 3L but do not overload with certain conditions o Physical activity Keep things moving o Psychosocial Factors Stress o Personal habits Lack of privacy in healthcare Bedpans, bedside toilets o Positioning Left side laying (think of colon side) o Pain People don’t want to strain and position when in pain o Pregnancy o Surgery & anesthesia Puts system to sleep o Medications Can constipate or cause diarrhea when they’re trying to prevent constipation o Age Gastrocolic reflex stimulated 30 minutes after morning meal in elderly They have to go when they have to go! People are obsessed with elimination Have you had a good BM? Causes of constipation o Overuse of laxatives
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Decrease peristaltic activity in colon o Age o Lack of fluid o Lack of fiber o Immobilization o Sedentary o Pregnancy Space diminishes and everything gets compacted o Medication Causes of diarrhea o Gastroenteritis viral and bacterial Foam doesn’t kill spores o Antibiotic therapy C-diff results from antibiotic therapy If you see a patient receiving antibiotics, wash your hands with soap and water instead of using foam when passing meds o Inflammatory bowel disease o IBS Constipation complications o Fecal impaction Not enough fluid intake o Hemorrhoids Straining Consider when thinking about enemas and delegation Also make sure they’re not at risk of bleeding from meds o Rectal fissures Consider when thinking about enemas and delegation Also make sure they’re not at risk of bleeding from meds o Bradycardia o Hypotension
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Diarrhea complications o Dehydration …which leads to constipation o Fluid and electrolyte imbalance Know defined limits o Skin breakdown around the anal area A lot of medications can cause this Prescription needed for barrier cream or skin care product Causes and symptoms of fecal impaction o Liquid seepage and absence of stool CARDINAL SIGN: little bit of diarrhea o Nonproductive desire to defecate o Rectal pain o Feeling of illness o Anorexia o Distended abdomen o Nausea and vomiting o Scenario: NPO waiting for a procedure, but they didn’t have a BM before – lack of fluids, maybe immobile, pain meds, etc… o Disimpaction Consider meds, bleeding Paralytic ileus o Intestinal obstruction caused by: Bowel manipulation in OR Electrolyte imbalance Wound infection Effects of meds o Assess with bowel sounds
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If we do not hear bowel sounds in each quadrant, that defines a medical emergency Before we can identify a true ileus, you have to listen to each quadrant for 5 minutes Nurse must be first to report o Treatment Nasogastric tube to decompress stomach to give bowels a break o If it is not treat….
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  • Summer '17
  • Bowel obstruction

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