Bowel Fall 10_students

Bowel Fall 10_students - K imberly Glenn M N, RN, CPN...

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Kimberly Glenn MN, RN, CPN Clinical Associate Professor Nurs 312 Foundations 1
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S AFE - System Specific Physiology Small Intestine: duodenum, jejunum, ileum Duodenum: processes chyme Ileum: absorbs water, fat, bile salts If small intestine is impaired, then digestive process is impaired Peristalsis is disrupted; less absorption; fluid & electrolytes are disrupted 2 Men
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S AFE - System Specific Physiology Large Intestine: cecum, colon, rectum Functions (3) Secretes HCO3 Eliminates K+ What happens if peristalsis is fast? Less water absorbed and stools watery What happens if peristalsis is slow? More water is absorbed and constipated 3
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S AFE - System Specific Physiology: Risk factors Factors Effect on elimination Age related issues Diet Fluid intake Physical activity/inactivity Personal/psychological factors Pain Medications Older: loose muscle tone Bulk: keeps stool soft, transports waste Need 6-8 glasses/day Stress increases digestion Surgery can temp cease peristalsis (paralytic ileus; 24-48 hrs after surgery, temporary) Can or peristalsis; chronic use of laxatives lazy bowel; cause GI bleed (NSAID) 4
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Assessment Bowel elimination- general ?? Usual pattern of elimination: when, how much, appearance, routines Recent changes in elimination: related to pattern; Aids to elimination: what helps you ‘go’ GI symptoms: diarrhea, constipation, vomiting, nausea 5
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S AFE : System Specific Assessment Physical Mouth: tongue, gums, teeth Abdomen: shape, & color. Watch for peristalsis (not normal) . Observe for scars, venous patterns, lesions, stomas. Bowel sounds: Hypoactive: <5/min (? Paralytic ileus) Hyperactive: 35 or>/min (?small bowel obstruction) Rectum: look for discoloration, inflammation & hemorrhoids 6
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S AFE: System Specific Assessment: Stool appearance Stool Color Significance Brown/green Frank blood ‘Clay’ colored (modeling clay) Black/tarry Pale with fat Translucent mucus Normal Lower GI bleed Absence of bile Upper GI bleed, or iron Malabsorption of fat (CF) Spastic constipation, colitis 7
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S AFETY – System Specific Assessment - Lab Lab Test Normal value Nursing management Fecal specimen for organism (ova, paracite) Negative Non-sterile Occult blood (Guiac) Negative Get sample from 2 different portion of stool Total bilirubin 0.1-1.0 Rises with any type of jaundice Amylase: measure of pancreatic function 56-190 IU/L ( not testable ) Elevated is bad Alkaline phos: measure of liver & intestinal function 30-85 ImU/mg ( not testable Elevated is bad 8
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S AFETY System Specific Assessment-Diagnostics Diagnostic Test Pre-procedure Nursing management Post-procedure Nursing Management Upper GI/Barium Swallow: Visualizes structural motility of
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This note was uploaded on 02/16/2011 for the course NURS 312 taught by Professor Glenn during the Fall '10 term at South Carolina.

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Bowel Fall 10_students - K imberly Glenn M N, RN, CPN...

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