N 336 Bowel Elimination student 2011

N 336 Bowel Elimination student 2011 - Jacqueline Tulley RN...

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Unformatted text preview: Jacqueline Tulley, RN, MSN, ACNP Defecation: process of eliminating waste from bowels Feces: stool – semisolid mass of fiber, undigested food, inorganic (Ca# etc) material, bacteria and water Flatus: gas produced during digestion Fecal material reaches the rectum Distention stimulates stretch receptors to initiate contraction of the sigmoid colon and rectal muscles Internal anal sphincter relaxes Sensory impulses cause voluntary “bearing down” External anal sphincter relaxes Range from several times daily to once weekly ◦ No excessive urgency ◦ No blood ◦ Minimal effort and no straining ◦ Without laxatives History ◦ Bowel patterns ◦ Previous surgeries ◦ Laxatives ◦ Other meds ◦ Travel ◦ Interpersonal contacts ◦ Family hx Observe ◦ Amount ◦ Stool color  Clay or white  Black or tarry  Red  Pale ◦ Stool consistency  Hard, dry  Diarrhea Observe (cont.)  Stool shape  Stool odor  Stool constituents Auscultate Percuss Provide privacy Correct position • Seated upright Timing • Often occurs after meals • Some clients may need assistance Encourage fluids Proper diet • Fresh fruits, vegetables, whole grains, fiber Exercise • 3-5 times a week • Range of motion for clients on bedrest Diarrhea Constipation Fecal impaction Fecal incontinence Flatulence Bowel diversions A symptom, not a disease Etiology ◦ Decreased fluid absorption ◦ Increased fluid secretion ◦ Motility disturbances Clinical manifestations ◦ Chronic ◦ Acute Infectious diarrhea ◦ Bacterial  E. Coli  Salmonella  Clostridum difficile ◦ Viral  Rotovirus, Norwalk virus ◦ Parasitic  Giardia lamblia Monitor stools to quantify diarrhea Assess and monitor for fluid imbalance Monitor for alterations in perineal skin integrity Frequency, amount, color, consistency Monitor I & O, body weight, VS Skin turgor, mucous membranes Check electrolytes Assess perineal area for irritation and excoriation Provide assistance with hygiene...
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This note was uploaded on 05/30/2011 for the course NUR 336 taught by Professor Patriciakelly during the Spring '11 term at St. Xavier.

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N 336 Bowel Elimination student 2011 - Jacqueline Tulley RN...

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