Exam 4 review sheet.docx - Bowel Elimination...

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Bowel Elimination: Gastrointestinal System: breakdown, absorption, elimination-Inspection, Auscultation, Palpation, and PercussionInspection: Abdomen and stool sample Auscultation: Abdomen and listen for bowel sounds in the 4 quadrantsPalpation: Abdomen and rectum Percussion: Abdomen and start over the costovertebral angle (kidney)Gastrointestinal Tract Route:MouthEsophagusStomachSmall intestineLarge intestineAnusDefecationAbnormal Bowel Patterns:Diarrhea:is an intestinal disorder that is characterized by an abnormal frequency and fluidity of fecal evacuations.Clostridium difficile (C. difficile): often called "C. diff," is a bacterium that causes diarrheaIncontinence:refers to the loss of ability to voluntarily control fecal and gaseous discharges through the anus. VOCAB:Constipation:Infrequent or difficult bowel movements; fewer than three bowel movements per weekValsalva maneuver:Occurs when a person’s breath is held while bearing downImpaction:Hard fecal mass in the rectum or colon that the patient is incapable of expellingFlatulence:Production of a mixture of gases in the intestine; byproducts of digestionHemorrhoids:are swollen and inflamed veins in the anus or lower rectum.Ostomy:the surgically created opening in the gastrointestinal, urinary, or respiratory organs, which is exited onto the skin.
Stoma:the actual protuberance of the organ through the skin. Colostomy:surgically created when a portion of the colon (large intestine) or the rectum is removed and the remaining colon is brought through the abdominal wall.Colostomies and Ileostomy Locations:Changing the ostomy pouch is critical to:-Maintain skin integrity-Assess stoma healing and integrity-Prevent odors-Promote comfort-Maintain or increase self-esteem and dignity
Factors affecting Bowel Elimination:-Age-Diet-Physical Activity-Psychological factors-Personal Habits-Position during defecation-Pain-Pregnancy-Surgery and anesthesia-Medications-Diagnostic testsHealth History:-Elimination pattern-Characteristics of stool-Routines-Use of medications or enemas-Presence of bowel diversion-Changes in appetite-Diet and fluid intake-Prior medical history-Emotional state-Exercise patterns-Presence of discomfort
-Social history-Mobility and dexterityEnemas:Enema:introduction of solutions into the rectum and sigmoid colon via the anus. The increase in the volume of fluid rapidly distends the colon and irritates the intestinal mucosa lining, stimulating complete evacuation of the lower intestinal tract.Common uses of enemas:-Relief of constipation-Removal of impacted feces-Emptying of the bowel before diagnostic tests or surgery-Beginning a program of bowel training-Instill medicationsTypes of Enemas:Saline: safest, exerts same osmotic pressure as fluids in interstitial space surrounding bowelSoapsuds:creates intestinal irritation to stimulate peristalsis, only pure castile soap is safe Tap water: hypotonic, escapes into interstitial spaces, volume stimulates defecation-never repeat-fluid overload

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