Adaptive Q Bowel Elimination

The primary health care provider prescribes guaiac fecal occult blood testing for a patient who reports constipation and a family history of colon cancer. Which instruction should be provided to the patient?

"Avoid eating red meat for 3 days before testing." A patient who is scheduled for guaiac fecal occult blood testing should be instructed to avoid eating red meat for 3 days before testing to prevent altered test results. This test should be repeated at least three times on three separate bowel movements. The patient should also avoid vitamin C supplements and citrus fruits and juices for 3 days before the test to prevent a false-negative result. The nurse should also instruct the patient to stop taking aspirin, ibuprofen, naproxen, or other nonsteroidal antiinflammatory drugs for 7 days, not 4 days, before the test to prevent a false-positive test result.

A nurse is assessing a patient with diarrhea. Which question will help determine the presence of other symptoms?

"Have you had fever, chills, weight loss, or abdominal pain recently?" Diarrhea may be associated with fever, chills, weight loss, or abdominal pain; therefore, the nurse should ask the patient about the presence of these symptoms. A bloated feeling after eating may be present in patients with indigestion. Patients with constipation may have to strain to have a bowel movement and may have abdominal or rectal pain when they have a bowel movement. Test-Taking Tip: Multiple-choice questions can be challenging, because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.

Which medication is used to treat hyperactive bowel disorder?

Atropine is an anticholinergic drug that inhibits gastric acid secretion and depresses gastrointestinal motility. It is used to treat patients with hyperactive bowel disorder. Polycarbophil is used to treat constipation. Docusate calcium is a stool softener and is used as a short-term therapy to relieve straining on defecation. Casanthranol is used to cleanse and prepare the bowel for diagnostic procedures.

A nurse is caring for four patients. While collecting stool specimens for laboratory examination, the nurse observes the stool colors. Which patient does the nurse suspect to be taking iron supplements?

Black stool Black or tarry stool indicates iron ingestion or gastrointestinal bleeding; therefore, patient B is most likely to be taking iron supplements. White or clay-colored stool indicates an absence of bile. Red stool may indicate gastrointestinal bleeding, hemorrhoids, or ingestion of beets. Brown stool is a normal finding.

The nurse is caring for a 78-year-old man with diarrhea. Which problem is the most important to consider?

Dehydration Diarrhea interferes with absorption time of digestive juices. With frequent loose, watery stools, dehydration becomes a major problem in the older adult. Skin breakdown is another outcome of diarrhea that should be prevented with meticulous hygiene, though it is not the most important factor to consider. Malnutrition and incontinence are not the most important factors to consider in this case.

Which may be recommended for a patient in whom fecal impaction is suspected?

Digital examination of the rectum Digital examination of the rectum may be recommended for a patient in whom fecal impaction is suspected. Gastroscopy is used to gain direct visualization of the upper gastrointestinal tract. A barium swallow is a radiographic examination using an opaque contrast medium (barium, which is swallowed) to examine the structure and motility of the upper gastrointestinal tract. The fecal occult blood test is a stool test to measure microscopic amounts of blood in the feces. These examinations may not be recommended for a patient in whom fecal impaction is suspected. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

Which condition may be caused by frequent straining during defecation?

Hemorrhoids Increased venous pressure from straining at defecation, pregnancy, heart failure, and chronic liver disease cause hemorrhoids. Flatulence is caused by an accumulation of gas in the lumen of the intestines. Improper diet, reduced fluid intake, lack of exercise, and certain medications may cause constipation. Physical conditions that impair anal sphincter function or large-volume liquid stools may cause incontinence.

Which statement about fecal incontinence is correct?

It is the inability to control the passage of feces and gas from the anus. Fecal incontinence is the inability to control the passage of feces and gas from the anus. Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. Fecal impaction results when a patient has unrelieved constipation and is unable to expel the hardened feces retained in the rectum. Constipation is characterized by infrequent bowel movements (less than three per week) and hard, dry stools that are difficult to pass.

During the nursing assessment, a patient reveals that he has diarrhea and cramping every time he has ice cream. He attributes this to the cold nature of the food. However, the nurse begins to suspect that these symptoms are associated with which condition?

Lactose intolerance This patient possibly lacks the enzyme needed to digest milk sugar lactase and therefore is potentially lactose intolerant. Lactose intolerance is not a food allergy but rather a food intolerance that increases peristalsis, not decreases. Based on the circumstances of the condition, irritable bowel is not indicated. Test-Taking Tip: Remember that lact- means milk, as in lactation. Milk-containing products may produce diarrhea in lactose-intolerant patients. Lactose is the sugar (-ose is the suffix indicating sugar), and lactase (-ase indicates enzyme) is the enzyme that breaks down lactose.

A patient is admitted to the hospital with constipation. Which could be a possible reason?

Reduced fluid intake A reduced fluid intake may make the stool hard and difficult to pass, causing constipation. A lack of exercise usually results in constipation due to slow peristalsis. Antibiotic use destroys the intestinal flora and causes diarrhea. Food allergies also tend to induce diarrhea by increasing the peristalsis.

The nurse is caring for a patient with a colostomy. Which intervention is most important?

Selecting a bag with an appropriate-size stoma opening The opening of the appliance should be no larger than 0.15 to 0.3 cm (1/16 to 1/8 in) surrounding the stoma to ensure that the skin around the stoma is protected from the enzymes present in the effluent without impinging the stoma.