NUR 204 Bowel Elimination - exam 5 check book for enema types
flushable reagent pad
place a pad in the toilet 3 days in a row pad changes color when blood is detected record results yourself
large volume enema (cleansing)
effective treatment for constipation as it cleanses a large part of the colon. The fluid amount used in this type is 500-1,000 ml. The doctors may ask you to hold the fluid in your anal opening for a long time to release the stool completely.
how often to replace food containers
every 24 hours
how often to rinse feeding containers
every 8 hours
if you feel resistance while inserting the enema
stop and alert the provider
ostomies can be
temporary or permanent
the nurse is caring for a client who has cancer of the rectum and is scheduled for an abdominoperineal resection with creation of a colostomy. for which type of surgery would the nurse prepare this client?
temporary transverse loop colostomy
colostomy
the surgical creation of an artificial excretory opening between the colon and the body surface
older adults start having decreased peristalsis
the wave goes down sphincter relaxes
the nurse provides post op teaching about colostomy care to a client who underwent surgery for cancer of the colon. the education would include which instruction related to skin care around the stoma?
wash the area with soap and water then apply a protective ointment
preventative screening
fecal occult blood test sigmoid and colon scopy
type 6 stool is
fluffy with ragged edged, mushy inflammation
the nurse provides education to a pt abt how to prevent constipation. the nurse concludes that the teaching is understood when the client says
" I should drink at least 6 glasses of water /day" " I can include bran muffins in my daily breakfast" " I will walk every day"
the nurse provides education to a client with a new colostomy bag. which client statement indicated correct understanding of teaching?
"i will irrigate it during the late morning, the same time as I had a bowel movement everyday before my surgery"
which instruction would the nurse include regarding an ileal conduit when providing a clients discharge teaching?
"maintain fluid intake of at least 2 L a day"
length of the duodenum
1-2 ft
enema insertion depth for infants
2.5-3.75 cm (1-1.5in)
1 in =
2.54 cm
the small intestine is
24 ft long
guaiac test
3 samples smear sample on lab color changing chemical detects blood
fecal occult blood test
3 small samples taken 1 day apart a special diet prescribed 48-72 hours before the test
regular enema height
30 cm (12 in)
high enema height
30-45 cm (12-18 in)
A high cleansing enema is prescribed for a client. What is the maximum height at which the container of fluid should be held by the nurse when administering this enema?
46 cm (18 in)
length of large intestine
5-6 ft
what is the recommended length of insertion of the enema tube in a child of 3 years?
5-7.5 cm
enema insertion depth for children
5-7.5 cm (2-3in)
length of the jejunum
6-8 ft
low enema
7.5 cm (3 in)
enema insertion depth for adults and adolescents
7.5-10 cm (3-4 in)
loop stoma
A loop stoma can be made in the ileum ("loop ileostomy") or colon ("loop colostomy"). A loop stoma often is made when the stoma will be temporary. However, not all loop stomas are temporary
coolin enema
If your temperature is extremely high, the doctor may use a cooling enema to lower your body temperature. It is not a common procedure.
small volume enema (cleansing)
It is used to clean the lower part of the colon. The fluid amount used is less than 500 ml. It is recommended to people who are not constipated from the upper part of the colon.
a lack of bowel sounds means the patient should be
NPO
enemas are used to
Promote bowel cleansing Relieve constipation Empty the bowel for diagnostic testing or surgery Begin a bowel training program
cleansing enema
This procedure is water-based. It includes holding the injection in the rectum for a short time to flush the colon thoroughly. Your body then releases the stool within a few minutes.
what is the rationale for auscultating the bowel in all 4 quadrants before advancing to a clear liquid diet?
You must hear bowel sounds in all 4 quadrants
type 3 stool is
a sausage with cracks on the surface normal
organs in the right iliac region
appendix cecum
BRAT diet
bananas, rice, applesauce, toast
lower GI series
barium enema radiologic study
upper GI series tests
barium swallow radiologic study
a client has a surgically created colostomy, which is the most effective nursing intervention initially to help the client accept the colostomy
begin to teach self care of the colostomy by introducing equipment.
fiber-optic endoscope
biopsy electrosurgical treatment photos or videos
which test result would confirm the diagnosis of benign prostatic hyperplasia
biopsy of prostatic tissue
Organs in the Hypogastric region
bladder sigmoid colon female RE organs
which assessment finding would the nurse report to the provider when giving immediate post op care to a client with a newly placed ostomy?
blanching, dark red to purple color of the stoma
what are normal symptoms after an enema?
bloating and cramping
if you do not hear any bowel sounds then
call the provider
large intestines consist of
cecum ascending colon transverse colon descending colon sigmoid colon rectum anus
Fecal immunochemical test (FIT)
collect 1-3 samples smear on card and send to lab antibodies detect blood
colonoscopy
colonscope - video - biopsy
Opiods cause
constipation
soapsuds enema
creates intestinal irritation to stimulate peristalsis, only pure castile soap is safe
nasogastric intubation
decompression of the GI tract Administration of med or enteral feedings compression of internal hemmorhage gastric lavage
which information would the nurse include in the teaching plan for a client who will receive TPN at home?
demonstrate capillary glucose levels
organs of the left lumbar region
descending colon L kidney
organs in the left iliac region
descending colon sigmoid colon
antibiotics cause
diarrhea
Abnormal Defecation Patterns
diarrhea incontinence constipation impaction flatuelence
return flow enema
done on people with trouble pooping due to intestinal gas. In this method, a large fluid volume is used, which is injected in 100-200 ml increments. The fluid is then drawn out along with the flatus (intestinal gas). This process is repeated three to five times until the gas is entirely out.
which dietary instruction would be beneficial to a client who has undergone a hypophysectomy and has difficulty passing stools?
drink plenty of water
most nutrients are absorbed in he
duodenum jejunum
Valsalva maneuver
forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure
organs in the right lumbar region
gallbladder liver R colon
upper endoscopy examinations
gastroscopy duodenoscopy fiber-optic endoscope
Diet for constipation
high fiber increased fluids hot liquids prune/ fruit juice
types of pouches for illeostomy
illeoanal pouch kock pouch
when inserting a catheter to irrigate a colostomy the nurse meets some resistance. which action would the nurse take?
instill a small amount of solution from the irrigating container into the stoma
colostomys can be of the
sigmoid descending transverse ascending
diet for diarrhea
small bland meals tepid liquids BRAT diet
type 5 stool is
soft blobs with clear cut edges - easily passed lack of fiber
organs in the left hypochondriac region
spleen colon kidney pancreas
a colostomy is a
stoma in the colon
Illeostomy is a
stoma in the small intestine
organs in the epigastric region
stomach liver pancreas spleen adrenal glands
fecal lab tests
stool culture fecal occult blood test
regular pan
•higher sides, more uniquely shaped, similar to a standard toilet seat; alllow the patient to be raised to a more normal position for elimination.
fracture pan
•shallow, used for pt with hip/back fractures or to promote comfort in patients who may have to lie flat or are unable to raise their buttocks off the bed. Placed with the handle toward the patients feet.
which information about benign prostatic hyperplasia is important for the nurse to consider when caring for a client with the condition?
it predisposes hydronephrosis
Organs in right hypochondriac region
liver gallbladder R kidney small intestine
types of bowel diversions
loop colostomy double barrel colostomy
barium swallow
radiographic examination of the esophagus, stomach, and small intestine after oral administration of barium sulfate
medicated enema
relieves the intestinal mucosa, and the medicines balance the electrolytes and fight infections. This procedure is done after cleansing enemas.
type 2 stool is
sausage shaped and lumpy somewhat constipated
type 4 stool is
sausage with cracks normal
type 1 stool is
separate hard lumps like nuts very constipated
type 7 stool is
watery no solids inflammation or infection
the client is undergoing an enema and experiences cramping, what action should the nurse take?
lower the height of the enema bag
the nurse is preparing to administer an oil-retention enema and understands that it works primarily by which action?
lubricating the sigmoid colon and rectum
what type of fluid is used in an oil retention enema
mineral oil
organs in umbilical region
navel part of S intestine duodenum
which response would the nurse give to a client who asks if having a hemicolectomy means wearing a pouch and having bowel movements in an abnormal way?
no, part of the colon is removed and the rest is attached
what type of fluid is used in a cleansing enema
normal saline solution
ostomy appliances for care
one or two piece used to protect skin, collect drainage, control odor
oil retention enema
or people whose stool has hardened. The oil-retention enema softens the stool. The enemas used in this process usually contain 90-120 ml solution. The doctor may ask you to retain the solution for at least an hour to get effective results.