NUR 143 GI

1. timing 2. positioning 3. privacy 4. nutrition 5. exercise

5 ways to promote regular bowel habits

Fiber: 25-30g Fluid: 2000-3000mL

A high fiber diet and fluid intake initiate bowel elimination... how much fiber and how much fluid?

anus

A muscular opening at the end of the rectum through which waste material is eliminated from the body; the outlet of the gastrointestinal tract

Check the pH of gastric aspirate.

A nurse is preparing to administer an enteral feeding to a client who has an NG tube in place. which of the following methods should the nurse use to verify correct placements of the NG tube?

Valsalva maneuver

Any forced expiratory effort against a closed airway such as when an individual holds his or her breath and tightens his or her muscles in a concerted, strenuous effort to move a heavy object or change positions in bed.

Feces move more quickly due to fiber, allowing less time for the water to be reabsorbed making the stool soft and easy to pass.

Bulkier feces increase the pressure on the intestinal wall, which serves as a stimulus for peristalsis. Does this soften or harden the stool?

processed cheese, lean meat, eggs, pasta, rice, white bread, iron and calcium supplements

Constipating foods:

Light palpation

Describe the palpation of the abdomen?

Developmental, daily patterns, food and fluid, activity and muscle tone, lifestyle, psychological variables, pathologic conditions, medications, diagnostic studies, surgery and anesthesia

Factors that effect the GI tract (10)

Older adults

Fecal impaction, fecal incontinence, and diarrhea are can all result from lifestyle and physiologic changes in which age group?

"heard in all 4 quadrants"

How do you document normal bowel sounds?

30-50mL

How much water do you flush PEG tube with before/after feeding to keep it patent?

Hydration (skin turgor) Respiratory System Gastric motility (bowel sounds) Site of feed tube (pH)

How to assess someone with a feeding tube?

Incontinence Associated Dermatitis (IAD)

Prolonged contact of the skin with urine or feces leads to a form of moisture-associated skin damage

occult blood test

Test used to detect occult blood (hidden) in stool.

suppository

Used to stimulate the bowel in a constipated patient. This is a conical or oval solid substance shaped for easy insertion into a body cavity and designed to melt at body temperature.

waste residues of digestion: bile, intestinal secretions, shed epithelial cells, bacteria, and inorganic material, seeds, meat fibers, and fat

What are normal findings in constituents of stool?

Increase the bulk

What does fiber (whole grains and bran, dried peas, beans, fresh fruits and veggies) do to fecal matter?

soft, semisolid, and formed

What is a normal finding in consistency of stool?

Pungent; may be affected by foods ingested

What is a normal finding of odor of stool?

Infant: yellow to brown Adult: brown

What is a normal finding of stool color?

constipation

What is often a chronic problem with older adults when it comes to the GI tract?

inspection, auscultation, percussion, palpation It is different because percussion and palpation can stimulate bowel sounds.

What is the order for assessing the abdomen properly? Why is is different?

RLQ

What quadrant is the appendix in?

LUQ

Which quadrant are the stomach and spleen located in?

RUQ

Which quadrant is the liver located in?

Guaiac Fecal Occult Blood Test

a chemical test that detects the enzyme peroxidase in hemoglobin molecules when blood is present in the stool sample

fissures

a linear break on the margin of the anus

ileostomy

allows liquid fecal content from the ileum of the small intestine to be eliminated through the stoma

occult blood

blood that is hidden in the specimen or cannot be seen on gross examination

paralytic ileus

complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction

peristalis

contractions of smooth muscle that pushes food through the digestive system and occurs every 3-12 minutes, moving waste products along the length of the intestine continuously

constipation

dry, hard stool; persistently difficult passage of stool; and/or the incomplete passage of stool

flatulence

excessive formation of gases in the stomach or intestine

stool

excreted feces

flatus

intestinal gas released from the anus

enema

is the introduction of a solution into the large intestine, usually to remove feces

laxatives

medications or foods given to stimulate bowel movements

diarrhea

passage of more than three loose stools a day; an increased frequency and change in consistently

bowel-training program

program that manipulates factors within a person's control (timing of defecation, exercise, diet) to produce a regular pattern of comfortable defecation without medication or enemas; this is for patients with a history of chronic constipation and impaction

fecal impaction

prolonged retention or an accumulation of fecal material that forms a hardened mass in the rectum

defaction

refers to the emptying of the large intestine

feces

solid waste products that have reached the distal end of the colon and are ready for excretion

hemorrhoids

swollen, twisted, varicose veins in the rectal region

bowel incontinence

the inability to control the excretion of feces

fecal incontinence

the inability to control the passage of feces and gas through the anus

stoma

the opening of the ostomy attached to the skin

defection

the process of bowel of bowel elimination; a bowel movement

colostomy

the surgical creation of an artificial excretory opening between the colon and the body surface; visual examination of the sigmoid colon, the rectum, and the anal canal

endoscopy

visual examination of a body cavity or canal using a specialized lighted instrument called an endoscope