Stool
Cleansing Enema
relieve constipation or empty bowel. Prevent escape of fecal material during a procedure. Promotes visualization of intestinal tract. Helps establish regular bowel function. Tap water, NSS, soap solution, hypertonic solution
Laxatives
DO NOT TAKE IF ABDOM PAIN
ileostomy
Surgery that makes temp or perm opening called a stoma. Stoma is a pathway from the lowest part of the small intestine called the ileum to the outside of the abdomen. This helps solid waste & gas exit the body without passing the colon or rectum.
Culture
Suspects infection from bacteria, virus, fungi, parasites. Obtain stool prior to initiation of anti-infective therapy.
Colostomy
Temporary or Permanent. In ANY portion of the colon. Colon beyond colostomy is disconnected. Anus no longer is an exit. Problems:Diverticulitis, Inflammed bowel disease, cancer, birth defect, trauma. Preop care:Ostomy nurse mark abdomen. Lying, sitting, standing. Educate patient. Enema night before, Consent form, IV
Odor
Unpleasant due to presence of bacteria. Pungent-affected by food. Cancer, Blood
Traveler's diarrhea
diarrhea caused by ingesting contaminated food or water; so called because it is often contracted by travelers in countries where the water supply is contaminated
Timed specimen
1st stool is start of collection. Entire or part of stool. Require volume of every stool passed in a period. Follow lab instructions.
Shape
2.5 cms in diameter. tubular shape of colon
chronic diarrhea
3-4 weeks. Cause:crohns, IBS, bowel tumor, alcoholism. Antidiarrheal meds only used for CHRONIC. Loperamide:acts directly on smooth muscle to decrease paristalsis
Bristol Stool Chart
7 categories. Made by Englands Bristol Royal Infirmary. Based on study of 2000 people.
Constipation
Dry hard stool, persistently hard to poop. Less than 3 a week. Excessive straining. Rectal pain. Distention, anorexia, pain, pressure. Caused by meds, diet low fiber, low fluid, anesthesia, immobility, sedentary, spinal injury, depression
Laxatives & Cathartics
Empty intestinal tract. Softens stool. Draws water into intestines. Increases peristalsis. Cathartics are stronger on intestines. Castor oil, senna, & dulcolax act chemically by starting peristalsis.
direct visualization studies
Endoscopy, Colonoscopy, Ultrasound, Barium enema, Upper GI series, MRI, CT scan
diarrhea
Frequent fluidly stools(more than 3 daily). Hyperactive bowel sounds. Urgency, bad pain. Stool pass too fast thru intestinal tract. No time for absorption of nutrients
Flatulence
Gas mixing in intestines by digestive process. Mouth=Belching. Causes: Bacteria in chyme, swallowed air, food(cabbage, cauliflower, onion), and surgery. Treat: walking, rectal tube
Stomas
Greek meaning opening or mouth. Beefy red round bud. 1/4 to 1/2 inch from skin surface. Shrink over time. No nerves. Bleed easily.
occult blood
Hematest & guaiac test. 3 small stool specimens. Take 1 day apart. False pos from foods or meds. No laxatives or or suppos for 3 days prior. If mentral postpone test til 3-4 days after period over. Postpone if hematuria or bleeding hemorrhoids. AVOID red meat, salmon, tuna, tomatoes, cauliflower, cantaloupes, grapefruit, mushroom, poultry, ASA aspirin, steroids, iron, vit c, vit k
Food to avoid
High fiber can stimulate the gut and give diarrhea or cause blockage. Cabbage, pineapple, bean sprout, tomato skin, NUTS, coconuts, bamboo shoots, lettuce, celery, popcorn, mushrooms, dried FRUIT
History
How often do you move bowels? Any special time of day? Any changes in stool? Do you use anything to help u poop?
bowel-training program
Manipulate factors in persons control (food, fluid, exercise, time for poop) produce soft formed stool. Monitor bowel movements, frequency, consistency, shape, vol. Monitor bowel sounds. Teach about food. Ensure privacy. Encourage fluids. Lower part of intestine. Need appliance (high vol) R lower quad. Output of 500 ML/day. Maybe 1000-1500 mL/day
descending and sigmoid colon
Semi-formed to normal
Nutrition
Small, frequent meals. 6 small instead of 3 large meals. Eat slow. Drink 8-10 oz. Bland, low fiber foods. Introduce new food one at a time.
Consistency
Soft, semisolid, formed, hard
retention enema
Stays in bowel for a prolonged time. Oil-lubes stool and intestinal mucosa 150-200mL. Carminative-remain flatus from rectum give relief from gaseous distention/milk & molasses. Medicated enema. Anthelmintic-Kills intestinal parasites
Characteristics
Volume, color, odor, consistency, shape, constituents
Pinworms
Collected in AM prior to void. Tape across anus. Place on side
colonoscopy
Informed consent. Prior-Low fiber diet for several days. Clear liquids 24-24 hr prior. 2 day bowel prep drink gallon. Enema on day 2. NPO 6-8 hrs prior to procedure. Sedation given. After-May have gas, Resume normal diet once sedation is over. VS per facility policy. Observe for S/S of bowel perforation, severe rectal bleeding, abdominal pain & detention, fever, malaise
Enemas
Into rectum & sigmoid colon. Increase of vol of fluid distends colon & irritates intestinal lining. Starts evacuation of lower intestinal tract. Hypotonic=tap water large vol for rapid colonic empty. Isotonic=NSS. 500-1000 mL. Careful if weak intestinal walls, bowel infection, inflammation. Hypertonic=smaller vol 70-130 mL into colon for defecation reflex. Bad for PTs with Na+ retention. Contraindicated renal impairment.
Nurse Responsibilities
Label specimen. Ensure transport to lab. PATIEN VOID PRIOR TO COLLECTION. Amount needed, time frame collected, type of container. Medical aseptic technique.
Transverse Colostomy
Liquid to semi-formed
ascending colostomy
Liquid to semi-liquid
Snare polypectomy
Most common removal technique.
Color
Normal-Brown cuz of presence of bilirubin-pigment by product of breakdown of RBCs in body. Green, black, white, red
acute diarrhea
Rehydration orally, IV, runs its course. Avoid antidiarrheal meds until cause is recognized.
Lab tests
Stool collection, culture, occult blood, timed specimens, specimens for pinworms
