3614 Alterations in Bowel Elimination

The nurse knows that an adult should have an intake of approximately how many ounces of fluid daily? 8 16 32 64

64 Rationale: 8 Significantly, adults require more fluid intake to avoid chronic constipation. 16 Adults should consume significantly more fluid daily to avoid constipation. 32 This is approximately half of the amount of fluid an adult should consume daily. 64 An adult should consume approximately 64 ounces of fluid daily.

Match the nasogastric tube insertion purpose with its corresponding patient example. A 25-year-old who has just returned from surgery with absent bowel sounds Decompression of the GI tract A 48-year-old with gastric bleeding due to multiple trauma from a car crash A 75-year-old stroke patient who cannot swallow foods or fluids safely A 3-year-old who swallowed an unknown quantity of a prescription medication Gastric lavage Administration of medications Compression of internal hemorrhage Decompression of the GI tract

A 25-year-old who has just returned from surgery with absent bowel sounds Decompression of the GI tract A 48-year-old with gastric bleeding due to multiple trauma from a car crash Compression of internal hemorrhage A 75-year-old stroke patient who cannot swallow foods or fluids safely Administration of medications A 3-year-old who swallowed an unknown quantity of a prescription medication Gastric lavage

The nurse is educating a patient who reports frequent episodes of constipation. Which patient statement indicates the need for further teaching at the completion of the educational session? "I should drink at least 6 to 8 glasses of fluid every day." "I usually have a bowl of bran cereal in the morning for breakfast." "I should avoid drinking apple or prune juice." "I have been eating at least one fresh orange a day."

"I should avoid drinking apple or prune juice."

A patient with an acute infection of the intestine has developed diarrhea and has been prescribed an opiate-based antidiarrheal agent. Which statement, if made by the patient, indicates an understanding of this drug group? "This medication speeds up my intestinal motility to clear the stool from my system." "I should take the medicine for no more than 72 hours." "It's good to know that these drugs are not habit-forming." "I need to carefully insert the suppository into my rectum using a clean disposable glove."

"I should take the medicine for no more than 72 hours." Rationale "This medication speeds up my intestinal motility to clear the stool from my system." Antidiarrheal agents slow intestinal motility or promote absorption of excess intestinal fluid. "I should take the medicine for no more than 72 hours." It is recommended that a person limit use of antidiarrheal drugs to 48 to 72 hours. "It's good to know that these drugs are not habit-forming." Opiate-based antidiarrheal agents are habit-forming. "I need to carefully insert the suppository into my rectum using a clean disposable glove." Antidiarrheal agents are oral medications.

The nurse is preparing a public education talk about screening guidelines specific to colorectal health. Which guidelines will the nurse include in the talk? Select all that apply. A fecal occult blood test should be performed every year beginning at the age of 50. Sigmoidoscopy or colonoscopy screening should begin at the age of 50 in persons with no personal or family history of colorectal cancer. Sigmoidoscopy or colonoscopy screening begins at the age of 25 in patients with a family history of colorectal cancer. A sample of stool should be examined for parasites every 5 years after the age of 60. Persons with a family history of colorectal cancer should have sigmoidoscopy or colonoscopy screening every 5 to 10 years.

A fecal occult blood test should be performed every year beginning at the age of 50. Sigmoidoscopy or colonoscopy screening should begin at the age of 50 in persons with no personal or family history of colorectal cancer. Rationale A fecal occult blood test should be performed every year beginning at the age of 50. This statement reflects the recommended screening guidelines for fecal occult blood testing. Sigmoidoscopy or colonoscopy screening should begin at the age of 50 in persons with no personal or family history of colorectal cancer. Sigmoidoscopy and colonoscopy screening for colorectal polyps and early signs of cancer begins at age 50 for most people. Sigmoidoscopy or colonoscopy screening begins at the age of 25 in patients with a family history of colorectal cancer. There is no screening guideline that specifies initiating sigmoidoscopy or colonoscopy at the age of 25. A sample of stool should be examined for parasites every 5 years after the age of 60. There is no recommended guideline for routine screening for parasites in stool. Persons with a family history of colorectal cancer should have sigmoidoscopy or colonoscopy screening every 5 to 10 years. Persons with no family history of colorectal cancer or a personal history of inflammatory bowel disease should have a sigmoidoscopy or colonoscopy screening every 5 to 10 years. A person with a positive family history should have them more often.

Which patient would benefit from a bedside commode? A completely bedbound patient A patient who is unable to ambulate even with assistance A patient requiring a lift device for transfer to a chair A patient who has difficulty ambulating to the bathroom

A patient who has difficulty ambulating to the bathroom Rationale A completely bedbound patient A completely bedbound patient would not be permitted to use a bedside commode. A patient who is unable to ambulate even with assistance A patient who is unable to ambulate even with assistance would not be a good candidate for a bedside commode. A person using a bedside commode must be able to ambulate to and from the commode, with or without assistance. A patient requiring a lift device for transfer to a chair A patient who requires a lift device for transfer to a chair would not be a candidate for using a bedside commode. It would take too long to complete the transfer, resulting in incontinency, and the patient may not be able to safely sit up on a commode. A patient who has difficulty ambulating to the bathroom A patient who has difficulty ambulating to the bathroom would benefit by having a bedside commode.

A nurse is providing care to several patients in a healthcare provider's office. Which patients would meet recommended guidelines for sigmoidoscopy or colonoscopy screening before the age of 50? Select all that apply. A patient with a personal history of constipation A patient with a personal history of inflammatory bowel disease A patient with a family history of colorectal cancer A patient with a personal history of heartburn A patient with a personal history of irritable bowel syndrome

A patient with a personal history of inflammatory bowel disease A patient with a family history of colorectal cancer

The nurse is explaining the advantages of a regular regimen of exercise to digestive health. What information should the nurse include in the explanation? Early ambulation after surgery or illness decreases peristalsis. Exercise should wait until at least two hours after eating to prevent cramping. Walking 5 to 10 minutes each day increases digestion. Aerobic exercise stimulates intestinal muscle contraction.

Aerobic exercise stimulates intestinal muscle contraction. Rationale Early ambulation after surgery or illness decreases peristalsis. Early ambulation after surgery or illnesses, turning and changing positions in bed, and passive or active range-of-motion exercises all increase peristalsis and help prevent constipation. Exercise should wait until at least two hours after eating to prevent cramping. Strenuous exercise causes blood to be diverted to the heart and brain. Waiting approximately one hour after a meal to exercise is advised. Walking 5 to 10 minutes each day increases digestion. Taking a walk for 10 to 15 minutes each day stimulates the digestive process. Aerobic exercise stimulates intestinal muscle contraction. Active aerobic exercises that raise the heart and respiratory rates result in stimulation of the intestinal muscles.

When discussing ostomy care with a patient before surgery, what does the nurse explain is the main factor determining the stool consistency? Fluid intake Laxative use Dietary fiber Anatomical location

Anatomical function Rationale: Fluid intake Fluid intake is an important but not the main factor determining the stool consistency. Laxative use Laxatives are not necessarily indicated after colostomy placement and are not a "main factor" for determining stool consistency. Dietary fiber Fiber is important after a colostomy but it is not the main factor determining the stool consistency. Anatomical location Location determines the consistency of the stool when a patient has any type of ostomy.

Match each type of colostomy with its anatomical location. Ascending colostomy Transverse colostomy Descending colostomy Sigmoid colostomy Right side of abdomen Lower left quadrant Upper left quadrant Upper middle to right of abdomen

Ascending colostomy Right side of abdomen Transverse colostomy Upper middle to right of abdomen Descending colostomy Upper left quadrant Sigmoid colostomy Lower left quadrant

The nurse is preparing to administer a cleansing enema to a patient who can walk to the bathroom. What nursing actions should the nurse anticipate directly after completion of the enema? Select all that apply. Assisting the patient onto the bedpan Assuring that no-skid footwear is in place Placing the patient in a position of comfort for the specific enema retention time Assisting the patient to the bathroom Providing or assisting the patient with perineal care

Assuring that no-skid footwear is in place Assisting the patient to the bathroom

The nurse is preparing to administer a cleansing enema to a patient who can walk to the bathroom. What nursing actions should the nurse anticipate directly after completion of the enema? Assisting the patient onto the bedpan A patient who is able to sit on the toilet should be allowed to do so rather than evacuating the enema and stool into a bedpan. Assuring that no-skid footwear is in place The patient is likely to feel an urgent need to defecate. For safety, the patient should have no-skid footwear readily available and in place before being immediately assisted into the bathroom. Placing the patient in a position of comfort for the specific enema retention time A cleansing enema is not a type of retention enema, and it is evacuated directly following the procedure. Assisting the patient to the bathroom The patient is likely to feel an urgent need to defecate. For safety, the patient should be assisted immediately into the bathroom once non-skid footwear is in place. Providing or assisting the patient with perineal care Perineal care will not be performed until the bowel contents have been evacuated.

Assuring that no-skid footwear is in place Assisting the patient to the bathroom The patient is likely to feel an urgent need to defecate. For safety, the patient should have no-skid footwear readily available and in place before being immediately assisted into the bathroom. The patient is likely to feel an urgent need to defecate. For safety, the patient should be assisted immediately into the bathroom once non-skid footwear is in place.

The nurse has completed administering an oil retention enema to a patient. What will the nurse need to document? Select all that apply. Characteristics of the stool Urine output in addition to stool Patient's tolerance to the procedure How far the rectal tube was inserted into the rectum Amount of stool

Characteristics of the stool Patient's tolerance to the procedure Amount of stool

A patient on long-term antibiotic therapy is experiencing frequent, foul-smelling diarrhea. The nurse suspects that the diarrhea is most likely due to which underlying cause? Food-borne pathogens Excessive laxative use Psychological stress Clostridium difficile

Clostridium difficile

The nurse is preparing to administer an enema to a patient undergoing a diagnostic test that requires bowel cleansing. The nurse knows that enemas stimulate the evacuation of the lower intestinal tract as a result of what intestinal activity? Intestinal spasm Stomach irritation Rectal stimulation Colon distension

Colon distension Rationale Intestinal spasm The intestine does not spasm to stimulate the evacuation of the lower intestinal tract with the administration of an enema. Stomach irritation An enema irritates the intestinal mucosa lining, not the stomach, which stimulates the complete evacuation of the lower intestinal tract. Rectal stimulation Rectal stimulation is not the reason for the evacuation of the lower intestinal tract with the administration of an enema. Colon distension 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.

The nurse knows that patients may experience which potential response to sharing a bathroom? Select all that apply. Constipation Diarrhea Stool incontinence Embarrassment Continence

Constipation Embarrassment

When planning care for a patient who does not recognize the urge to defecate, what is a potential bowel elimination concern that the nurse should take into consideration? Select all that apply. Constipation Diarrhea Increased peristalsis Bowel incontinence Flatulence

Constipation Bowel incontinence Rationale: Constipation Constipation may result if the patient lacks the recognition of the urge to defecate and fails to do so. Diarrhea This is not an expected bowel elimination risk for patients who lack the recognition of the urge to defecate. Increased peristalsis This is not an expected bowel elimination risk for patients who lack the recognition of the urge to defecate. Bowel incontinence Bowel incontinence can result when a patient fails to recognize the urge to defecate. Flatulence Flatulence is a normal occurrence in the GI tract and is not a concern specific to failure to recognize the urge to defecate.

When caring for a patient on antibiotic therapy, the nurse identifies which abnormal assessment finding as most likely the result of antibiotic therapy? Blood in the stool Constipation Diarrhea Impaction

Diarrhea

The nurse is aware that common alterations in bowel elimination patterns include which problems? Select all that apply. Diarrhea Anorexia Bowel incontinence Constipation Flatulence

Diarrhea Bowel incontinence Constipation Rationale: Diarrhea Diarrhea is a common alteration in bowel elimination. Anorexia Anorexia is not an alteration in bowel elimination. Bowel incontinence Bowel incontinence is a common alteration in bowel elimination. Constipation Constipation is a common alteration in bowel elimination. Flatulence Flatulence, the passing of flatus, is a normal part of GI function.

The emergency room (ER) nurse is caring for a patient who received intravenous fluid (IV) fluid for dehydration secondary to diarrhea. Which teaching point is accurate for the nurse to include in the discharge instructions for this patient? Eat three regular meals each day. Eat bland foods. Drink hot fluids. Drink two caffeinated beverages each day.

Eat bland foods.

The nurse is discussing a dietary plan with an obese patient who will be discharged from the hospital. Which recommendations focus on factors that affect bowel elimination? Select all that apply. Follow a high-fiber diet. Follow a low carbohydrate diet. Increase consumption of spicy foods. Drink plenty of fluids. Increase physical activity.

Follow a high-fiber diet. Drink plenty of fluids.

Which fiber-rich foods would the nurse recommend to a patient who is experiencing constipation? Select all that apply. Milk products Fresh fruits Beans Bran cereal Coffee

Fresh fruits Beans Bran cereal

Which fiber-rich foods would the nurse recommend to a patient who is experiencing constipation? Select all that apply. Milk products Fresh fruits Beans Bran cereal Coffee

Fresh fruits Beans Bran cereal Rationale Milk products Milk products are not considered fiber-rich food. These products are also known to irritate or stimulate the stomach, which could increase discomfort in the patient. Fresh fruits Fresh fruits are examples of fiber-rich food that are recommended for patients experiencing constipation. Beans Beans are a fiber-rich food that is recommended for patients experiencing constipation without flatus. Beans should be avoided by patients who have excess flatus. Bran cereal Bran cereal is a fiber-rich food that is recommended for patients experiencing constipation. Coffee Coffee is not a fiber-rich food. It can be a GI irritant.

The staff nurse is admitting a patient who has just arrived from the emergency room after eating a poisonous substance. A large-bore nasogastric (NG) tube is in place. For which purpose was the NG tube likely inserted? GI tract decompression Enteral feedings Gastric lavage Medication administration

Gastric lavage

The nurse is preparing to perform routine ostomy care on a patient. Which actions are correct steps in this procedure? Select all that apply. Gently washing the stoma and peristomal area with water Providing a 30-minute "resting" time before applying the new pouch Measuring the stoma Irrigating the ostomy with water using a catheter Assessing the pouch seal

Gently washing the stoma and peristomal area with water Measuring the stoma

A nurse caring for an obese person understands the increased risk for which complication of bowel function? Hemorrhoid formation Poor nutrient absorption Decreased food intake Diarrhea

Hemorrhoid formation Rationale: Hemorrhoid formation Due to the higher risk for developing constipation and straining to have a bowel movement, the incidence of hemorrhoids increases for obese individuals. Poor nutrient absorption Obesity itself does not cause poor nutrient absorption. Decreased food intake Obese individuals are not commonly at risk for decreased food intake. Diarrhea Obese individuals are not at increased risk for development of diarrhea.

A patient has a history of chronic constipation. The nurse knows this can lead to which alterations? Select all that apply. Clostridium difficile Hemorrhoids Stool incontinence Impaction Diarrhea

Hemorrhoids Impaction

A patient is asking for guidance in developing a more healthy diet plan to improve bowel management. Which information should the nurse provide the patient? Eat foods that are low to moderately low in fiber. If there are no contraindications, 6 to 8 glasses of fluid should be consumed per day. Fluids should be at a tepid temperature. Consume small, bland meals.

If there are no contraindications, 6 to 8 glasses of fluid should be consumed per day. Rationale Eat foods that are low to moderately low in fiber. High-fiber foods, not low-fiber foods, are an essential part of a healthy diet plan for bowel health. If there are no contraindications, 6 to 8 glasses of fluid should be consumed per day. Adequate fluid intake has many advantages, including maintaining normal bowel elimination. Fluids should be at a tepid temperature. Fluids at a tepid temperature are recommended for a person who has diarrhea. Consume small, bland meals. This is not a general recommendation for overall bowel health. It is a recommendation for a person with diarrhea.

When caring for a patient post-ostomy, the nurse knows which type of procedure would not leave a stoma on the abdomen? Double-barrel colostomy Temporary colostomy Kock pouch Ileoanal pouch

Ileoanal pouch

A patient with familial polyps and intact anal sphincter is scheduled for a bowel diversion procedure. The nurse knows this patient will most likely undergo which bowel diversion procedure? Kock pouch Ileoanal pouch Loop colostomy Double-barrel colostomy

Ileoanal pouch Rationale: Kock pouch Kock pouch is an alternative to ileostomy and is not a common bowel diversion procedure for a patient with familial polyps and intact anal sphincter. Ileoanal pouch The Ileoanal pouch is a type of ileostomy and is the procedure of choice for patients with familial polyps and an intact anal sphincter. Loop colostomy Loop colostomy is a temporary colostomy created in a surgical emergency and is not a common bowel diversion procedure for a patient with familial polyps and intact anal sphincter. Double-barrel colostomy Double-barrel colostomy has two distinct stomas and is not a common bowel diversion procedure for a patient with familial polyps and intact anal sphincter.

The nurse caring for a patient suffering from chronic constipation must be aware of which potential complication? Incontinence Diarrhea Continence Impaction

Impaction Rationale: Incontinence Incontinence is not a typical complication for patients with chronic constipation. Diarrhea Diarrhea is not a complication for patients with chronic constipation. Continence Continence is a normal defecation pattern, rather than a potential complication. Most patients with chronic constipation are continent of stool. Impaction Chronic constipation can lead to impaction.

Prior to administering an enema, the nurse is mentally reviewing the procedure. What enema administration techniques best assure the patient's comfort during the procedure? Select all that apply. Inserting the rectal tube slowly Administering the solution at a rapid rate Using a warm enema solution Administering enema solution at a slow rate Using a cool enema solution

Inserting the rectal tube slowly Using a warm enema solution Administering enema solution at a slow rate

A nurse, conducting a patient interview, is asking questions that focus on bowel elimination. Which questions address psychological factors that can affect bowel elimination? Select all that apply. Is the patient experiencing feelings of depression? Has the patient ever had a problem with obesity? Does the patient have any food intolerances? Is the patient experiencing emotional stress? What is the patient's religion?

Is the patient experiencing feelings of depression? Is the patient experiencing emotional stress?

A patient is scheduled to have a diagnostic test that requires thorough cleansing of the colon. The nurse will anticipate which type of enema to meet this outcome? Oil retention enema Isotonic enema Carminative enema Medication enema

Isotonic enema

A patient is scheduled to have a diagnostic test that requires thorough cleansing of the colon. The nurse will anticipate which type of enema to meet this outcome? Oil retention enema Isotonic enema Carminative enema Medication enema

Isotonic enema Rationale Oil retention enema Oil retention enemas are used to treat occasional constipation and are not a type of cleansing enema. Isotonic enema The isotonic enema is a type of cleansing enema that would be an appropriate choice for the purpose of thoroughly cleansing the intestine in preparation for a diagnostic test. Carminative enema The carminative enema is used for the purpose of relieving abdominal distention by facilitating evacuation of flatus. Medication enema A medication enema is a type of retention enema for the purpose of instilling a drug into the bowel, usually to treat localized infection or inflammation.

The nurse is preparing to insert a Salem sump nasogastric (NG) tube after receiving a provider order to do so. Which statements apply to this tube? Select all that apply. Its major use is to deliver enteric feedings. It has two lumens. It has an air vent lumen. It is the NG tube of choice used for gastric decompression. It has one lumen.

It has two lumens. It has an air vent lumen. It is the NG tube of choice used for gastric decompression. Rationale Its major use is to deliver enteric feedings. While enteric feedings can be instilled through a Salem sump tube, it is not the tube of choice for that purpose. It has two lumens. The Salem sump tube has an air vent lumen and a suction lumen. It has an air vent lumen. The Salem sump tube has an air vent lumen and a suction lumen. It is the NG tube of choice used for gastric decompression. The Salem sump tube is the preferred type of NG tube for decompressing the stomach. It has one lumen. The Levine tube has one lumen, not the Salem sump tube.

A patient with a new ostomy asks the wound ostomy continence nurse (WOCN) the purpose of doing ostomy care. When answering the patient, the nurse would take into consideration which purposes? Select all that apply. It protects the stoma and skin. It reduces fecal drainage. It allows the stoma and skin to be assessed. It frees the patient from requiring an ostomy pouch. It promotes patient comfort.

It protects the stoma and skin. It allows the stoma and skin to be assessed. It promotes patient comfort. Rationale It protects the stoma and skin. Ostomy care maintains skin integrity by cleansing the skin and preventing leakage. It reduces fecal drainage. Ostomy care does not alter fecal drainage. It allows the stoma and skin to be assessed. By removing the ostomy appliance, the stoma and peristomal skin can be thoroughly assessed. It frees the patient from requiring an ostomy pouch. Ostomy care does not change the need for using the appliance. It promotes patient comfort. Ostomy care promotes patient comfort by preventing skin injury and preventing odors.

The nurse is preparing to teach a patient about the safe use of laxatives. Which information should the nurse include? Laxatives provide only temporary relief from constipation. Laxatives can relieve an episode of constipation; however, they do not correct the problem causing the constipation. Laxatives require a prescription from the primary care provider. Many laxatives are available over-the-counter. Correct A laxative should not be taken if the patient has nausea and vomiting. Nausea and vomiting are two contraindications for use of laxatives. Correct Prolonged use of laxatives can cause rebound constipation. Prolonged use can weaken natural bowel responses and result in rebound constipation. A laxative may be effective in treating an episode of abdominal pain. The presence of undiagnosed abdominal pain is a contraindication for use of laxatives.

Laxatives provide only temporary relief from constipation. A laxative should not be taken if the patient has nausea and vomiting. Prolonged use of laxatives can cause rebound constipation.

The nurse is preparing to teach a patient about the safe use of laxatives. Which information should the nurse include? Select all that apply. Laxatives provide only temporary relief from constipation. Laxatives require a prescription from the primary care provider. A laxative should not be taken if the patient has nausea and vomiting. Prolonged use of laxatives can cause rebound constipation. A laxative may be effective in treating an episode of abdominal pain.

Laxatives provide only temporary relief from constipation. A laxative should not be taken if the patient has nausea and vomiting. Prolonged use of laxatives can cause rebound constipation.

The nurse is preparing to administer an enema to a patient. Into what position should the patient be placed for the administration of the enema? Right side-lying with left knee flexed Prone Supine Left side-lying with right knee flexed

Left side-lying with right knee flexedProne

An unconscious patient has begun enteral feedings. This places the patient at increased risk for which defecation pattern alteration? Constipation Continence Loose stools Impaction

Loose stools

The nurse is providing care to a completely bedbound patient who does not have a continence problem. Which nursing action meets this patient's elimination needs? Offering a bedpan to the patient Ordering adult diapers for the patient Assisting the patient to the bathroom Preparing the bedside commode for the patient

Offering a bedpan to the patient Rationale Offering a bedpan to the patient A patient who is bedbound should be offered a bedpan to meet elimination needs. Ordering adult diapers for the patient An adult diaper is only appropriate for a patient who is incontinent. Assisting the patient to the bathroom A bedbound patient must stay in bed and therefore cannot be assisted to the bathroom. Preparing the bedside commode for the patient A bedbound patient must stay in bed and therefore cannot use a bedside commode.

The nurse caring for a patient who recently had a loop colostomy performed. The nurse is aware that this type of colostomy has what characteristics? Select all that apply. Two distinct stomas One stoma with two openings Distal end of the stoma may discharge mucus Proximal end of the stoma discharges stool A permanent type of colostomy

One stoma with two openings Distal end of the stoma may discharge mucus Proximal end of the stoma discharges stool

A patient, during a bout of prolonged diarrhea, purchased an over-the-counter antidiarrheal agent to try to find some relief. What important considerations about antidiarrheal drugs should the patient keep in mind? Over-the-counter antidiarrheal medications are less effective than prescription antidiarrheals. Prescription antidiarrheal medications are more effective than those that can be purchased over-the-counter. Antidiarrheal medications are usually not to be taken for longer than 48 hours. The use of antidiarrheal medications is usually limited to 48 to 72 hours. Antidiarrheals act on the intestines to produce soft or liquid stools. Laxatives, not antidiarrheals, act on the intestine to produce soft or liquid stools. Rectal suppositories are more effective than oral forms of antidiarrheals. Laxatives, not antidiarrheals, are more effective when administered as rectal suppositories.

Over-the-counter antidiarrheal medications are less effective than prescription antidiarrheals.

A patient, during a bout of prolonged diarrhea, purchased an over-the-counter antidiarrheal agent to try to find some relief. What important considerations about antidiarrheal drugs should the patient keep in mind? Over-the-counter antidiarrheal medications are less effective than prescription antidiarrheals. Antidiarrheal medications are usually not to be taken for longer than 48 hours. Antidiarrheals act on the intestines to produce soft or liquid stools. Rectal suppositories are more effective than oral forms of antidiarrheals.

Over-the-counter antidiarrheal medications are less effective than prescription antidiarrheals.

The nurse is determining the type of alternative toileting needed for a patient. Which criteria indicate the need for use of a bedpan? Patient is having liquid stools. Patient has orders to sit in a chair at bedside. Patient is too weak to walk to the bathroom. Patient is unable to ambulate.

Patient is unable to ambulate.

The nurse is teaching a patient how to complete ostomy care. Which patient action best indicates competency with this procedure? Stating the steps in the correct order Performing a return demonstration Asking a question about a step in the process Watching the nurse complete the procedure

Performing a return demonstration

Match the lifestyle factor with its related example. Person consumes foods that are low in fiber. Person plays a computer game rather than hiking with friends. Person is experiencing high work-related stress. Person chooses not to go to the bathroom while eating dinner with friends. Diet Personal habits Psychological factors Physical activity

Person consumes foods that are low in fiber. Diet Person plays a computer game rather than hiking with friends. Physical activity Person is experiencing high work-related stress. Psychological factors Person chooses not to go to the bathroom while eating dinner with friends. Personal habits

Which findings, if present, would be considered contributing factors for development of altered bowel elimination in a patient? Select all that apply. Pregnancy High blood pressure Narcotic pain medication Urinary catheterization Decreased mobility

Pregnancy Narcotic pain medication Decreased mobility Rationale: Pregnancy Several issues during pregnancy can affect bowel elimination. High blood pressure This is not a contributing factor to the alteration in bowel elimination. Narcotic pain medication This is a contributing factor to the alteration in bowel elimination. Urinary catheterization This is a not a contributing factor to the alteration in bowel elimination. Decreased mobility This is a contributing factor to the alteration in bowel elimination.

Match each cause of altered bowel elimination to the type of alteration. Prolonged constipation Weakening of muscles in the rectum Too much water being absorbed by the intestine Not enough water being absorbed by the intestine Incontinence Diarrhea Impaction Constipation

Prolonged constipation Impaction Weakening of muscles in the rectum Incontinence Too much water being absorbed by the intestine Diarrhea Not enough water being absorbed by the intestine Constipation

The nurse is caring for a patient who requires a bedpan for toileting. Which interventions should the nurse anticipate specific to the patient's comfort needs? Select all that apply. Promptly respond to a patient's call for toileting. Perform perineal care after bedpan use. Close the curtains around the patient's bed. Ensure correct placement on the bedpan. Assist the patient, as needed, to the commode.

Promptly respond to a patient's call for toileting. Close the curtains around the patient's bed. Ensure correct placement on the bedpan. Rationale Promptly respond to a patient's call for toileting. This is a necessary intervention to promote patient comfort and continence. The patient who requires a bedpan is dependent on personnel to meet this need. Incontinence may result from a delay in response. Perform perineal care after bedpan use. Perineal care focuses on meeting patient hygiene needs rather than comfort needs. Close the curtains around the patient's bed. This intervention focuses on the need for privacy, a comfort measure. Ensure correct placement on the bedpan. Sitting on a bedpan can be very uncomfortable and requires careful placement. It is a comfort measure. Assist the patient, as needed, to the commode. This would be a safety-related intervention for a person using the bedside commode, not a bedpan.

The nurse is providing care to a patient who requires the use of a bedside commode to meet bowel elimination needs. Which key principles must the nurse implement before leaving the patient alone to have a bowel movement? Select all that apply. Providing the patient with privacy Assuring that the patient can safely sit on a commode without assistance Ensuring the call bell is within the patient's reach Noting the patient's tolerance to the bedside commode after use Performing perineal care for the patient

Providing the patient with privacy Assuring that the patient can safely sit on a commode without assistance Ensuring the call bell is within the patient's reach

Place the ostomy care events in their appropriate order. Remove and dispose of the used ostomy pouch. Assess the integrity of the stoma and peristomal skin. Cleanse the area surrounding the stoma. Measure the stoma. Apply the new pouch. Prepare the new pouch to fit stoma.

Remove and dispose of the used ostomy pouch. Cleanse the area surrounding the stoma. Assess the integrity of the stoma and peristomal skin. Measure the stoma. Prepare the new pouch to fit stoma. Apply the new pouch. Rationale Ostomy care is a multistep process that requires caution to prevent skin injury. When the pouch has been removed, it is important to prevent the effluent from draining directly onto the skin while the rest of the care procedure proceeds. The shape and size of the stoma is carefully measured to ensure that the pouch is an exact fit. This will prevent injury to the stoma and skin irritation.

The nurse limits a patient to 10 minutes on the bedpan to decrease the risk for which adverse reaction? Hemorrhoids Rectal bleeding Skin breakdown Fatigue

Skin breakdown Rationale Hemorrhoids Hemorrhoids often are the result of straining to pass stool, as with constipation. It is not the reason for limiting time on a bedpan. Rectal bleeding Rectal bleeding may result from straining to pass stool, as with constipation. It is not a result of prolonged sitting on bedpan. Skin breakdown Patients are limited to 10 minutes on the bedpan to decrease the risk for skin breakdown from pressure points pressing on a hard bedpan surface for a prolonged time. This can result in tissue injury and possibly pressure ulcers. In addition, it is uncomfortable. Fatigue Fatigue is associated with lack of sleep or a variety of health problems. It is not the reason for limiting a patient to 10 minutes on the bedpan.

The nurse is preparing a presentation on ostomies and includes what information regarding ileostomies? Well-formed stool is expected. Stool drainage can be regulated. Skin breakdown is a potential complication. Permanent placement is necessary.

Skin breakdown is a potential complication. Rationale: Well-formed stool is expected. Ileostomies drain liquid stool. Stool drainage can be regulated. Ileostomy stool cannot be regulated and requires continuous use of a stool collection appliance. Skin breakdown is a potential complication. Because ileostomy stool contains digestive enzymes, it can irritate skin and cause breakdown. Permanent placement is necessary. Ileostomies can be temporary or permanent.

What are some reasons for using ostomy appliances for a patient with a bowel diversion? Select all that apply. Skin protection Drainage collection Stoma assessment Self-esteem enhancement Odor control

Skin protection Drainage collection Odor control Rationale Skin protection Ostomy appliances are used to protect the skin from stool drainage. Drainage collection Ostomy appliances are used to collect stool that is excreted from the ostomy. Stoma assessment Ostomy appliances are not used to assess stoma healing. Self-esteem enhancement Ostomy appliances are not used to increase self-esteem. Odor control Ostomy appliances are used to control odor.

A nurse planning care for hospitalized patients understands that patients may experience diarrhea due to which of these causes? Select all that apply. Stress Inadequate liquid intake Antibiotics Enteral nutrition Hemorrhoids

Stress Antibiotics Enteral nutrition Rationale: Stress Psychological stress can cause diarrhea. Inadequate liquid intake Inadequate liquid intake may cause constipation rather than diarrhea. Antibiotics Antibiotics can cause diarrhea. Enteral nutrition Receiving enteral nutrition (nutritional feedings delivered through a gastric or intestinal tube) can cause diarrhea. Hemorrhoids Hemorrhoids do not cause diarrhea.

The nurse is aware that laxatives are contraindicated under which patient circumstances? Select all that apply. The patient is experiencing nausea. The patient has been vomiting. The patient has a drug allergy to opiates. The patient is not currently constipated. The patient reports abdominal pain of unknown origin.

The patient is experiencing nausea. The patient has been vomiting. The patient is not currently constipated. The patient reports abdominal pain of unknown origin. Rationale The patient is experiencing nausea. Nausea is a contraindication for taking a laxative. The patient has been vomiting. Vomiting is a contraindication for taking a laxative. The patient has a drug allergy to opiates. Laxatives are not opiate-based drugs. The patient is not currently constipated. Laxatives should be taken for temporary relief of constipation. If constipation is not present, they should not be consumed, since prolonged use can weaken natural bowel responses and result in rebound constipation. The patient reports abdominal pain of unknown origin. Laxatives are contraindicated if the patient is experiencing undiagnosed abdominal pain.

While performing ostomy care on a patient with a new colostomy, the nurse incorporates self-image education and promotes a positive self-image. Why is it important for the nurse to address self-image with the patient? The patient may be hesitant to express feelings regarding self-esteem. A positive self-image decreases recovery time from the surgery. The patient is more likely to participate in self-care. A patient's positive body image before surgery will remain unchanged after surgery. NOT SURE

The patient is more likely to participate in self-care.

The nurse is performing ostomy care on a patient with a colostomy. Which key principles should the nurse keep in mind while moving through the procedure? The procedure should be performed at least every 10 hours. Cool water with adhesive remover mixed into it is applied to remove any residue. Small amounts of effluent are allowed to drain onto the abdomen during the procedure. The stoma and peristomal area is washed using water only.

The stoma and peristomal area is washed using water only. Rationale The procedure should be performed at least every 10 hours. The ostomy pouch should only be changed as needed. Frequent changes can contribute to skin injury and breakdown. Cool water with adhesive remover mixed into it is applied to remove any residue. Warm water is used, and possibly an adhesive remover, to remove adhesive residue. Small amounts of effluent are allowed to drain onto the abdomen during the procedure. Effluent (fecal drainage) should be prevented from draining onto the skin to prevent skin irritation. The stoma and peristomal area is washed using water only. The stoma and peristomal area should be washed gently with water only because soap may dry the skin, resulting in potential complications.

A patient has just been placed on a bedpan by the nurse. The nurse knows that the patient should be removed from the bedpan within 10 minutes for which reason? Patient's blood pressure and heart rate may increase. If patient has not defecated within that time, a laxative is indicated. Tissue injury can result from prolonged sitting. Patient's hip joints can become stiff.

Tissue injury can result from prolonged sitting.

Match the type of enema with its description. Uses osmotic pressure to pull water into colon Lubricates rectum and softens stool to ease feces evacuation Instills drugs to be absorbed into intestinal wall Stimulates peristalsis to facilitate flatus passage Medication Carminative Oil retention Hypertonic cleansing

Uses osmotic pressure to pull water into colon Hypertonic cleansing Lubricates rectum and softens stool to ease feces evacuation Oil retention Instills drugs to be absorbed into intestinal wall Medication Stimulates peristalsis to facilitate flatus passage Carminative

The nurse is caring for a patient with a new sigmoid colostomy and prepares supplies for drainage of stool with what characteristics? Select all that apply. Liquid stool is produced. Well-formed stool is produced. Semi-formed stool is produced. Skin breakdown is common. Evacuation can be regulated.

Well-formed stool is produced. Evacuation can be regulated.

A patient with a new ostomy asks the wound ostomy continence nurse (WOCN) the purpose of doing ostomy care. When answering the patient, the nurse would take into consideration which purposes? Select all that apply. It protects the stoma and skin. It reduces fecal drainage. It allows the stoma and skin to be assessed. It frees the patient from requiring an ostomy pouch. It promotes patient comfort.

t protects the stoma and skin. It allows the stoma and skin to be assessed. It promotes patient comfort.