Bowel Elimination

-Abdominal fullness -pain -cramping

A home health patient reports frequent episodes of flatulence. Which sign and/or symptom would the nurse expect the patient to report? Select all that apply. -Abdominal fullness -pain -cramping -loose water stools -involuntary passage of stools

Bulk forming laxatives

A laxative that has high fiber content and causes increased gas formation and flatus for the first 4-5 days.

-red Red stools indicate lower GI bleeding. Upper GI bleeding would results in black stools. Clay-colored stools indicate the absence of bile. Green and orange stools are not indicators of bleeding.

A patient is admitted for lower GI bleeding. Which color of stool would the nurse anticipate the patient to have? -red -clay -green -orange

-reduced fluid intake reduced fluid intake may make stools hard and difficult to pass, causing constipation.

A patient is admitted to the hospital with constipation. The nurse suspects that which history finding is the cause of the condition? -reduced fluid intake -vigorous exercise -antibiotic use via any route -food allergies

absence of bile absence of bile results in white or clay colored stools. White or clay-colored stools may be caused by liver, common bile duct, or pancreas disorders. iron ingestion causes black stools. malabsorption of fat causes pale and oil stools. GI bleeding can cause black or tarry or red stools.

A patient reports passing clay-colored stools. Which condition does the nurse suspect? -iron ingestion -absence of bile -malabsorption of fat -GI bleeding

-lactose intolerance

A patient reports to the nurse, "Every time that I eat ice cream, I experience diarrhea and cramping." The nurse suspects which condition? -food allergy -irritable bowel -lactose intolerance -decreased peristalsis

-The ileum absorbs fats and bile salts -The jejunum absorbs carbs and proteins -nutrients are absorbed into the blood vessels Fats and bile salts undergo absorption in the ileum, whereas the carbohydrates and protein undergo absorption in the jejunum. Nutrients that cross the mucosal barrier of the intestine are absorbed into the lymph fluids or blood vessels. Iron and vitamins are absorbed in the ileum, not the duodenum. Plant fiver is not digested in the small intestine; the undigested fiber is emptied into he cecum.

A patient who has malabsorption syndromes ask the nurse about the process of nutrient absorption. Which response would the nurse give the patient? Select all that apply. -The ileum absorbs fats and bile salts -the duodenum absorbs iron and vitamins -the jejunum absorbs carbs and proteins -nutrients are absorbed into the blood vessels -plant fiber undergoes absorption in the small intestines'

12 seconds Rationale: normal bowel sounds occur every 5 to 15 seconds. Therefore a cap of 12 seconds between consecutive bowel sounds is a normal finding.

How many seconds between consecutive bowel sounds is a normal finding? a) 3 b) 12 c) 18 d) 23

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

The health care provider prescribes guaiac fecal occult blood testing for a patient who reports constipation and a family history of colon cancer. Which instruction does the nurse provide to the patient? -"Avoid eating red meat for 3 days before testing" -"Repeat the test at least 2 times on two separate bowel movements" -"Take vitamin C supplement and citrus fruits and juice's before the test." -"Stop taking aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs for 4 days before the test. "

-mix the powder with 250 mL of water or juice and swallow it quickly Methylcellulose is a bulk-forming stool softener that absorbs water and increased solid intestinal bulk. Drug of choice for constipation. Mix with at least 250 mL of water or juice and swallow quickly; if not, it could cause constipation. Should be taken regularly. Should cause passage of stool within 12-24 hours after taking medication.

The healthcare provider prescribes methylcellulose to a patient with chronic constipation. Which instruction provided by the nurse will help prevent complications? -do not use the medication on a regular basis -mix the powder with 250 mL of water or juice and swallow it quickly -report to the health care provider if you do not pass a stool within 8 to 10 hours of taking medication. -stop taking medication if you notice increased gas formation and flatus when you first start taking it

black color iron indigestion can cause black or tarry stools.

The nurse anticipates that a patient who takes iron supplements will have stools with which appearance? -red color -black color -oily texture -claylike appearance

6 times a day Rationale: the normal frequency of passing stools in breastfed infants is 4-6 times a day. The normal frequency of passing stools in bottle fed infants are 1-3 times a day. Passing stools 8 times a day indicates an abnormal high frequency. The normal frequency of passing stools in adults ranges from twice a day to 3 times a week.

The nurse cares for an infant in the neonatal unit who is being breastfed. How often should the infant pass stools? a) 3 times a day b) 6 times a day c) 8 times a day d) 3 times a week

-I'll perform regular physicals exercise -I'll include high-fiber foods in my diet -I'll attempt to defecate at the same time each day A person should drink at least 1.5 L/day

The nurse educates a group of patients about the prevention of constipation. Which statement made by a patient indicates effective learning? Select all that apply. -I'll perform regular physicals exercise -I'll include high-fiber foods in my diet -I'll regularly eat meats and carbs -I'll attempt to defecate at the same time each day -I'll ensure that my daily fluid intake is not less than 1 liter.

-malabsorption syndrome Malabsorption syndrome may lead to oily stool. Infection and intestinal irritation may lead to the presence of mucus in the stool. Infestation of parasites may lead to the the presence of blood, pus, mucus, and worm in the stool.

The nurse examines a patient's stool specimen and notes that the stool is oily. The nurse suspects which cause of this assessment finding? -infection -intestinal irritation -infestation of parasites -malabsorption syndrome

-have you had fever, chills, weight loss, or abdominal pain recently?

The nurse is assessing a patient with diarrhea. Which question will help determine the presence of other symptoms? -do you feel bloated after eating? -do you have to strain to have a bowel movement? -have you had fever, chills, weight loss, or abdominal pain recently? -do you have abdominal pain when you have a bowel movement?

-rolling the patient onto the bedpan when positioning an immobilized patient on a bedpain, the nurse should roll the patient onto the bedpan to ensure the patient's safety. the nurse should never try and lift the patient onto the bedpan. after a patient is positioned on a bedpan, the nurse should elevate the head of the patient's bed to 30-45 degrees, not 15-25 degrees. a smaller fracture pan should be provided to patients with leg fractures, not arm fractures.

The nurse is caring for a patient who is immobilized. Which action taken by the nurse while positioning the patient on a bed pain will help the patient evacuate bowel contents without discomfort? -lifting the patient onto the bedpan -rolling the patient onto the bedpan -elevating the head of the patients bed to 15 to 25 degrees -providing a smaller fracture pan if the patient has a humerus fracture

Every 3 years, starting at age 45

The nurse is educating a middle-aged patient about screening guidelines for early detection of colorectal cancer in average-risk asymptomatic people as specified by the American Cancer Society. At which frequency would the nurse advise the patient to get DNA stool test? -annually, starting at age 45 -every 3 years, starting at age 45 -every 5 years, starting at age 50 -every 10 years, starting at age 50

-Storage of food -secretion of intrinsic factors -production of hydrochloric acid Function of stomach include: storage of food and liquids, secretion of intrinsic factors which is responsible for absorption of vitamin b12. Stomach produces hydrochloric acid with pepsin, and helps protein digestion. Reabsorption of nutrients occur in small intestine, not in the stomach. Mucus is secreted form the stomach, but does not aid in proteins digestion. Instead, it forms a protective barrier on stomach mucosa.

The nurse is explaining to a patient with gastritis about the task performed by the stomach and includes which physiological function? Select all that apply. -Storage of food -reabsorption of nutrients -secretion of intrinsic factors -production of hydrochloric acid -mucus secretion to aid proteins digestion

-Dietary fiver should be an essential -Fluid intake should be at least six to eight glasses of water per day. -stress management techniques should be practiced. Consuming dietary fiber increases bulk of stool and helps in better bowel elimination. Maintaining adequate fluid intake increases the water content of the stool, prevents it from hardening, and permits easy passage through the rectum and anus. Stress can cause constipation; therefore the patient should instructed to practice stress management techniques. Laxative should not be used regularly because the bowel becomes habituated to laxative use. Physical activity helps prevent constipation by facilitating bowel movements.

The nurse is teaching a patient about healthy bowel habits and includes which information? Select all that apply. -Laxatives should be used regularly -Dietary fiver should be an essential component of the diet -Fluid intake should be at least six to eight glasses of water per day. -physical exercises should avoided to prevent constipation -stress management techniques should be practiced.

-gives the enema with the patient sitting on the toilet

The nurse observes a caregiver administering an enema to a patient who is scheduled for a colonscopy. The nurse intervenes when the caregiver takes which action? -gives the enema with the patient sitting on the toilet -gives the enema with the patient positioned on a bedpan -uses clean, nonsterile gloves while administering the enema -ask the patient to retain the enema solution for a specific length of time

-fresh fruits -legumes -whole grains -vegetables Will promote normal elimination. Low fiber diets high in animal fats-meats and carbs are common causes of constipation and should be avoided by the patient

The nurse provides care for a patient who reports constipation. Which food item does the nurse recommend for the patient to include in the diet to relieve the condition. Select all that apply. -meats -fresh fruits -legumes -whole grains -vegetables

-Diphenoxylate with atropine most common used antidiarrheal agents are Diphenoxylate with atropine and loperamide. polycarbophil used to treat constipation. docusate calcium is a stool softener and is used for short-term therapy to relieve straining on defecation. casanthranol is used to cleanse and prepare the bowel for diagnostic procedures.

The nurse provides care for a patient with diarrhea and expects the health care provider to prescribe which medication? -Diphenoxylate with atropine -polycarbophil -casanthranol -docusate calcium

"Suppositories' usually start acting within 30 minutes of application"

The nurse provides education for a nursing student about laxatives and cathartics. Which statement by the student indicates effective learning? -"laxatives have a stronger effect than cathartics." -"oral laxatives are faster acting than suppositories." -"A suppository should be given immediately before a meal." -"Suppositories' usually start acting within 30 minutes of application"

-it is a short-term therapy to relieve straining defecation -it lowers the surface tension of feces, allowing water and fate to penetrate Docusate sodium laxative is a stool softener that increases the secretion of water by the intestines. It is a short-term therapy that may be prescribed to a patient to relieve straining on defecation. It lowers surface tension of feces, allowing water and fat to penetrate. Saline-based agents are only for acute emptying of the bowel. Bulk forming stool softeners such as methycellulose are the drugs of choice for chronic constipation.

The nurse provides medication education for a group of nursing students about stool softeners that increase the secretion of water by the intestine. The nurse includes which information in the teaching? Select all that apply. -it is only for acute emptying of the bowel -it is the drug of choice for chronic constipation -it is a short-term therapy to relieve straining defecation -it lowers the surface tension of feces, allowing water and fate to penetrate -chronic use of this medication could cause fluid and electrolyte imbalances.

-use of antibiotics -food allergies -prolonged stress

The nurse reviews the medical record of a patient with diarrhea and identifies which potential cause of the condition? Select all that apply. -Use of opioid drugs -use of antibiotics -food allergies -prolonged stress -hypothyroidism

-lowering the surface tension of feces Emollient laxative, or stool softeners, are detergents that lower surface tension of feces, allowing water and fate to penetrate. Saline based laxative have an osmotic effect that increases pressure in the bowel to act as a stimulant for peristalsis. Stimulant cathartic caused local irritation to the intestinal mucosa, increase intestinal motility, and inhibit reabsorption of water in the large intestines.

What is the mode of action of emollient laxatives? -increasing pressure in the bowel -lowering the surface tension of feces -causing local irritation to the intestinal mucosa -inhibiting reabsorption of water in the large intestines

Colon Normal defecation begins with movement in the left colon, moving stool toward the anus. It does not begin in the anus, stomach, or small intestine.

Where does normal defecation begin? a) anus b) colon c) stomach d) small intestine

sodium phosphate Rationale: sodium phosphate is an osmotic agent used to treat constipation. polycarbophil is a bulking forming agent. casanthranol is a stimulant cathartic. docusate potassium is an emollient.

Which agent is osmotic and used to treat constipation? a)polycarbophil b)casanthranol c)docusate potassium d)sodium phosphate

-diphenoxylate with atropine Most common antidiarrheal agent is loperamide, or diphenoxylate with atropine. Codeine or tincture of opium may be used to manage chronic severe diarrhea with disease such as Crohn's disease, ulcerative colitis, and acquired immunodeficiency syndrome (AIDS). Polycarbophil is a bulk-forming laxative that is used to relieve mild diarrhea.

Which antidiarrheal agent is most commonly used? -codeine -polycarbophil -tincture of opium -diphenoxylate with atropine

a bowel movement every 5 days a bowel movement every 5 days indicates constipation, which is an abnormal finding.

Which assessment finding does the nurse associate with a problem with bowel elimination? -a bowel movement every 5 days -loose abdominal skin -bowel sounds every 5 to 15 seconds -absence of peristaltic waves on the abdomen

-flatulence Flatulence may cause abdominal fullness; cramping; distention; and severe, sharp pain. Diarrhea may be associated with fever, chills, weight loss, or abdominal pain. Hemorrhoids are associated with pain the area around the anus. Fecal incontinences is the inability to control passage of fecal matter from the anus.

Which bowel elimination problem is associated with abdominal fullness; cramping; distention; and severe, sharp pain? -diarrhea -flatulence -hemorrhoids -fecal incontinence

-firm left abdominal quadrant -feeling of abdominal fullness -less than 3 bowel movements per week Signs of constipation include infrequent bowel movements, hard, dry stools that are difficult to pass. Assessment finding also include a firm left abdominal quadrant and a feeling of abdominal fullness. Difficulty to controlling the urge to defecate indicates diarrhea. Abdominal distention and severe, sharp pain are characteristic of flatulence.

Which characteristic indicates constipation? Select all that apply. -firm left abdominal quadrant -feeling of abdominal fullness -less than 3 bowel movements per week -difficulty controlling the urge to defecate -abdominal distention and severe, sharp pain.

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

Which condition may be caused by frequent straining during defecation? -flatulence -constipation -hemorrhoids -fecal incontinence

digital examination of the rectum Digital examination of the rectum may be recommended for a patient whom fecal impaction is suspected. Gastroscopy is used to gain direct visualization of the upper GI tract. A barium swallow's is a radiographic examination using an opaque contrast medium to examine the structure and motility of the upper GI tract. The fecal occult blood test is stool test to measure microscopic amounts of blood in the feces.

Which examination may be recommended for a patient whom fecal impaction is suspected? -gastroscopy -barium swallow -fecal occult blood test -digital examination of the rectum

-Improper diet -Lack of exercise -reduced fluid intake

Which factors may cause constipation? Select all that apply. -Improper diet -Lack of exercise -use of laxatives -use of antibiotics -reduced fluid intake

Should be repeated with caution. Rationale: Tap-water enemas should be used with caution if they need to be repeated because water toxicity or circulatory overload develops if the body absorbs large amounts of water. A hypertonic solution enema is contraindicated for patients who are dehydrated. Tap-water enemas are not associated with any particular advisory that they a should be used with caution in pregnant women. A normal saline enema is associated with decreased risk of excess fluid absorption.

Which information about tap-water enemas is true? a) should be repeated with caution b) contraindicated for patients who are dehydrated c) should be used with caution, particularly in pregnant women d) associated with decreased risk of excess fluid absorption

it is shorter than the small intestine it has a role in the elimination function it can develop hemorrhoid's Large intestine is the primary organ for bowel elimination and fluid absorption. Absorbs water, sodium, and chloride form digested food. the circular muscles are responsible fore preventing regurgitation.

Which information is true about the large intestine? Select all that apply. -it is shorter than the small intestine -it has no absorptive role -it has a role in the elimination function -it can develop hemorrhoid's -it has longitudinal muscles that prevent regurgitation.

-aspirin Aspirin is a NSAID used to relieve pain. it is a prostaglandin inhibitor. aspirin interferes with the secretion of protective mucus and thereby increased the risk of gastric bleeding. Glycopyrrolate inhibits gastric acid secretion and depression GI motility; it does not increase the risk of gastric bleeding. Dicyclomine HCl suppresses peristalsis and decreases gastric emptying; it does not increase the risk of gastric bleeding. Iron supplements cause discoloration of the stool, nausea, constipation, and abdominal cramps as side effects.

Which medication could increase a patient's risk for gastric bleeding? -aspirin -glycopyrrolate -dicyclomine HCl -iron supplements

laxatives laxatives promote defecation. codeine and opium tincture used to manage chronic severe diarrhea. loperamide is used as an antidiarrheal agent

Which medication may be used to promote defecation? -codeine -laxatives -loperamide -opium tincture

opioid analgesics opioid analgesics slow peristalsis and contractions. laxative & cathartics are used to promote defecation. antibiotics decrease intestinal bacteria flora, thereby causing diarrhea.

Which medications may cause constipation? -laxatives -antibiotics -cathartics -opioid analgesics

It is the inability to control the passage of feces and gas from the anus.

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

-normal saline normal saline enemas are sued for infants and children because they are at greater risk for fluid imbalances. Soapsuds enemas and tap water enemas should not be used in infants and children. Hypertonic solutions enemas are contraindicated in infants.

Which types of enema is used in infants and children? -soapsuds -tap water -normal saline -hypertonic solution

-Immediate relief of constipation -Beginning a program of bowel training -emptying the bowel before diagnostic test or surgery Enemas are used for the immediate relief of constipation, to begin a program of the bowel training, and to empty the bowel before a diagnostic test or surgery. To establish regular bowel habits, a patient should try and defecate at the same time every day. An ice pack or warm sitz bath may provide temporary relief of pain caused by hemorrhoids.

Which use is true of an enema? Select all that apply. -Immediate relief of constipation -Establishing regular bowel habits -Beginning a program of bowel training -Temporary relief of pain caused by hemorrhoids -Emptying the bowel before a diagnostic test or surgery

-it provides a baseline for determining the effectiveness of the enema Should assess for a baseline, review provider's prescription for the type of enema and the amount to be given. Also review their record for increased intracranial pressure, glaucoma, or recently abdominal, rectal or prostate surgery because these conditions contraindicate the use of enemas.

While assessing a patient before administering an enema, the nurse inspects the patient's abdomen for distention. For which purpose is this nursing intervention done? -it allows for the nurse to plan for appropriate teaching measures -it helps determine the number and type of enemas to be given -it helps determine conditions that contraindicate the use of enemas. -it provides a baseline for determining the effectiveness of the enema

-Constipation

While performing an assessment of a patient's bowel function, the nurse ask the patient, "Do you feel as though your bowel movements are incomplete?" The nurse is trying to determine if which bowel problem is present? -Diarrhea -Indigestion -Constipation -Hemorrhoids

stimulant cathartics

act by causing local irritation to intestinal mucosa

wetting or emollient laxative

act by lowering surface tension of the feces

Osmotic laxatives

increase bowel pressure and acts as stimulant for peristalsis

to minimize distension and discomfort in the colon

the nurse gives a patient an enema using a prepackaged disposable container. why would the nurse expel air from the enema container before inserting the tip into the patients rectum? -to promote defecation -to prevent trauma to the rectal mucosa -to minimize distension and discomfort in the colon -to promote relaxation of the external rectal sphincter.

Endoscopy

which diagnostic test uses direct visualization of the gastrointestinal tract? -endoscopy -barium enema -colonic transit study -anorectal manometry