Ch Bowel

A patient is admitted with diarrhea caused by Clostridium difficile (C. difficile). Which question should the nurse ask to obtain the most helpful information about the cause of the dysentery?

"Are you taking any antibiotics?"

The primary health care provider prescribes guaiac fecal occult blood testing for a patient who reports constipation and a family history of colon cancer. Which instruction should be provided to the patient?

"Avoid eating red meat for 3 days before testing."

A nurse cares for a patient who has hemorrhoids. What advice should the nurse give to the patient to relieve discomfort? Select all that apply.

"Exercising regularly might help you have regular bowel movements." "Using a warm sitz bath can give you temporary pain relief." "Using an ice pack can help you feel better for a while."

A nurse is assessing a patient with diarrhea. Which question will help determine the presence of other symptoms?

"Have you had fever, chills, weight loss, or abdominal pain recently?"

A nurse educates a group of patients on the prevention of constipation. Which statements if made by a patient indicate effective understanding? Select all that apply.

"I'll attempt to defecate at the same time each day." "I'll include high-fiber foods in my diet." "I'll perform regular physical exercise."

A registered nurse is educating nursing students about the required interventions while administering an enema. Which statements if made by a student nurse indicate effective understanding? Select all that apply.

"If the patient has poor sphincter control, I'll position the patient on a bedpan in a comfortable dorsal recumbent position." "I'll cover the patient with a bath blanket, exposing only the rectal area, and clearly visualizing the anus.\ "I'll place a waterproof pad under the patient's hips and buttocks."

A nurse is caring for a pregnant patient who is prescribed a stool softener that increases the secretion of water by the intestine. Which statements if made by the nurse about the prescribed medication are correct? Select all that apply.

"It lowers the surface tension of feces, allowing water and fat to penetrate." "It is a short-term therapy to relieve straining on defecation.

A nursing student is learning about administering high-cleansing soapsuds enemas to patients. Which statements if made by the nursing student indicate effective learning? Select all that apply.

"Liquid soap can be mixed with either tap water or saline to create this enema." Correct 4 "This type of enema is not recommended for pregnancy-related constipation."

While inspecting the area around a patient's anus, the nurse notices lesions, discoloration, inflammation, and dilated, engorged veins in the rectum. Which instruction provided by the nurse will help manage the patient's condition? Select all that apply.

"Perform regular exercise and drink at least 1.5 L of fluid per day." "Take warm sitz baths frequently."

The nurse categorizes a patient's stools as Type 2 according to the Bristol stool form scale. How would a patient most likely described his or her stools?

"They are sausage-shaped, but lumpy."

A nurse is assisting an immobilized patient with bowel elimination to use a bedpan. Arrange the steps of this process in the correct order.

1. Perform hand hygiene, apply clean gloves, and close the room curtain for privacy. 2. Raise the side rail opposite the nurse. 3. Lower the head of the bed flat and roll the patient onto his or her side facing away from the nurse. 4. Place a bedpan firmly against the buttocks. 5. Push bedpan down into mattress with the open rim toward the patient's feet. 6. Keeping one hand against the bedpan, place the other hand on the patient's hip. 7. Allow the patient to roll onto the pan and flat on the bed 8.Raise the head of the bed 30 degrees

After assessing a patient, the primary health care provider confirms that the patient will require digital removal of stool. Arrange the steps of this process in the correct order?

1. Perform hand hygiene, pull the curtains around the bed, obtain the patient's baseline vital signs, assess the patient's level of comfort, and palpate for abdominal distention. 2. Position the patient on his or her left side in Sims' position with the knees flexed and the back toward the nurse. 3. Drape the trunk and legs with a bath blanket, and place a waterproof pad under the buttocks. 4. Apply clean gloves and lubricate the index finger of the dominant hand with a water-soluble lubricant. 5. Instruct patient to take slow, deep breaths, and gently insert the index finger into the rectum. 6. With the finger, work the feces downward toward the end of the rectum, remove small pieces one at a time, and discard them into a bedpan. 7. Wash and dry the buttocks and anal area. 8. Remove the bedpan and inspect the feces for color and consistency. 9. Perform hand hygiene and record the results of the procedure.

An enema is prescribed for an adolescent. What is the appropriate length of insertion of the enema tube into the patient's rectum?

7.5 to 10 cm

A nurse is assigned to take care of a patient who is scheduled to undergo a colonoscopy. Which statements are true regarding a colonoscopy? Select all that apply.

A clear liquid diet is ordered for the patient the day before the test. A colonoscopy uses a lighted fiberoptic tube to gain visualization.

Which medication could increase a patient's risk of gastric bleeding?

Aspirin

Which medication is used to treat hyperactive bowel disorder?

Atropine

The nurse is taking care of a patient who is bedridden. The patient complains of constipation. Which food items should the nurse include in the patient's diet to relieve constipation? Select all that apply.

Beans Cauliflower Broccoli Fresh fruits

A nurse is performing a physical assessment of a patient with bowel elimination problems. Which finding does the nurse anticipate is most likely in the patient?

Bowel movements every 5 days

A nurse performs a physical assessment of a patient. Which observations most likely indicate normal functioning? Select all that apply.

Bowel sounds audible every 10 seconds Lack of visible peristaltic waves

What are the normal constituents of feces? Select all that apply.

Cells lining the intestinal mucosa Dead bacteria Bile pigment

Where does normal defecation begin?

Colon

A nurse learns about the screening guidelines of the American Cancer Society for the early detection of colorectal cancer in average-risk asymptomatic people. Which tests should be ordered for an individual every 5 years, starting at age 50? Select all that apply.

Computed tomography Flexible sigmoidoscopy

Which procedures require the patient to undergo a bowel-cleansing program before they can be performed? Select all that apply.

Computerized tomographic colonography Colonoscopy

While caring for a debilitated patient, a nurse learns that the patient has been unable to pass stool for several days, despite the repeated urge to defecate. The nurse suspects that the patient has a fecal impaction. Which other findings support the nurse's suspicion? Select all that apply.

Continuous oozing of liquid stool Rectal pain Anorexia

The nurse is caring for a 78-year-old man with diarrhea. Which problem is the most important to consider?

Dehydration

Which may be recommended for a patient in whom fecal impaction is suspected?

Digital examination of the rectum

Which is caused by straining on defecation? Select all that apply.

Dysrhythmias Hemorrhoids

What are the uses of an enema? Select all that apply.

Emptying the bowel before diagnostic tests or surgery Beginning a program of bowel training Immediate relief of constipation

A nurse is caring for a patient who recently underwent abdominal surgery. Which actions taken by the nurse will help prevent constipation in this patient? Select all that apply.

Establishing a regular defecation schedule for the patient Increasing the amount of fluids in the patient's diet Encouraging ambulation as early as possible

In which order should the nurse perform the steps for digital removal of stools from a patient's rectum?

First, the nurse performs hand hygiene, obtains the patient's baseline vital signs, assesses the patient's level of comfort, and palpates for abdominal distention. Then the nurse helps the patient lie on the left side in Sims' position with the knees flexed and the back toward the nurse. After this step, the nurse drapes the trunk and lower extremities with a bath blanket and places a waterproof pad under the buttocks, keeping a bedpan next to patient. The nurse then applies clean gloves and lubricates the index finger of the dominant hand with a water-soluble lubricant. While instructing the patient to take slow and deep breaths, the nurse gradually and gently inserts the index finger into the rectum and advances the finger slowly along the rectal wall. The nurse then gently loosens the fecal mass by massaging around it and works the finger into the hardened mass. Finally, the nurse works the feces downward toward the end of the rectum and removes small pieces one at a time and discards them into the bedpan.

A patient is prescribed a soapsuds enema. In which order does the nurse take the steps to prepare the enema bag and administer the enema?

First, the nurse should add warmed saline solution to the enema bag. Then, the nurse then adds castile soap. After this step, the container is raised, the clamp is released, and the solution is allowed to flow long enough to fill the tubing. The tubing is then reclamped. About 6 to 8 cm (2.5 to 3 in) of the tip of the rectal tube is lubricated with water-soluble lubricating jelly. Then, the nurse gently separates the patient's buttocks and locates the anus, and instructs the patient to relax by breathing out slowly through mouth. Finally, the nurse inserts the tip of the enema tube slowly by pointing the tip in the direction of the patient's umbilicus.

Which are predisposing factors for the development of hemorrhoids? Select all that apply.

Hepatic disorders Cardiac failure Pregnancy

A nurse performs a physical assessment of a patient. Which findings are most likely to indicate that the patient has an intestinal obstruction? Select all that apply.

High-pitched and hyperactive bowel sounds Observable peristalsis

Which statement about fecal incontinence is correct?

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

During the nursing assessment, a patient reveals that he has diarrhea and cramping every time he has ice cream. He attributes this to the cold nature of the food. However, the nurse begins to suspect that these symptoms are associated with which condition?

Lactose intolerance

Which are short-term solutions to constipation? Select all that apply.

Laxatives Enema

A nurse looks at the findings of a patient's stool analysis. Which findings in the report indicate an abnormality? Select all that apply.

Mucus Pus

Which are defining characteristics of constipation? Select all that apply.

No bowel movement for 4 days Feeling of abdominal fullness Firm left abdominal quadrant

A patient who has malabsorption syndrome asks the nurse about the process of nutrient absorption. What response should the nurse give the patient? Select all that apply.

Nutrients are absorbed into the blood vessels. The jejunum absorbs carbohydrates and proteins. The ileum absorbs fat and bile salts.

A nurse cares for a patient who has pancreatic cancer. Which stool finding is consistent with the patient's disorder?

Oily stool

Which medication may cause constipation?

Opioid analgesics

The nurse is caring for a patient who has undergone a surgery on the pharynx. The patient has a small-bore nasogastric (NG) tube for enteral feeding. After an assessment, the health care provider orders removal of the tube. The nurse follows all the steps of the procedure to remove the tube. Arrange the steps of the procedure in the correct sequence.

Performing hand hygiene and applying gloves reduces transmission of infection. The suction should be turned off and the nasogastric tube should be disconnected from the drainage bag or suction. The tape and fixation device should be removed. These activities make the tube free of all connections for easy removal. The nurse should stand on the patient's right side if right-handed, or left side if left-handed. This allows for easiest manipulation of the tube. Facial tissue may be used to blow the nose if required. A towel placed on the chest prevents the gown from getting soiled. The patient should hold the breath during removal of the tube to prevent aspiration. Clamping the tube prevents aspiration of gastric contents. The tube is received into the towel, because it can be an unpleasant sight. The nares are cleaned and mouth care is provided to promote comfort. The tube and the drainage equipment are disposed to reduce transmission of microorganisms.

A nurse has been assigned to care for a patient who has been prescribed docusate calcium. What conditions would warrant the issuing of this laxative? Select all that apply.

Perianal surgery Hemorrhoids

A nurse cares for a patient who is about to receive a Sengstaken-Blakemore nasogastric tube. What is most likely to be the purpose behind this type of intubation?

Prevention of internal esophageal or gastrointestinal (GI) hemorrhage using pressure

The nurse is explaining to a patient with gastritis about the various physiological functions of the stomach. Which statements pertain to the functions of the stomach? Select all that apply.

Production of hydrochloric acid Secretion of intrinsic factor Storage of food

A nurse is caring for immobilized patients in a hospital setting. Which action taken by the nurse while positioning patients on a bedpan will help them evacuate bowel contents without discomfort?

Rolling the patient onto the bedpan

The nurse is caring for a patient with a colostomy. Which intervention is most important?

Selecting a bag with an appropriate-size stoma opening

The nurse is teaching a patient healthy bowel habits. Which information should be included in the teaching? Select all that apply.

Stress management techniques should be practiced. Fluid intake should be at least 6 to 8 glasses of water per day. Dietary fibers should be an essential component of the diet.

Which are causes of diarrhea? Select all that apply.

Surgeries of the lower gastrointestinal tract Clostridium difficile Antibiotic use

Which should the nursing mentor include in an explanation to nursing students about the various roles of the large intestine? Select all that apply.

The large intestine can develop hemorrhoids. The large intestine has a role in the elimination function. The large intestine is shorter than the small intestine.

The nurse is assigned to a patient who has been ordered to undergo a colonic transit study. Which statement is true about the procedure?

There is a gap of a few days between the patient swallowing radiopaque markers and the x-ray film examination.

A patient who has constipation is prescribed an osmotic laxative. Which statements are true regarding the risks associated with osmotic laxatives? Select all that apply.

These agents are not meant for the long-term management of constipation. These agents are unsuitable for patients who have kidney dysfunction

A patient complains of difficulty passing stools, which are small, hard lumps. According to the Bristol stool form scale, what would be the classification of these stools?

Type 1

During a history intake assessment, a patient describes stools as soft and smooth, like a sausage. According to the Bristol stool form scale, what would be the classification of these stools?

Type 4

Which condition may be caused by frequent straining during defecation?

hemorrhoids

Which medication may be used to promote defecation?

laxatives

A patient is admitted to the hospital with constipation. Which could be a possible reason?

reduced fluid intake