NSG 3100 EXAM 3 NOTES QUESTIONS AND ANSWERS

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Exam 3- Unit 6-8. Ch. 34 Diagnostic testing p. 718-748 Carpentino- p. 58, p. 63, p. 80, p. 152-153, 153-156, Ch. 48 Urinary Elimination p. 1174-1209 p. 157-161, p. 161-162, p. 162-164 Ch. 49 Fecal ... Elimination p. 1210-1240 Ch. 35 Medication p. 750-825 Fecal Elimination  Elimination of the waste products of digestion from the body is essential to health.  Feces/stool- excreted waste products.  Hasutra- pouches in large intestine.  Ingestion- the act of taking in food.  Chyme- waste product that leaves the stomach through the small intestine and then passing through the ileocecal valve. o As much as 1,500 mL of chyme passes into the large intestine daily.  Flatus- largely air and the by products of the digestion of carbohydrates.  Haustral Churning- involves movement of the chyme back and forth within the haustra.  Peristalsis- wavelike movement produced by the circular and longitudal muscle fibers of the intestinal walls: it propels the intestinal contents forward.  Mass peristalsis- third type of colonic movement involves a wave of powerful muscular contraction that moves over large areas of the colon.  Hemorrhoids- when veins become distended.  Defecation- expulsion of feces from the anus and rectum. Also called a bowel movement.  Individuals may use different terms for a bowel movement. The nurse may need to try several different common words before finding one the client understands.  Feces o 75% of water o 25% of solid materials  Factors that affect defecation o Development  Newborns and infants- meconium is the first fecal material passed by the newborn within the first 24 hours after birth. Infants pass stool frequently.  Toddlers- some control of defecation at 1 ½ to 2 years of age.  School aged and Adolescents- have similar bowel habits to adults.  Older adults- constipation problems, o Diet  sufficient bulk in the diet is necessary to provide fecal volume.  Inadequate intake of dietary fiber contributes to the risk od developing obesity, type 2 diabetes, coronary artery disease, and colon cancer. o Fluid intake and output  Reduced fluid intake will slow the chyme’s passage along the intestines, further increasing reabsorption of fluid from the chyme. o Activity o Psychological factors  People who are anxious or angry experience increased peristaltic activity. o Defecation habits o Medications NSG 3100 EXAM 3 NOTES QUESTIONS AND ANSWERS o Diagnostic procedures o Anesthesia and surgery o Pathologic conditions  Spinal cord injuries and head injuries can decrease sensory stimulation for defecation. o Pain  Fecal elimination problems o Constipation  Insufficient fiber intake  Insufficient fluid intake  Insufficient activity or immobility  Irregular defecation habits  Change in daily routine  Lack of privacy  Chronic use of laxatives  IBS  Pelvic floor dysfunction  Poor motility or slow transit  Neurologic conditions  Emotional disturbances  Medications  Habitual denial and ignoring urge o Diarrhea  Passage of liquid feces and an increased frequency of defecation. o Bowel Incontinence  Loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter. o Flatulence  Presence of excessive flatus in the intestines and leads to stretching and inflation of the intestines.  Bowel Diversion Ostomies o Ostomy- opening for the GI, Urinary, or respiratory tract onto the skin. o Gastrostomy- opening through the abdominal wall into the stomach. o Jejunostomy- opens through the abdominal wall into the jejunum. o Ileostomy- opens into the colon. o Stoma- opening created in the abdominal wall by the ostomy. o Permanence  Permanent colostomies are performed to provide a means of elimination when the rectum or anus is nonfunctional as a result of a birth defect or a disease such as cancer of the bowel. o Surgery to reconnect the ends of the bowel of a temporary ostomy may be called a take-down.  Surgical construction of a stoma o End or terminal colostomy- created when one end of the bow is brought out through an opening on to the anterior abdominals wall. This is permanent. o Loop Colostomy- A loop of bowel is brought out onto the abdominal wall and supported by a plastic bridge or by a piece of rubber tubing. o Divided colostomy- consists of two edges of valve brought out onto the abdomen but separated from each other. o Double barreled colostomy- the proximal and distal loops of bowel are sutured together for about 10 centimeters (4 in.) and both ends are brought up on to the abdominal wall.  Assessing o Vitals o Examination of abdomen, rectum, and anus o Inspecting feces o Diagnostic testing data o Pain level o Nursing history- normal pooping pattern, current or past medical problems  Diagnosing o Bowel incontinence o Constipation o Risk for constipation o Perceived constipation o Diarrhea o Dysfunctional GI motility o Risk for deficient fluid volume and.or risk for electrolyte imbalance o Risk for impaired skin integrity o Situational low self-esteem o Disturbed body image o Deficient knowledge (bowel training, ostomy management) o Anxiety  Planning o Maintain and restore normal bowel elimination o Maintain or regain normal stool consistency o Prevent associated risks such as fluid and electrolyte imbalance, skin breakdown, abdominal distention, and pain. o Planning for homecare  Implementation o Provision of privacy  Nurse should provide as much privacy as possible for patient o Timing  The client and the nurse can discuss when mass peristalsis normally occurs and provide time for defecation. Nurse should encourage client to poop multiple times daily. o Nutrition and fluids  For constipation, increase daily fluid intake and instruct the client to drink hot liquids, warm water with a squirt of fresh lemon, and fruit juices, especially prune juice. Include fiber in the diet.  For diarrhea, encourage oral intake of fluids and bland foods. Eating small amounts can be h [Show More]

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