10. What is fecal incontinence?
Answer
- recurrent, involuntary passage of stool from rectum for at least 3 months
- can occur for different reasons, including radiation therapy
11. What contributes to fecal incontinence?
Answer
- weakness or disruption of the internal or external anal sphincter
- damages to nerves or anal tissue
- amount and consistency of stool
- motility
- inflammation
- disorders of the pelvic floor (rectal prolapse)
- impaction with overflow
- diarrhea
12. How would you treat fecal incontinence?
Answer
- regular defecation or bowel training
- high fiber diet or psyllium fiber supplement (matamucil)
- increase intake of caffeine-free foods
,- eliminate foods that cause diarrhea and rectal irritation
- kegal exercises (for pelvic floor issues)
- treatment of diarrhea
- removal of fecal impaction
- stop laxatives or stool softeners
13. What is most important with fecal incontinence?
Answer
- maintaining skin integrity and doing appropriate interviews and assessments
14. What is bowel retention/constipation?
Answer
- fewer that 3 bowel movements (BMs) weekly or BMs that are hard, dry, small, or difficult to
pass
- obstruction, inflammation, or ineffective neuromuscular activation can lead to retention of
stool
- constipation is a symptom, not disease
15. What are some of the contributing factors that can lead to constipation?
Answer
- ignoring "urge to go"
- decreased peristalsis (can occur w/ diabetes)
- insufficient dietary fiber or fluids
- decreased activity
- medications (opioids, antidepressants, anticonvulsants etc)
- emotions (fatigue/stress)
- pregnancy
- recent surgery (encourage hydration and movement)
16. What are clinical manifestations of constipation?
Answer
- <3 BMs/week
- mild to severe discomfort
- stools are absent or hard, dry and difficult to pass
- small volume of stool
- abdominal distention, bloating, increased flatulence, and increased rectal pressure
- hemorrhoids/straining
- sensation of incomplete emptying of stool
, 17. What are diagnostic tests for constipation?
Answer
- abdominal x-rays
- barium enema
- colonoscopy/sigmoidoscopy
18. Prevention and treatment of constipation?
- laxatives, suppositories, and enemas are LAST RESORT for treating acute con- stipation
19. What are nursing implications for constipation?
Answer
- education on prevention
- positioning - semi-squatting to maximize the use of abdominal muscles and force of gravity
- regular time intervals/routines can help
- respond to the urge to defecate
- record bowel elimination patterns
- avoid repetitive, chronic use of laxatives (cathartic colon)
20. What is the pathophysiology of an intestinal obstruction?
Answer
- blockage that prevents the normal flow of intestinal contents through the intestinal tract
- intestinal contents, fluid, and gas continue to accumulate proximal to the obstruc- tion
21. What are the different types of intestinal obstructions?
Answer
- partial vs complete
- small bowel vs large bowel
- mechanical vs functional (paralytic)
- simple vs strangulated
22. What is a partial intestinal obstruction?
Answer
- some gas, liquid stool can pass through the narrowing
23. What is a complete intestinal obstruction?
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