NURS 220 Exam 3 Study Guide with Complete Solutions.

NURS 220 Exam 3 Study Guide with Complete Solutions. Bowel Elimination Process of Bowel Elimination -Defecation: process of elimination of waste -Feces: semisolid mass of fiber, undigested food, inorganic material Anatomy and Physiology of the Gastrointestinal Tract -Mouth -Esophagus -Stomach -Small intestine: 3 Sections -duodenum, jejunum, ileum -Large intestine -cecum, colon, rectum -Anus -Defecation: dependent on sensory awareness, voluntary sphincter control -Functions Process of Bowel Elimination -Fecal material reaches rectum -Stretch receptors initiate contraction of sigmoid colon/rectal muscles -Internal anal sphincter relaxes -Sensory impulses cause voluntary “bearing down” -External sphincter relaxes -Developmental stage -Personal factors -Sociocultural factors- stress is one of the factors that cause diarrhea -Nutrition/hydration-put on potty after eat Know place of small intestine, especially jejunum and ileum 1 -Medications-it does cause some constipation -Procedures -Culture- it fixated on drugs Absence of bowel sounds-hypoactive onesdistention, hardness, tenderness Factor Affecting Bowel Elimination -Pregnancy- pregnant women are always compensated -Pathological conditions -Bowel diversions -Ileostomy -Colostomy Characteristics of Feces -Color -Consistency -Shape -Amount -Odor -Constituents Common Diagnostic Tests -Direct visualization -Colonoscopy –does the whole tract -this one needs sedation -Sigmoidoscopy – it goes lower GI tract but not the whole colon -don’t necessary have sedation -Radiographic views -Flat plate of the abdomen ***KNOW difference between these*** -Both tests need permit and bowel prep -They do a lot of flat plate or X-ray to see if you have an obstruction -Laboratory studies (of feces) -Stool for occult blood -Stool for fecal fat -Stool for ova and parasites -Be aware of nursing responsibilities/patient preparation for all tests -Take sample from two different areas -If come out blue, it is positive for blood -This is screening then you need to do more for further evaluation -Red meat can give you positive result or women on period Question The nurse knows that the results of a fecal occult blood test can be inaccurate if a. - The female client is menstruating 2 Promoting Regular Defecation -Provide privacy -Correct position -Seated upright -Timing -Often occurs after meals -Some clients may need assistance -Allow patients to do hand hygiene -Don’t put bed pan on bedside table, or on the floor -Cardiac patients- don’t want them to strain -most ppl if they have a bowel movement you hold your breath, for cardiac patients, it cause them to increase pressure in chest and cause the reflex to go down -make sure they eliminating routinely so they don’t get restrained, hold breath too much not good -Encourage fluids -entourage fluids, the softer the stool is the easier to get out -don’t pick caffeinated fluid -Proper diet -Fresh fruits, vegetables, whole grains, fiber -Exercise -Three to five times a week -Range of motion for clients on bedrest -help to get stool out, get patients moving.