Bellringer What causes black and tarry stools What causes green stools Diseases and infection cause what color stools Bowel Elimination Bowel elimination is the excretion of wastes from the gastrointestinal GI system ID: 1047953
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1. Bowel EliminationChapter 26
2. BellringerWhat causes black and tarry stools?What causes green stools?Diseases and infection cause what color stools?
3. Bowel EliminationBowel elimination is the excretion of wastes from the gastrointestinal (GI) system.Factors affecting bowel elimination include:PrivacyHabitsAgeDiet and fluidsExercise and activityDrugsDisability
4. Normal Bowel EliminationFeces move through the intestines by peristalsis.Feces move through the large intestine to the rectum.Feces are stored in the rectum until excreted from the body.Frequency and time of bowel movements vary from person to person.
5. Stools are normally brown, soft, formed, moist, and shaped like the rectum.They have a normal odorObserve and report the following:ColorAmountConsistencyPresence of blood or mucusOdorShapeFrequency of defecationComplaints of pain or discomfort
6. ConstipationOccurs when feces move slowly through bowelCommon causes:Low-fiber dietIgnoring the urge to have a BMDecreased fluid intakeInactivityDrugsAgingCertain diseasesTreatmentIncrease fluid intake and activityStool softeners, Laxatives, Suppositories, Enemas
7. Fecal ImpactionFeces are hard or putty-likeSymptoms include:Abdominal discomfort, abdominal distention (swelling), nausea, cramping, and rectal painOlder persons may have poor appetite, confusion, or even a feverResult of constipation is not relievedTreatment:Digital removalDrugs, Suppositories, EnemasBellringer: Why is checking for and removing impactions dangerous?
8. DiarrheaFeces move through intestines rapidly and reduces time for fluid absorption, causing fluid lossDehydration occurs if fluid is not replaced, which can lead to deathCauses:Irritating foods, some drugs, and microbes in food and waterDehydrationBellringer: What are signs & symptoms of dehydration?
9. Spread of InfectionPreventing the spread of infection is important!!Good hand hygieneStandard Precautions and Bloodborne Pathogen Standard
10. Fecal IncontinenceCauses:Intestinal diseases, Nervous system diseases, Fecal Impaction, Diarrhea, Chronic Illness, Aging, Mental Health problems or dementia, Not getting to bathroom in time, Problems removing clothesAffects person emotionallyPerson with fecal incontinence may need:Bowel trainingHelp with elimination after meals and every 2 to 3 hoursIncontinence products to keep garments and linens cleanGood skin care
11. FlatulenceCauses include:Swallowing air while eating and drinkingBacterial action in the intestinesGas-forming foods – onions, beans, cabbage, cauliflower, radishes, and cucumbersConstipationBowel and abdominal surgeriesDrugs that decrease peristalsisIntestines distend if flatus is not expelled, leading to abdominal cramping, shortness of breath, and swollen abdomen Exercise, walking, moving in bed, and left side-lying position often assist with expelling flatus
12. Bowel TrainingBowel training has 2 goals:Gain control of bowel movements (BM)Develop a regular pattern of eliminationFecal impaction, constipation, and fecal incontinence are preventedCare Plan will include:Person’s usual time for BMToilet, commode, or bedpan useHigh-fiber dietIncreased fluidsWarm fluidsActivityPrivacy
13. SuppositoriesInserted into rectumBowel movement about 30 minutes laterOrdered for:ConstipationFecal impactionBowel training
14. EnemasDoctors order enemas:To remove fecesTo relieve constipation, fecal impaction, or flatulenceTo clean the bowel of feces before certain surgeries and diagnostic proceduresDoctor orders enema solution, solution determined by purpose:Tap-water enema (obtained from a faucet)Saline enema (solution of salt and water)Soapsuds enema (castile soap and water)Small-volume enemaOil-retention enema (has mineral, olive, or cottonseed oil)
15. Giving EnemasPerson should void firstGive amount of solution orderedSims’ position or left side-lying positionEnema tubing inserted 2 to 4 inches for adultsAdminister fluid slowlyPerson should retain fluid based on amount and type of solution
16. EnemasCleansing EnemasRelieve constipation and fecal impactionNeeded before certain surgeries and diagnostic proceduresSoapsuds enemas irritate the bowel’s mucous liningSmall-volume EnemasIrritate and distend the rectumOrdered for constipation and when bowel does not need complete cleansingOil-retention EnemasRelieve constipation and fecal impactions
17. OstomyColostomyPermanent colostomy, diseased part of the colon is removedTemporary colostomy, gives diseased or injured bowel time to healSite depends on site of disease or injuryStool consistency depends on the colostomy siteSkin care prevents skin breakdown around the stoma
18. IleostomyEntire colon is removedLiquid stools drain constantlyStools must not touch the skin, digestive juices irritating to the skin
19. Ostomy PouchesEmptied when stools are presentPouch is opened when it balloons or bulges with flatusDrain is wiped with toilet tissue before it is closedPouch is changed every 3 to 7 days and when it leaksFrequent pouch changes can damage the skinPerson can wear normal clothesShowers and baths are delayed 1 to 2 hours after applying new pouchDO NOT flush pouches down the toilet