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Bowel Elimination Part 2

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by

Natalie Salgado

on 8 October 2015

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Transcript of Bowel Elimination Part 2

Bowel Elimination Part 2
Pathological Conditions
Food Allergies- dairy products, eggs, gluten, peanuts, shellfish, citrus fruits
Food Intolerances- S/S GI discomfort, pain, gas, bloating, diarrhea, constipation after the food is eaten (example: Lactose intolerance- deficiency of enzyme lactase)
Divericulosis/diverticulitis
Surgery & Procedures
Anesthesia - decrease peristalsis
Stress - decrease peristalsis
Bowel manipulation during surgery (Paralytic ileus/NG tube placement to reduce secretions) - halts peristalsis
Decreased mobility after surgery
Perineal surgery
Anal sphinter surgery
ASSESSMENT
Bowel pattern history
Characteristics of stool
Size, shape, and contour
Bowel sounds - normal high pitched 5-15 gurgles per minute; hyperactive very high pitched & more frequent than normal; hypoactive low pitched infrequent; absent after listening for 3-5 minutes you hear no sounds
BOWEL DIVERSION A DEFINITION
A surgically created opening for elimination of waste products - stoma or ostomy
PROMOTING NORMAL OR REGULAR DEFECATION
Provide privacy
Assist with positioning
Consider timing
Support healthful intake of 25-30 gm of fiber Qd; 2000-2500 mls of fluid Qd preferably H2O
Encourage exercise 3-5 times per wk daily walking
Managing flatulence
Be aware of & avoid
foods that cause gas
Follow self-care strategies
for maintaining regular BMs
Ambulation & excercise stimulates peristalsis
Teach patients when to see a physician
Blood in the stool/unless hemorrhoids
Severe stomach pain
Change in bowel habits
Unintended weight loss
Unrelieved constipation
Diarrhea
Monitor:
stools, fluid balance, serum electrolyte levels, skin integrity
TX interventions:

medications, diet modifications, attention to fluid
balance and skin integrity
Diet & fluids: Clear liquid diet, sip liquids, reduce fiber, limit caffeine, avoid large intake of food or fluid, PLAIN YOGURT or other probiotic foods, BRAT diet
Constipation
Increase intake of fiber
Increase fluid intake
Increase physical activity
Assist patient to a
seated or squatting position
Allow uninterrupted time
Do not ignore urge
Assess for complications
Fecal Impaction
Ileostomy- Kock pouch/continent- ileostomy an internal reservoir; total colectomy with ileoanal reservoir - colon is removed a pouch is created out of the ileum & connect to the rectum
Colostomy- double barrel colostomy; loop colostomy
Paralytic Ileus
KEEP PATIENT NPO
Full transcript