bowel elimination bowel elimination is a basic physical need. it is the excretion of wastes from the...
Post on 24-Dec-2015
237 Views
Preview:
TRANSCRIPT
BOWEL ELIMINATION
BOWEL ELIMINATION• Bowel elimination is a basic physical need. • It is the excretion of wastes from the
digestive system.• As a health care worker, you will deal with
bowel elimination on a regular basis.• Remember, this can be embarrassing and
uncomfortable for the pt.• Some people have BM’s OD, and some
have them q2-3 days. It is important to know what is normal for that specific pt.
BOWEL ELIMINATIONOBSERVATIONS• As a health care worker you must be able to
make the following observations regarding bowel elimination and report/record any abnormalities.
• Colour – brown, white, black/tarry, coffee grounds red/melena, pale, yellow, green,
• Amount - (if diarrhea)• Consistency- soft, formed, liquid, hard• Odour – may be affected by food, infection• Shape – should be shaped like the rectum• Size – Lg, mod, sm• Frequency- varies• C/O Pain – constipation, nausea• Constituents – undigested food, blood, pus,
worms, mucous
BOWEL ELIMINATION
Many factors affect bowel elimination including:
• Age• Fluid intake• Personal habits• Pain• Surgery• Infection
• Physical activity• Disability• Pregnancy• Medications• Diet• Psychological• Positioning• Anesthesia• Dx tests
COMMON BOWEL
PROBLEMS
BOWEL ELIMINATIONCOMMON PROBLEMSCommon problems include:
Constipation: a condition in which BM’s are less frequent and stool is hard and dry as well as difficult to pass. • Defecation many cause pain and the client may only
pass a very small amount of stool. • Constipation occurs when peristalsis slows down and
more water is absorbed by the large intestine. There are many causes including:• low fiber diet * medications• ignoring the urge to defecate * aging• ↓ fluid intake * certain diseases• inactivity
BOWEL ELIMINATION• Fecal impaction: is the prolonged
retention and accumulation of feces in the rectum when constipation is not relieved.
• The feces becomes extremely hard and cannot be expelled.
• If left untreated, a fecal impaction can lead to a complete bowel obstruction requiring surgery.
• Most fecal impactions are manually removed. Signs/symptoms may include:• abd. swelling/cramping * fullness/pain in • N & V * fever• ↑ need to urinate• Liquid feces seeping from the anus
BOWEL ELIMINATIONDiarrhea: the frequent passage of liquid stools. • The feces moves through the intestines at a rapid
rate and fluid is not absorbed. • This causes urgency as well as cramping & nausea.• Causes can include anxiety, infection, food and
medication intolerances. • Dehydration is a concern c diarrhea d/t the
excessive fluid loss. • Dehydration can cause death, be aware of the
signs/symptoms including:• pale, dry skin * oliguria• dry, cracked lips * thirst• weakness * dizziness• confusion * ↓ BP , P & R
BOWEL ELIMINATIONFecal Incontinence: is the inability to control the passage of feces and gas through the anus.
Causes can include:• intestinal & nervous system diseases• injuries • fecal impaction • diarrhea• medications• Those with mental health issues, dementia or
other cognitive disorders may not recognize the need to defecate.
• They may also play with their stool.
BOWEL ELIMINATION• Flatulence: is the
excessive formation of gas or air in the stomach and intestines.
• The gas and air that is passed is called flatus. There are many causes including:
• swallowing air• bacteria• gas forming foods• constipation• surgery • medications
BOWEL ELIMINATIONSUPPOSITORIES• A bullet shaped solid medication that is inserted
into a body opening.• Supps melt at body temperature • Rectal suppositories are usually given to relieve
constipation and results take about 30 mins• Supps can also be used to relieve fever, nausea,
and pain• Suppositories can be inserted by an RN,RPN, or
PSW• Some pt.’s can self medicate.
BOWEL ELIMINATIONENEMAS• An enema is the introduction of fluid into
the rectum and lower colon. • They are given to remove feces and
relieve constipation or fecal impaction. • The most common type of enema is the
commercial enema. • They irritate and distend the rectum to
promote defecation.• Takes approx. 5-10 mins for results
BOWEL ELIMINATIONOSTOMY• Surgical removal of part of the intestine is
sometimes necessary. • This can be d/t cancer, disease or trauma. • An ostomy is the surgical creation of an
artificial opening. This opening is called a stoma.
• Stool consistency depends on the location of the ostomy.
• The higher the ostomy the more liquid the stools
BOWEL ELIMINATIONCOLOSTOMY• A colostomy is the surgically created
opening b/t the colon and the abd. wall. • Part of the colon is brought out onto the
abd. wall and a stoma is made. • Feces and flatus pass through the stoma
into a pouch. • Colostomies can be temporary ( diseased
bowel can heal) or permanent (diseased bowel is removed).
BOWEL ELIMINATIONILEOSTOMY• An ileostomy is the surgically created opening b/t
the ileum and the abd. wall. • The entire large intestine is removed. • Liquid feces drains constantly from an ileostomy. • Good skin care is essential. Ostomy pouches: • must fit well• must be emptied and cleaned frequently• An ostomy is a serious body image change. • It is imperative that health care professionals be
empathetic to the needs of those with ostomies.
ILEOSTOMY
top related