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Download Alteration in Bowel Elimination
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Elimination Anuradha Perera (B.Sc.N)special Alteration in Bowel Elimination • • • • • Diarrhea Constipation Incontinence Fecal Impaction Flatulence Characteristics of Stool • • • • • • Volume Color Odor Consistency Shape Constituents Factors That Influence Bowel Elimination • • • • • • • Age Fluid Intake & Diet Daily Routine Activity Medications Health Status Stress Diet High fiber foods: • Legumes (beans) • Cereals • Whole grains • Raw Fruits • Vegetables Laxative effect foods: • Spicy & greasy • Bran/Chocolate • Coffee/Alcohol • Raw fruits & vegetables Assessing Elimination Status • Usual pattern • Changes in bowels • Aids to eliminate • Current problems Physical Assessment • Inspection- observe contour of abd and note visible peristalsis • Auscultation- listen for bowel sounds all quadrants • Percussion- resonant or tympany over hollow organs…dullness over intestinal obstruction • Palpation- feel for masses, tenderness etc… Stool Specimen Collection • Routine specimen • Occult blood • Ova & parasite • Timed specimens Nursing Dx R/T Bowel Elimination ? Outcome Criteria • Pt. will: • Develop regular pattern of elimination • Have less episodes of incontinence • Incorporate fluids/diet that promote bowel elimination Interventions to Promote Elimination • • • • • • Routine Positioning Privacy Comfort Activity Diet/Fluids Interventions: Promote Bowel Elimination • • • • Laxatives and Cathartics Enemas Suppositories Digital Removal Enema Administration • PPE • IV pole • Position L Sims • Lubricant • Linen protector • Enema bag with solution • Receptacle (bedpan, commode, toilet) • Tissue paper Enema Administration • • • • • • Position L Sims Insert lubricated tip 4” Bag raised 18-20” above anal canal Administer slowly - 10 min. Administration is individualized. Pt. holds for 15 min. Evaluation • Unusual findings • Solution given blood, • Amount expelled helminthes, pus • Characteristics of etc. stool • Client reaction: • Passing of flatus change in skin color, VS changes, fatigue Medications Effecting Bowel Elimination • Laxatives- induce emptying of GI tract • Antidiarrheal- slow peristalsis, Pepto Bismol, Kaopectate • Codeine/morphine/iron- cause constipation • Antibiotics-may cause diarrhea • Opiates: paragoric, lomotil- habit forming Flatulence Causes: • Decreased peristalsis • Constipation • Medications • Surgery • Diet • Stress • Decreased activity NonInvasive Interventions for Flatulence *Ambulation* • Knee chest position Evaluation of Bowel Function • Achievement of regular defecation habits • Patient’s understanding of normal elimination • Maintenance of adequate food and fluid intake • Regular exercise program • Comfort • Skin integrity
