Fundamentals of Nursing 7th Edition By Barbara Astle
Defacation - ANSWER:- movement of stool into the left colon resulting in distention
and relaxation of the internal sphinchter
- external sphinchter relaxes and the abdominal muscles contract forcing the stool
out by increasing intrarectal pressure
Factors influencing patterns of defacation - ANSWER:- Age
- Diet
- Fluid intake
- Positioning
- Pregnancy
- Pain
- Psychological factors
- Physical activity
What is normal? - ANSWER:Colour= yellow (infant) to brown (adult)
Odour= pungent= affected by food type
Consistency= soft formed
Frequency= infant 4-6x (if breast fed); 1-3x (if formula fed)
Amount= 150g/day (adult)
Constituents= undigested food, dead bacteria, fat, bile pigment, cells lining mucosa,
water
<3x/wk can lead to focal impaction - ANSWER:Constipation
Collection of hardened faces wedged into a colon - ANSWER:Impaction
Several bm's in one day, bowel fluids excoriate skin. contaminants= E. Coli -
ANSWER:Diarrhea
Involuntary loss of stool, embarrassment, social isolation - ANSWER:Incontinence
Excess stool in raw bowel, distention, discomfort - ANSWER:Flatulence
Painful, dilated, engorged veins in the lining of the rectum. May bleed , alter
activities, make - ANSWER:Hemorrhoids
Bowel diversions - ANSWER:Ostomies= ileostomy, colostomy
Enterostomal therapist (ET)
Stoma
Effluent
Results in:
, - life style changes
- learning difficulty
- emotional impact
Assessment of bowel elimination - ANSWER:Health pattern history:
- identify clients perception of habits
- Frequency
- Time of day
- Keep a bowel diary (1 week)
- Description of stool characteristics
- Assessment of cognitive ability
Presence and status of bowel diversions:
- frequency of drainage
- character of feces (colour, shape, frequency, consistency, amount 150g per day)
- Condition of stoma
- Type of collection device
Health pattern history:
- changes in appetite
- diet history
- daily fluid intake
- surgery history
- medication history
- emotional state
- pain
- exercise
- pain
- social history: different living arrangements, shared bathrooms
- mobility and dexterity
Assessment of bowel elimination cont. - ANSWER:- Physical examination and direct
observation
- mouth? chewing hydrated?
- Abdomen - assess for:
- observable peristalsis as a sign of intestinal obstruction
- abdominal distention
- gas or flatus
- tenderness during palpation
-Rectum:
- inspection around anus for: lesions, discolourations, inflammation
-Hemorrhoids
Routine diagnostic tests - ANSWER:- stool for focal analysis
- stool for culture and sensitivity