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Med Surg Chapter 47 - medical surgical
Medical/Surgical Nursing I: Acute (University of Phoenix)
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Medical-Surgical Nursing
Chapter 47- Management of Patients with Intestinal and Rectal Disorders
Abnormalities of Fecal Elimination
• Changes in patterns of fecal elimination are symptoms of functional disorders or diseases
of the GI tract
• Most common changes: constipation, diarrhea, and fecal impaction
Constipation
• Constipation- defined a fewer than three bowel movements that are hard, dry, small, or
difficult to pass
• Assessment and Diagnostic Findings:
o Patient history o Physical examination o Barium enema
o Sigmoidoscopy
o Stool testing for occult blood o Anorectal manometry
o Colonic transit studies o Defecography o Pelvic floor MRI
• Complications:
o Increased arterial pressure o Fecal impaction fecal incontinence o
Hemorrhoids (dilated portions of anal veins) o Fissures (normal/abnormal folds,
grooves, or cracks in body tissues) o Rectal prolapse o Megacolon
• Gerontologic Considerations:
o Most common in people 65 years or older
o Most common complaint they voice is the need to strain at stool
• Treatment: o Education o Exercise o Bowel habit training o Increased fiber and fluid
intake
o Use of laxatives
o Gastrocolic reflex- peristaltic movements of the large bowel occurring five to six
times daily that are triggered by distention of the stomach
Selected Laxatives
Bulk Forming Polysaccharides and cellulose and wheat
methycellulose (Citrucel), psyllium derivatives mix with intestinal fluids, swell,
(Metamucil), wheat dextrin (Benefiber) and stimulate peristalsis
Saline Agent Alter stool consistency by drawing water into
magnesium hydroxide (Milk of Magnesia) the intestines by osmosis; action occurs
within 2 hours
Lubricant Soften fecal matter by lubricating the
mineral oil, glycerin suppository intestinal mucosa; action occurs within 6-8
hours for mineral oil and within 30 minutes
for glycerin suppository
Downloaded by Antony Njoroge ()
Med Surg Chapter 47 - medical surgical
Medical/Surgical Nursing I: Acute (University of Phoenix)
Scan to open on Studocu
,Studocu is not sponsored or endorsed by any college or university
Downloaded by Antony Njoroge ()
, lOMoARcPSD|637 929 53
Medical-Surgical Nursing
Chapter 47- Management of Patients with Intestinal and Rectal Disorders
Abnormalities of Fecal Elimination
• Changes in patterns of fecal elimination are symptoms of functional disorders or diseases
of the GI tract
• Most common changes: constipation, diarrhea, and fecal impaction
Constipation
• Constipation- defined a fewer than three bowel movements that are hard, dry, small, or
difficult to pass
• Assessment and Diagnostic Findings:
o Patient history o Physical examination o Barium enema
o Sigmoidoscopy
o Stool testing for occult blood o Anorectal manometry
o Colonic transit studies o Defecography o Pelvic floor MRI
• Complications:
o Increased arterial pressure o Fecal impaction fecal incontinence o
Hemorrhoids (dilated portions of anal veins) o Fissures (normal/abnormal folds,
grooves, or cracks in body tissues) o Rectal prolapse o Megacolon
• Gerontologic Considerations:
o Most common in people 65 years or older
o Most common complaint they voice is the need to strain at stool
• Treatment: o Education o Exercise o Bowel habit training o Increased fiber and fluid
intake
o Use of laxatives
o Gastrocolic reflex- peristaltic movements of the large bowel occurring five to six
times daily that are triggered by distention of the stomach
Selected Laxatives
Bulk Forming Polysaccharides and cellulose and wheat
methycellulose (Citrucel), psyllium derivatives mix with intestinal fluids, swell,
(Metamucil), wheat dextrin (Benefiber) and stimulate peristalsis
Saline Agent Alter stool consistency by drawing water into
magnesium hydroxide (Milk of Magnesia) the intestines by osmosis; action occurs
within 2 hours
Lubricant Soften fecal matter by lubricating the
mineral oil, glycerin suppository intestinal mucosa; action occurs within 6-8
hours for mineral oil and within 30 minutes
for glycerin suppository
Downloaded by Antony Njoroge ()
