1 / 66

Basic Human Needs Bowel Elimination

Basic Human Needs Bowel Elimination. Bowel Elimination. GI Tract is a series of hollow mucous membrane lined muscular organs Purpose is to absorb fluids & nutrients, prepare food for absorption & provide storage for feces. GI Tract Anatomy. Mouth Esophagus Stomach Small Intestine

Download Presentation

Basic Human Needs Bowel Elimination

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Basic Human NeedsBowel Elimination

  2. Bowel Elimination • GI Tract is a series of hollow mucous membrane lined muscular organs • Purpose is to absorb fluids & nutrients, prepare food for absorption & provide storage for feces

  3. GI Tract Anatomy • Mouth • Esophagus • Stomach • Small Intestine • Large Intestine • Rectum

  4. Colon • 3 Divisions: Ascending, Transverse, Descending • Colon Functions: Absorption, Protection, Secretion, & Elimination (stool and flatus)

  5. Flatus Formation • Air swallowing • Diffusion of gas from bloodstream into intestines • Bacterial action on unabsorbable CHO (Beans) • Fermentation of CHO (cabbage, onions • Can stimulate peristalsis • Adult forms 400-700 ml of flatus daily

  6. Factors Affecting Bowel Elimination • Age • Infection • Diet • Fluid Intake • Physical Activity • Psychological factors • Personal Habits

  7. Factors Affecting Bowel Elimination • Position during Defecation • Pain • Surgery and Anesthesia • Medications

  8. Common Bowel Elimination Problems • Constipation • Impaction • Diarrhea • Incontinence • Flatulence • Hemorrhoids

  9. Constipation • More of a symptom than a disorder • Decrease in frequency of BM • Straining & pain on defecation is associated symptoms(Valsalva maneuver) • Can be significant heath hazard (increase ICP, IOP, reopen surgical wounds, cause trauma, cardiac arrhythmias)

  10. Impaction • Results from unrelieved constipation • Collection of hardened feces wedged into rectum • Can extend up to sigmoid colon • Most at risk: depilated, confused, unconscious (all are at risk for dehydration)

  11. Impaction • When a continuous ooze of diarrheal stool develops, impaction should be suspected • Associated S/S: Loss of appetite, abdominal distention, cramping, rectal pain

  12. Diarrhea • Increase in number of stools & the passage of liquid, unformed stool • Symptom of disorders affecting digestion, absorption, & secretion of GI tract • Intestinal contents pass through small & large intestines too quickly to allow for usual absorption of water & nutrients

  13. Diarrhea • Irritation can result in increased mucus secretion, feces become too watery, unable to control defecation • Excess loss of colonic fluid can result in acid-base imbalances or fluid/electrolyte imbalances • Can also result in skin breakdown

  14. Conditions that cause Diarrhea • Emotional Stress • Intestinal Infection (Clostridium difficile) • Food Allergies • Food Intolerance • Tube Feedings (Enteral) • Medications • Laxatives • Colon Disease • Surgery

  15. Incontinence Inability to control passage of feces and gas from the anus • Caused by conditions that create frequent, loose, large volume, watery stools or conditions that impair sphincter control or function

  16. Flatulence • Gas accumulation in the lumen of intestines • Bowel wall stretches and distends • Common cause of abdominal fullness, pain, & cramping • Gas escapes through mouth (belching), or anus (flatus)

  17. Hemorrhoids • Dilated, engorged veins in the lining of the rectum • External (Clearly visible) or Internal • Caused by straining, pregnancy, CHF, chronic liver disease

  18. Clicker Question 1. A newly admitted client states that he has recently had a change in medications and reports that stools are now dry and hard to pass. This type of bowel pattern is consistent with: A. Abnormal defecation B. Constipation C. Fecal impaction D. Fecal incontinence 46 - 24

  19. Bowel Diversions • Certain diseases cause conditions that prevent normal passage of feces through rectum • Creates need for temporary or permanent artificial opening (stoma) in the abdominal wall

  20. Bowel Diversions • Surgical openings (ostomy) are most commonly formed in the ileum (ileostomy) or the colon (colostomy) • Incontinent ostomy- need to wear appliance pouch • Continent ostomy- have control through use of ostomy cap

  21. Incontinent Ostomy • Location of ostomy determines consistency of stool • Ileostomy bypasses the entire large intestine, stools are frequent & watery • Ascending colostomy- liquid stool • Sigmoid colostomy-most like normal stool

  22. Incontinent Ostomies • Loop colostomy- temporary, usually done on transverse colon • 2 openings through stoma, proximal loop for stool, distal loop for mucus • End colostomy- one stoma formed from the proximal end of the bowel with the distal portion removed or sewn shut (Hartmann’s Pouch)

  23. Incontinent Ostomies • End colostomy usually done for colorectal cancer • Ruptured diverticulum- temporary end colostomy with a Hartmanns Pouch • Double barrel colostomy- Bowel is surgically severed, 2 ends are brought out onto abdomen with 2 distinct stomas (proximal & distal)

  24. Continent Diversions • Ileoanal reservoir- restorative proctocolectomy, no outward stoma, no pouch wearing, clients have internal pouch created from the ileum • Ileal pouches constructed in various configurations (S,J,W) • End of the pouch is sewn or anastamosed to the anus

  25. Continent DiversionsIleoanal Reservoir • Several stages to surgery to create pouch • May need temporary ostomy to allow time for pouch to heal • Kegel exercises to increase pelvic floor muscle tone

  26. Continent Diversions • Kock Continent Ileostomy-Internal reservoir or pouch is created using piece of small intestine • Stoma brought out low on abdomen, end of internal part in pouch is a one way nipple valve to promote continence • Valve only allows fecal contents to drain when an external catheter is place in stoma, no pouch required

  27. Ostomy Nursing Considerations • Patient Education • Care of skin & stoma, appliance selection and use • Body Image considerations • Support groups (UOA) • Enterostomal nursing- specialty within profession

  28. Nursing ProcessAssessment • Nursing History • Physical Assessment • Lab Tests • Fecal characteristics • Diagnostic evaluation- Endoscopy, Colonoscopy

  29. Nursing Diagnosis • Bowel Incontinence • Constipation • Diarrhea • Impaired Skin Integrity • Body Image Disturbance • Altered bowel elimination • Pain

More Related