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Bowel Elimination

Bowel Elimination . Health Occupations February 2012. Objectives/Duty Tasks. Task1201- Assist the resident/patient in bowel training Task 1506 -Report nausea, vomiting, pain, inability to swallow, bowel movement changes such as color, diarrhea, or constipation. (gastrointestinal conditions)

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Bowel Elimination

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  1. Bowel Elimination Health Occupations February 2012

  2. Objectives/Duty Tasks • Task1201- Assist the resident/patient in bowel training • Task 1506 -Report nausea, vomiting, pain, inability to swallow, bowel movement changes such as color, diarrhea, or constipation. (gastrointestinal conditions) • 1603 Demonstrate intervention strategies to prevent abuse and neglect. • Label structures of the digestive system • Describe the functions of the digestive system • Describe normal defecation • List observations to be made about defecation • Explain how to promote safety and comfort during defecation

  3. More Objectives • Identify the factors that affect bowel elimination • Explain why enemas are given • Demonstrate competence in assisting resident/patient in toileting

  4. Vocabulary • Bowel movement/Defecation • Constipation • Dehydration • Diarrhea • Enema • Fecal impaction • Fecal incontinence • Feces/stool • Flatus/flatulence • Ostomy • Illeostomy • Colostomy • Stoma • Peristalsis • suppository

  5. Functions of the Digestive System • Ingestion- eating • Digestion- food broken down into small particles • Absorption- vitamins and nutrients are absorbed • Elimination- body expels waste products of metabolism

  6. The Mouth • Around the teeth and through the gums - look out stomach, here it comes ! • Digestion begins here • The teeth – • The Salivary Glands -

  7. Esophagus • Collapsible • Muscular • Mucous lined • 10 inches long

  8. Stomach • Expandable sac • Gastric juices • Chyme • 2-4 hours • Pyloric Sphincter

  9. Small Intestine • Nutrient absorption • 20 feet long • Large surface area • Villi • Ducts for pancreatic juices/bile

  10. Liver • Produces bile • Aids in fat digestion

  11. Gallbladder • Muscular sac - under the liver • Stores/ concentrates bile • Bile released from the GB into the Small Intestine

  12. Pancreas • Secretes digestive enzymes • Proteases - proteins • Lipase - fats • Amylase –starches

  13. Large Intestine • AKA Colon • 5 feet long • Absorbs water from food that can not be digested

  14. The End of the Line • Rectum • 2 inch long canal • Serves as a holding area for stool • Anus • 2 sphincters ( ring muscles) control defecation

  15. KITSES • Animation of Digestive system • http://kitses.com/animation/swfs/digestion.swf

  16. Normal Bowel Movements • Defecation • Feces • Stool • Frequency • Timing • color- • Diet- affects color • Diseases- affects color • Shape • Consistency • Odor

  17. NA Observations • Notice • Color • Amount • consistency • Frequency • Odor • Shape • Complaints of pain/discomfort

  18. Factors Affecting Bowel Elimination • Privacy • Habits • Diet • Fluids • Activity • Drugs • Disability • Age

  19. Comfort and Safety • in packet- complete this slide using Box 20-1 page 377

  20. Effects of Aging on Bowel Elimination • Complete this slide on the back of your PowerPoint packet using Page 377 in text packet as a reference

  21. Constipation • Passage of a hard dry stool • Caused by feces moving slowly through the bowel • Stools large or marble sized • Caused by low fiber diet, inactivity, medications, resisting the urge to defecate. Aging, certain diseases

  22. Fecal Impaction • Prolonged retention of feces in rectum • The longer the feces sits in the rectum the harder the feces gets • Feces becomes hard or putty like • Abdominal discomfort, nausea, cramping, rectal pain • Digital exam( not an NA function) • Digital removal of impaction ( not an NA function)

  23. Diarrhea • Frequent passage of liquid stools • Feces move through bowel rapidly reduces time for fluid absorption • Sometimes causes fecal incontinence • causes – infection, drugs, irritating foods, pathogens in food

  24. Care for residents/patients with diarrhea • Respond to elimination needs promptly • Dispse of stools promptly, using infection control measures • Good skin care liquid stools can be irritating to the skin • Risk of dehydration – flushed, dry sskin, headache , dizziness, oliguria , concentrated urine, coated skin

  25. Fecal Incontinence • Inability to control the passage of feces or flatus through the anus • Intestinal diseases • Nervous system diseases • Fecal impaction • Diarrhea • Some medications • dementia/ mental health disorders

  26. Care for people with Fecal Incontinence • Bowel Training • Help with toileting after meals and every 2-3 hrs. • Incontinence products to keep linens and garments clean • Good skin care

  27. Flatulence • Gas and air are normal in stomach and intestines • Expelled through mouth and anus • Gas and air through anus is called flatus • Flatulence is excessive flatus Causes • Swallowing air • Bacterial action of the intestines • Gas forming foods • Constipation • Medicines that decrease peristalsis • Bowel surgeries

  28. Bowel Training Goals • Gain control of bowel movements • Develop a regular pattern of elimination • Note resident’s normal time for elimination • Usually after a meal • Toilet resident at the same time each day after a meal • Also-high fiber diet, warm liquids, activity and privacy

  29. Enemas • Introduction of fluid into rectum and lower colon • Ordered by the physician, NP, PA

  30. Ostomies • Surgically created opening • In digestive system the opening is on the abdomen • Named by where in the intestine the opening is created • Colostomy- large intestine • Illeostomy – small intestine Care • Prevent skin irritation • Change ostomy pouch

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