Fundamentals of Nursing NUR 101

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Fundamentals of Nursing (NUR 101)

• Prepared by Nabeel Al-Mawajdeh RN.Mcs.King
  Saud University- Aflaj College

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Chapter 15

• Bowel Elimination

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Retention Enemas

• Oil-retention lubricate the stool and
  intestinal mucosa easing defecation.
• Carminative help expel flatus from rectum.
• Medicated provide medications absorbed through
  rectal mucosa.
• Anthelmintic destroy intestinal parasites.
• Nutritive administer fluids and nutrition
  rectally.

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The Large Intestine Function

• Primary organ of bowel elimination.
• Extends from the ileocecal valve to the anus.
• Functions.
• Completion of absorption.
• Manufacture of some vitamins.
• Formation of feces.
• Expulsion of feces from the body.

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Process of Peristalsis

• Peristalsis is under control of the nervous
  system.
• Contractions occur every 3 to 12 minutes.
• Mass peristalsis sweeps occur 1 to 4 times each
  24-hour period.
• One-third to one-half of food waste is excreted
  in stool within 24 hours.

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Variables Influencing Bowel Elimination

• Developmental considerations.
• Daily patterns.
• Food and fluid.
• Activity and muscle tone.
• Lifestyle, psychological variables.
• Pathologic conditions.
• Medications.
• Diagnostic studies.
• Surgery and anesthesia.

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Foods Affecting Bowel Elimination

• Constipating foods cheese, lean meat, eggs,
  pasta.
• Foods with laxative effect fruits and
  vegetables, bran, chocolate, alcohol, coffee.
• Gas-producing foods onions, cabbage, beans,
  cauliflower.

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Effect of Medications on Stool

• Aspirin, anticoagulants pink to red to black
  stool.
• Iron salts black stool.
• Antacids white discoloration or speckling in
  stool.
• Antibiotics green-gray color.

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Individuals at High Risk for Constipation

• Patients on bed rest taking constipating
  medicines.
• Patients with reduced fluids or bulk in their
  diet.
• Patients who are depressed.
• Patients with central nervous system disease or
  local lesions that cause pain.

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Nursing Measures for the Patient With Diarrhea

• Answer bell calls immediately.
• Remove the cause of diarrhea whenever possible
  (e.g., medication).
• If there is impaction, obtain physician order for
  rectal examination.
• Give special care to the region around the anus.
• After diarrhea stops, suggest the intake of
  fermented dairy products.

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Methods of Emptying the Colon of Feces

• Enemas.
• Rectal suppositories.
• Rectal catheters.
• Digital removal of stool.

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Types of Enemas

• Cleansing.
• Retention.
• Return flow.

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Bowel Training Programs

• Manipulate factors within the patient's control.
• Food and fluid intake, exercise, time for
  defecation.
• Eliminate a soft, formed stool at regular
  intervals without laxatives.
• When achieved, discontinue use of suppository if
  one was used.

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• The End