bowel elimination health occupations february 2012
TRANSCRIPT
Bowel Elimination
Health OccupationsFebruary 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)
• 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
More Objectives
• Identify the factors that affect bowel elimination
• Explain why enemas are given• Demonstrate competence in assisting
resident/patient in toileting
Vocabulary
• Bowel movement/Defecation
• Constipation• Dehydration• Diarrhea• Enema• Fecal impaction• Fecal incontinence
• Feces/stool• Flatus/flatulence• Ostomy• Illeostomy• Colostomy• Stoma• Peristalsis• suppository
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
The Mouth
• Around the teeth and through the gums - look out stomach, here it comes !
• Digestion begins here• The teeth –• The Salivary Glands -
Esophagus
• Collapsible• Muscular• Mucous lined• 10 inches long
Stomach
• Expandable sac• Gastric juices• Chyme• 2-4 hours• Pyloric Sphincter
Small Intestine
• Nutrient absorption• 20 feet long • Large surface area • Villi • Ducts for pancreatic
juices/bile
Liver
• Produces bile • Aids in fat digestion
Gallbladder
• Muscular sac - under the liver
• Stores/ concentrates bile
• Bile released from the GB into the Small Intestine
Pancreas
• Secretes digestive enzymes
• Proteases - proteins• Lipase - fats• Amylase –starches
Large Intestine
• AKA Colon
• 5 feet long
• Absorbs water from food that can not be digested
The End of the Line
• Rectum• 2 inch long canal• Serves as a holding area
for stool
• Anus• 2 sphincters ( ring muscles) control defecation
KITSES
• Animation of Digestive system• http://
kitses.com/animation/swfs/digestion.swf
Normal Bowel Movements
• Defecation• Feces• Stool• Frequency• Timing
• color-– Diet- affects color– Diseases- affects color
• Shape• Consistency• Odor
NA Observations
• Notice– Color– Amount – consistency – Frequency– Odor– Shape– Complaints of pain/discomfort
Factors Affecting Bowel Elimination
• Privacy• Habits• Diet• Fluids• Activity• Drugs• Disability• Age
Comfort and Safety
• in packet- complete this slide using Box 20-1 page 377
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
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
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)
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
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
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
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
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
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
Enemas
• Introduction of fluid into rectum and lower colon
• Ordered by the physician, NP, PA
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