NUR 326 Exam 7
- What is the function of the GI tract?
- breakdown and absorb nutrients from ingested foods
- eliminate waste
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- What composes the upper GI tract?
- mouth, salivary glands, esophagus, and stomach
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- What composes the lower GI tract?
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- small intestines
- large intestines (colon)
- rectum
- Organs involved in digestion?
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- liver, pancreas, gallbladder
- Populations at greatest risk
- all individuals, regardless of age, gender or race are potentially at risk for impaired elimination
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- Populations at greatest risk for impaired elimination?
- children, pregnant people, and older adults
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- How can we manage GI retention/incontinence?
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- promote hydration
- encourage adequate dietary fiber (whole grains, avocados, green leafy vegetables)
- regular toileting practices
- regular exercises 1 / 4
- avoidance of environmental contamination
- What are Collaborative Interventions for Clinical Management
- most common pharmacotherapy (ex
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stool softeners), incontinence management, invasive procedures and surgery (LAST RESORT)
- What medications might help encourage bowel elimination?
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- laxatives
- stool softeners
- antibiotics
- antispasmodics
- analgesics
- What is fecal incontinence?
- recurrent, involuntary passage of stool from rectum for at least 3 months
- can occur for different reasons, including radiation therapy
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- What contributes to fecal incontinence?
- weakness or disruption of the internal or external anal sphincter
- damages to nerves or anal tissue
- amount and consistency of stool
- motility
- inflammation
- disorders of the pelvic floor (rectal prolapse)
- impaction with overflow
- diarrhea
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- How would you treat fecal incontinence?
- regular defecation or bowel training
- high fiber diet or psyllium fiber supplement (matamucil)
- increase intake of caffeine-free foods 2 / 4
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- eliminate foods that cause diarrhea and rectal irritation
- kegal exercises (for pelvic floor issues)
- treatment of diarrhea
- removal of fecal impaction
- stop laxatives or stool softeners
- What is most important with fecal incontinence?
- maintaining skin integrity and doing appropriate interviews and assessments
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- What is bowel retention/constipation?
- fewer that 3 bowel movements (BMs) weekly or BMs that are hard, dry, small, or difficult to
- obstruction, inflammation, or ineffective neuromuscular activation can lead to retention of
- constipation is a symptom, not disease
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pass
stool
- What are some of the contributing factors that can lead to constipation?
- ignoring "urge to go"
- decreased peristalsis (can occur w/ diabetes)
- insufficient dietary fiber or fluids
- decreased activity
- medications (opioids, antidepressants, anticonvulsants etc)
- emotions (fatigue/stress)
- pregnancy
- recent surgery (encourage hydration and movement)
- What are clinical manifestations of constipation?
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- <3 BMs/week
- mild to severe discomfort
- stools are absent or hard, dry and difficult to pass
- small volume of stool
- abdominal distention, bloating, increased flatulence, and increased rectal pressure
- hemorrhoids/straining
- sensation of incomplete emptying of stool 3 / 4
- What are diagnostic tests for constipation?
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- abdominal x-rays
- barium enema
- colonoscopy/sigmoidoscopy
- Prevention and treatment of constipation?
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- increasing dietary fiber
- maintaining adequate fluid intake
- exercise
- laxatives, suppositories, and enemas are LAST RESORT for treating acute con- stipation
- What are nursing implications for constipation?
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- education on prevention
- positioning - semi-squatting to maximize the use of abdominal muscles and force of gravity
- regular time intervals/routines can help
- respond to the urge to defecate
- record bowel elimination patterns
- avoid repetitive, chronic use of laxatives (cathartic colon)
- What is the pathophysiology of an intestinal obstruction?
- blockage that prevents the normal flow of intestinal contents through the intestinal tract
- intestinal contents, fluid, and gas continue to accumulate proximal to the obstruc- tion
- What are the different types of intestinal obstructions?
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- partial vs complete
- small bowel vs large bowel
- mechanical vs functional (paralytic)
- simple vs strangulated
- What is a partial intestinal obstruction?
- some gas, liquid stool can pass through the narrowing
- What is a complete intestinal obstruction?
- / 4
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