Elimination Anuradha Perera B Sc Nspecial Alteration in

Elimination Anuradha Perera (B. Sc. N)special

Alteration in Bowel Elimination • • • Diarrhea Constipation Incontinence Fecal Impaction Flatulence

Characteristics of Stool • • • Volume Color Odor Consistency Shape Constituents

Factors That Influence Bowel Elimination • • Age Fluid Intake & Diet Daily Routine Activity Medications Health Status Stress

Diet High fiber foods: • Legumes (beans) • Cereals • Whole grains • Raw Fruits • Vegetables Laxative effect foods: • Spicy & greasy • Bran/Chocolate • Coffee/Alcohol • Raw fruits & vegetables

Assessing Elimination Status • Usual pattern • Changes in bowels • Aids to eliminate • Current problems

Physical Assessment • Inspection- observe contour of abd and note visible peristalsis • Auscultation- listen for bowel sounds all quadrants • Percussion- resonant or tympany over hollow organs…dullness over intestinal obstruction • Palpation- feel for masses, tenderness etc…

Stool Specimen Collection • Routine specimen • Occult blood • Ova & parasite • Timed specimens

Nursing Dx R/T Bowel Elimination ?

Outcome Criteria • Pt. will: • Develop regular pattern of elimination • Have less episodes of incontinence • Incorporate fluids/diet that promote bowel elimination

Interventions to Promote Elimination • • • Routine Positioning Privacy Comfort Activity Diet/Fluids

Interventions: Promote Bowel Elimination • • Laxatives and Cathartics Enemas Suppositories Digital Removal

Enema Administration • PPE • IV pole • Position L Sims • Lubricant • Linen protector • Enema bag with solution • Receptacle (bedpan, commode, toilet) • Tissue paper

Enema Administration • • • Position L Sims Insert lubricated tip 4” Bag raised 18 -20” above anal canal Administer slowly - 10 min. Administration is individualized. Pt. holds for 15 min.

Evaluation • Unusual findings • Solution given blood, • Amount expelled helminthes, pus • Characteristics of etc. stool • Client reaction: • Passing of flatus change in skin color, VS changes, fatigue

Medications Effecting Bowel Elimination • Laxatives- induce emptying of GI tract • Antidiarrheal- slow peristalsis, Pepto Bismol, Kaopectate • Codeine/morphine/iron- cause constipation • Antibiotics-may cause diarrhea • Opiates: paragoric, lomotil- habit forming

Flatulence Causes: • Decreased peristalsis • Constipation • Medications • Surgery • Diet • Stress • Decreased activity

Non. Invasive Interventions for Flatulence *Ambulation* • Knee chest position

Evaluation of Bowel Function • Achievement of regular defecation habits • Patient’s understanding of normal elimination • Maintenance of adequate food and fluid intake • Regular exercise program • Comfort • Skin integrity