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Bowel Elimination Care

Bowel Elimination Care. PN 1 Nursing Skill Labs. Factors affecting elimination. change in daily routine ignoring urge because not convenient not allowed out of bed - use of bedpan privacy issues change in diet - vacationers lack of exercise stress medications. Assessing the Abdomen.

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Bowel Elimination Care

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  1. Bowel Elimination Care PN 1 Nursing Skill Labs

  2. Factors affecting elimination • change in daily routine • ignoring urge because not convenient • not allowed out of bed - use of bedpan • privacy issues • change in diet - vacationers • lack of exercise • stress • medications

  3. Assessing the Abdomen • have client void • position supine with knees flexed • warm diaphragm of stethoscope and hands • use diaphragm of stethoscope not bell • start in RLQ >RUQ>LUQ>LLQ • listen for 1-5 mins in each quadrant • listen for 5 mins before declaring no BS

  4. always inspect, auscultate, and palpate in that order WHY?? • should hear high pitched gurgles • normally 5 - 30 bowel sounds per minute • document amount, frequency, consistency, colour, odour, etc.

  5. Collecting Stool Specimens • have patient void first • use a clean or sterile bed pan depending on type of specimen • tell the patient not to put toilet paper in with specimen • do not take specimen from toilet bowel • need 15 - 30 mL of stool

  6. bring requisition, plastic bag, stool container to bedside • fresh specimen produces best results • note on requisition if female patient who is menstruating or any patient who has visible hemorrhoids

  7. Treatments and Procedures Rectal Suppositories • check doctors order • check for patient allergies • 5 rights - patient, drug, route, time, dose • 3 checks - off shelf, before dispensing, prior to putting container away • often kept in fridge

  8. insert past anal sphincter - 4-10 cm • have patient breath in and out deeply to relax sphincter • wear gloves • lubricate suppository well • extra care with hemorrhoids • MAKE SURE YOU UNWRAP IT!!!!!!

  9. Enemas • introduction of solution into the large intestine to remove feces • work by distending or irritating the colon which increases peristalsis • different types • give large volume enemas over 5-10 mins and smaller volume ones over 1-2 mins

  10. pt. should be in left sims position • lubricate tubing and insert 7-10cm • be very gentle if hemorrhoids present • container should be 45cm above bed • have patient take deep breaths to relax • if cramping, lower container or clamp off • clamp tubing before removing • PAD PATIENT WELL!!!!

  11. 1. Cleansing enema • large volume of fluid used (500 - 1000 mL) • hypotonic = tap water • isotonic = NS • irritant = soap suds • hypertonic = fleet enema (smaller volume) • give large volume enemas

  12. 2. Retention Enemas • held in the bowel longer • oil retention enema used to lubricate stool and intestinal mucosa making defecation easier • carminative enema used to help expel flatus and relieve abdominal distension - black and white

  13. Rectal Tubes • helps gas escape by stimulating peristalsis and providing a passageway • may be a post op patients best friend!!! • usually size 22-34 French • position patient on left side AND PAD WELL • lubricate and insert tube about 10cm • DO NOT LEAVE IN LONGER THAN 20 MINS - MAY REPEAT Q 2-3 HOURS

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