Bowel Elimination

Nursing B20-

Fundamentals of Nursing

Psychological/ Physiological Factors Affecting Elimination Age and developmental factors Dietary intake Fluid intake Physical activity Psychological factors Personal elimination habits

Psychological/ Physiological Factors Affecting Elimination (contd)

Position during defecation Pain Pregnancy General anesthesia Medications Diagnostic GI tests

Common Bowel Elimination Problems Constipation Fecal Impaction Diarrhea Incontinence Flatulence Hemorrhoids

Bowel Diversions

Three types of colostomies– Loop Colostomy– End Colostomy– Double-Barrel Colostomy

Ileostomy

Bowel Diversions

Single (End) Colostomy

Bowel Diversions

Loop Colostomy

Bowel Diversions

Double Barrel Colostomy

Bowel Diversions

Assessment of Bowel Function

Nursing History Physical Assessment Fecal Characteristics Laboratory/ Diagnostic Tests

– Fecal specimens– Guaiac test– Diagnostic tests

• Direct visualization• Indirect visualization

Nursing Diagnosis

Constipation Diarrhea Bowel Incontinence Pain Self-Care Deficit- Toileting Body Image Disturbance Risk for/ Impaired Skin Integrity

Plan and Implementation

Promotion of regular bowel habits Promotion of normal defecation Digital removal of stool Maintenance of proper fluid/ food intake Promotion of regular exercise Promotion of comfort

Plan and Implementation (continued)

Use of enemas– Cleansing enemas

• Tap water- hypotonic• Normal saline- isotonic• Fleets- hypertonic• Soap Suds- intestinal irritation

– Oil Retention enemas– Carminative– Return flow or Harris flush– Medicated

Plan and Implementation (continued)

Care of Ostomies– Pouching of Ostomies

Plan and Implementation (continued)

Irrigating an ostomy