4. Feces enter rectumï distension of rectal wallsï initiates signal through mesenteric plexusï initiate peristaltic waves (descending, sigmoid colon, rectum)ï anusï internal sphincter inhibited from closingï relaxed external sphincterï defecation
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7. FACTORS AFFECTING DEFECATION Age Diet Fluid intake Physical Activity Psychological Factors Personal Habits Position During Defecation Pain Pregnancy Surgery and Anesthesia Medications Diagnostic Tests
17. Assessment of the GIT MTCAT '09 3. Normal pattern of bowel elimination frequency and character of stool use of laxatives, enemas 4. Recent changes in normal patterns changes in character of stool (constipation, diarrhea, or alternating constipation and diarrhea) changes in color of stool melena - black tarry stool (upper GI bleeding) hematochezia â fresh blood in the stool (lower GI bleeding) c. drugs /medications being taken d. measures taken to relieve symptoms
42. Sequential films taken as it moves through the system.Barium â is a radiopaque substance that when ingested or given by enema in solution, outlines the passage ways of the GIT for viewing by x-ray or fluoroscopy
43.
44. Pt. swallows a flavored barium solution and the radiologist observes the progress of the barium through the esophagus and take x-ray films
58. fiberscope â has a thin, flexible shaft that can pass through and around bends in the GIT, transmit light and the image can be seen in the monitor
98. Client who have a low-fiber diet high in animal fats and refined sugar often have constipation problems. Also low fluid intake slows peristalsis
99. Lengthy bed rest or lack of regular exercise causes constipation.
100. Heavy laxative use causes loss of normal defecation reflex. In addition, the lower colon is completely emptied, requiring a time to refill with bulk.
102. Older adult experience slowed peristalsis, loss of abdominal muscle elasticity, and reduce intestinal mucous secretion. Older adults often live alone and eat low-fiber foods.
103. Constipation is also caused by GI abnormalities such as bowel obstruction, paralytic ileus, and diverticulitis
171. Expose the anus and insert the rectal tube into the rectum 10cm (4in). The rectal tube will stimulate peristalsis. If no flatus is expelled, insert the tube another inch or so. Do not force the tube if it does not insert easily.
172. Wrap an abdominal or incontinence pad around the end of the rectal tube to catch any liquid that may be expelled. Or, placing the end of the tube into a receptacle filled with fluid.
173. Leave the tube in no longer than 3 minutes to avoid irritation of the rectal mucosa. If abdominal distention is not relieved, the tube may be inserted every 2 to 3 hours.
177. Critical Thinking Exercise Adam, 1 year old infant was admitted in the hospital due to fever with temperature of 38 C, vomiting and diarrhea for 2 days duration. The nurse reported that the infant defecated 3 times as many stool as usual with watery consistency. Initially, it is apparent that the child is mildly dehydrated because of stool losses secondary to acute infectious diarrhea. What appropriate nursing care plans could you formulate for Adam. Supplement necessary assessment findings significant to the patientâs case. Eve, 15 year old rider, was admitted in the hospital due to vehicular accident. She reportedly loss her consciousness when she was brought to ER thus upon admission, she was placed initially on NPO. After a few days, on a balance skeletal traction to treat fracture. She does not want to eat because according to her, she lost her appetite every time she sees other patients. She had not defecated also for 5 days already. Formulate appropriate nursing care plan for Eve. Supplement necessary assessment findings significant to the patientâs case.