Large Intestine A&P - ANSWER -starts at cecum (appendix)
-ascending->transverse->descending->sigmoid->rectum
-NO villi or enzymes
-absorbs water, breaks down, and eliminates
-uses bacteria to break down (can cause gas)
Control of Defecation - ANSWER -sphincter:
-internal: involuntary
-external: voluntary
-puborectal muscle
-bowel's own nerve supply
Physiology of Defecation - ANSWER Fecal Mass in Rectum-
>"defecation reflex"->sphincter relax->
rectum contracts->diaphragm and abdominal muscle assist->defecation
*Avoidance can lead to constipation
Elimination: Age related changes - ANSWER -smooth muscle tone
decreases
-connective tissue increases
*End result is constipation
Nursing Assessment: Lower GI: Interview - ANSWER -wt change
-bowel pattern change (bowel habits)
-use of laxatives
-surgeries
-Family Hx: DM, cancer, obesity
Nursing Assessment: Lower GI: Physical Exam - ANSWER -Inspect
abdomen
-Auscultate bowel sounds
*start timing after you hear 1st bowel sound
, *If there is a belief of absence of sound be sure to listen for
2 full minutes in each quadrant
-Palpitate
* Palpitate known tender areas last
Lower GI: Radiology - ANSWER -Prep: enemas or stimulant laxatives
*Barium Enema used to visualize colon and lower GI
--Ultrasound also used
***increase fluid and fiber after barium is used
Lower GI: Endoscopy - ANSWER -prep: bowel evacuation
* polyethylene-GoLYTELY
* Fleet oral solution - causes cramping and diarrhea
-proctoscopy- visualize rectum
-sigmoidoscopy-visualize sigmoid
-colonoscopy - visualize colon
-post care: Assess for rectal bleeding, distended abd, fever
Lower GI: Labs - ANSWER -electrolytes: Decrease in K+ and NA+
-WBC-inflammation & infection
-blood cultures-septic
Lower GI: Stool Analysis - ANSWER -ova and parasites---make sure
sample is warm
-occult blood
-fecal fat-absorption problem such as crones or pancreatitis
** Be sure sample does not contain urine or toilet paper
Laxative: Stimulant - ANSWER -stimulates peristalsis
--Senokot
--Dulcolax
Laxative: Softener - ANSWER -draws water into stool
--Colace
--Surfak
Laxative: Bulk Producing - ANSWER -moves stool forward, helps to
absorb water in diarrhea
-ascending->transverse->descending->sigmoid->rectum
-NO villi or enzymes
-absorbs water, breaks down, and eliminates
-uses bacteria to break down (can cause gas)
Control of Defecation - ANSWER -sphincter:
-internal: involuntary
-external: voluntary
-puborectal muscle
-bowel's own nerve supply
Physiology of Defecation - ANSWER Fecal Mass in Rectum-
>"defecation reflex"->sphincter relax->
rectum contracts->diaphragm and abdominal muscle assist->defecation
*Avoidance can lead to constipation
Elimination: Age related changes - ANSWER -smooth muscle tone
decreases
-connective tissue increases
*End result is constipation
Nursing Assessment: Lower GI: Interview - ANSWER -wt change
-bowel pattern change (bowel habits)
-use of laxatives
-surgeries
-Family Hx: DM, cancer, obesity
Nursing Assessment: Lower GI: Physical Exam - ANSWER -Inspect
abdomen
-Auscultate bowel sounds
*start timing after you hear 1st bowel sound
, *If there is a belief of absence of sound be sure to listen for
2 full minutes in each quadrant
-Palpitate
* Palpitate known tender areas last
Lower GI: Radiology - ANSWER -Prep: enemas or stimulant laxatives
*Barium Enema used to visualize colon and lower GI
--Ultrasound also used
***increase fluid and fiber after barium is used
Lower GI: Endoscopy - ANSWER -prep: bowel evacuation
* polyethylene-GoLYTELY
* Fleet oral solution - causes cramping and diarrhea
-proctoscopy- visualize rectum
-sigmoidoscopy-visualize sigmoid
-colonoscopy - visualize colon
-post care: Assess for rectal bleeding, distended abd, fever
Lower GI: Labs - ANSWER -electrolytes: Decrease in K+ and NA+
-WBC-inflammation & infection
-blood cultures-septic
Lower GI: Stool Analysis - ANSWER -ova and parasites---make sure
sample is warm
-occult blood
-fecal fat-absorption problem such as crones or pancreatitis
** Be sure sample does not contain urine or toilet paper
Laxative: Stimulant - ANSWER -stimulates peristalsis
--Senokot
--Dulcolax
Laxative: Softener - ANSWER -draws water into stool
--Colace
--Surfak
Laxative: Bulk Producing - ANSWER -moves stool forward, helps to
absorb water in diarrhea
