Comprehensive Study Notes for NSG 3100
Units 6, 7, and 8
Unit 6: Gastrointestinal (GI) Elimination
Anatomy and Physiology of the GI Tract
The large intestine consists of the cecum, ascending colon, transverse colon, descending colon,
sigmoid colon, rectum, and anus. Feces formation and defecation involve coordinated muscular
activity, and stool characteristics depend on various physiological processes.
Altered Structure & Function
Bowel Diversions: Ostomies can be temporary or permanent; types include colostomies
(sigmoid, descending, transverse, ascending), gastrostomy, jejunostomy, and ileostomy.
The stoma is a piece of bowel pulled through the abdominal wall, typically pink and
moist, with stool consistency varying by ostomy location.
Fecal Characteristics: Stool color (green, red, black, orange, grey), consistency, shape,
amount, odor, and contents aid clinical assessment.
Factors Affecting Bowel Elimination
Age and developmental stage
Dietary habits and fluid intake
Physical activity and immobility
Psychological factors and defecation habits
Medications and pain
Medical procedures, pregnancy, personal habits
History and positioning during defecation
Assessment of GI Elimination
Physical assessment focusing on abdomen and bowel sounds
Stool analysis: color, consistency, shape, amount, odor, constituents
Diagnostic tests:
oEndoscopy: Upper endoscopy (gastroscopy, duodenoscopy) with patient
preparation and risks including biopsies and electrosurgical treatment
oColonoscopy: Patient prep, biopsy, stool culture and sensitivity, and fecal occult
blood tests (guaiac test requiring three stool samples over days with dietary
restrictions)
Common GI Disorders and Nursing Considerations
, Constipation
Risk Factors: Immobility, medication, dehydration, low fiber intake
Treatments: Stool softeners, various types of laxatives (bulk-forming, osmotic,
stimulant), enemas (cleansing, oil, carminative, return-flow, retention)
Teaching: Encourage fluid intake, fiber, activity, proper toileting habits
Complications: Fecal impaction, monitor for abdominal pain, decreased bowel sounds,
signs of obstruction
Fecal Impaction
Risk Factors: Prolonged constipation, immobility, medications
Teaching: Prevention through regular bowel habits, hydration, and avoidance of
straining
Differences from constipation: Impaction is hardened stool stuck in the rectum causing
obstruction
Diarrhea
Causes: Bacterial infections including Clostridiumdifficile(C-Diff)
Treatments: Anti-diarrheal medications, fluid and nutritional support
Teaching: Hydration, infection control precautions (contact isolation for C-Diff),
medication adherence
Complications: Electrolyte imbalances, dehydration, skin breakdown
Bowel Incontinence
Types include urge, passive, functional, and overflow incontinence
Psychological impact significant; nurses should provide support and education
Flatulence and Hemorrhoids
Causes of Flatulence: Certain foods, swallowing air
Teaching: Dietary modifications, avoidance of gas-producing foods
Hemorrhoids: Risks include chronic straining, sedentary lifestyle, pregnancy, low-fiber
diet, infections
Patient Teaching: Avoid straining, increase fiber and fluids, maintain proper hygiene
Colorectal Cancer Risk Factors and Patient Teaching
Modifiable Risk Factors Non-modifiable Risk
Factors Patient Teaching
Poor diet, lack of physical Age, race, family Encourage healthy diet, regular exercise,
activity, heavy alcohol use, history of limit alcohol and tobacco, screenings for
cigarette smoking polyps/disease high-risk individuals
Units 6, 7, and 8
Unit 6: Gastrointestinal (GI) Elimination
Anatomy and Physiology of the GI Tract
The large intestine consists of the cecum, ascending colon, transverse colon, descending colon,
sigmoid colon, rectum, and anus. Feces formation and defecation involve coordinated muscular
activity, and stool characteristics depend on various physiological processes.
Altered Structure & Function
Bowel Diversions: Ostomies can be temporary or permanent; types include colostomies
(sigmoid, descending, transverse, ascending), gastrostomy, jejunostomy, and ileostomy.
The stoma is a piece of bowel pulled through the abdominal wall, typically pink and
moist, with stool consistency varying by ostomy location.
Fecal Characteristics: Stool color (green, red, black, orange, grey), consistency, shape,
amount, odor, and contents aid clinical assessment.
Factors Affecting Bowel Elimination
Age and developmental stage
Dietary habits and fluid intake
Physical activity and immobility
Psychological factors and defecation habits
Medications and pain
Medical procedures, pregnancy, personal habits
History and positioning during defecation
Assessment of GI Elimination
Physical assessment focusing on abdomen and bowel sounds
Stool analysis: color, consistency, shape, amount, odor, constituents
Diagnostic tests:
oEndoscopy: Upper endoscopy (gastroscopy, duodenoscopy) with patient
preparation and risks including biopsies and electrosurgical treatment
oColonoscopy: Patient prep, biopsy, stool culture and sensitivity, and fecal occult
blood tests (guaiac test requiring three stool samples over days with dietary
restrictions)
Common GI Disorders and Nursing Considerations
, Constipation
Risk Factors: Immobility, medication, dehydration, low fiber intake
Treatments: Stool softeners, various types of laxatives (bulk-forming, osmotic,
stimulant), enemas (cleansing, oil, carminative, return-flow, retention)
Teaching: Encourage fluid intake, fiber, activity, proper toileting habits
Complications: Fecal impaction, monitor for abdominal pain, decreased bowel sounds,
signs of obstruction
Fecal Impaction
Risk Factors: Prolonged constipation, immobility, medications
Teaching: Prevention through regular bowel habits, hydration, and avoidance of
straining
Differences from constipation: Impaction is hardened stool stuck in the rectum causing
obstruction
Diarrhea
Causes: Bacterial infections including Clostridiumdifficile(C-Diff)
Treatments: Anti-diarrheal medications, fluid and nutritional support
Teaching: Hydration, infection control precautions (contact isolation for C-Diff),
medication adherence
Complications: Electrolyte imbalances, dehydration, skin breakdown
Bowel Incontinence
Types include urge, passive, functional, and overflow incontinence
Psychological impact significant; nurses should provide support and education
Flatulence and Hemorrhoids
Causes of Flatulence: Certain foods, swallowing air
Teaching: Dietary modifications, avoidance of gas-producing foods
Hemorrhoids: Risks include chronic straining, sedentary lifestyle, pregnancy, low-fiber
diet, infections
Patient Teaching: Avoid straining, increase fiber and fluids, maintain proper hygiene
Colorectal Cancer Risk Factors and Patient Teaching
Modifiable Risk Factors Non-modifiable Risk
Factors Patient Teaching
Poor diet, lack of physical Age, race, family Encourage healthy diet, regular exercise,
activity, heavy alcohol use, history of limit alcohol and tobacco, screenings for
cigarette smoking polyps/disease high-risk individuals
