Potter: Fundamentals of Nursing, 8th Edition

Chapter 46: Bowel Elimination Key Points - Printable Mechanical breakdown of food elements, gastrointestinal motility, and selective absorption and secretion of substances by the large intestine influence the character of feces. Food high in fiber content and an increased fluid intake keep feces soft. Ongoing use of cathartics, laxatives, and enemas affects and delays normal defecation reflexes. Vagal stimulation, which slows the heart rate, occurs during straining while defecating, taking rectal temperatures, enemas, and digital removal of impacted stool. The greatest danger from diarrhea is development of fluid and electrolyte imbalance. The location of an ostomy influences consistency of the stool. Focus assessment of elimination patterns on bowel habits, factors that normally influence defecation, recent changes in elimination, and a physical examination. Indirect and direct visualization of the lower GI tract requires cleansing of the bowel before the procedure. Consider frequency of defecation, fecal characteristics, and effect of foods on GI function when selecting a diet promoting normal elimination. Proper positioning on a bedpan allows the patient to assume a position similar to squatting without experiencing muscle strain. NG intubation decompresses the gastric contents by removing secretions and gaseous products from the GI tract. The purposes of gastric decompression are to keep the GI tract free of secretions, reduce nausea and gas, and decrease the risk of vomiting and aspiration. Proper selection and use of an ostomy pouching system is necessary to prevent damage to the skin around the stoma. Dangers during digital removal of stool include traumatizing the rectal mucosa and promoting vagal stimulation. Skin breakdown occurs after repeated exposure to liquid stool.

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