Astle/Duggleby: Potter and Perry’s Canadian Fundamentals of Nursing, 7th

Edition

Chapter 45: Bowel Elimination

Key Points – Printable

• The 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 fibre content and an increased fluid intake keep feces soft.
• Ongoing use of cathartics, laxatives, and enemas affects and delays the reflexes of normal
defecation.
• Vagal stimulation, which slows the heart rate, may occur during straining while defecating or
receiving enemas, and during digital removal of an impacted stool.
• The greatest danger from diarrhea is developing an imbalance of fluids and electrolytes.
• The location of an ostomy influences the consistency of the stool.
• Assessment of bowel elimination patterns should focus on bowel habits, factors that normally
influence defecation, recent changes in bowel elimination, and a physical examination.
• Indirect and direct visualization of the lower gastrointestinal tract requires cleansing of the
bowel before the procedure.
• When selecting a diet to promote normal bowel elimination, consider the frequency of
defecation, the fecal characteristics, and the effect of foods on the gastrointestinal function.
• Proper positioning on a bedpan allows the patient to assume a position similar to squatting
without experiencing muscle strain.
• Nasogastric intubation decompresses the gastric contents by removing secretions and gaseous
products from the gastrointestinal tract.
• The purposes of gastric decompression are to keep the gastrointestinal tract free of secretions,
to reduce nausea and gas, and to decrease the risk of vomiting and aspiration.
• Proper selection and use of an ostomy pouching system are 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 can occur after repeated exposure to liquid stool.

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