Bowel Elimination

Nursing B20Fundamentals of Nursing

Psychological/ Physiological Factors Affecting Elimination

Age and developmental factors Dietary intake Fluid intake Physical activity Psychological factors Personal elimination habits

Psychological/ Physiological Factors Affecting Elimination (contd)

Position during defecation Pain Pregnancy General anesthesia Medications Diagnostic GI tests

Common Bowel Elimination Problems

Constipation Fecal Impaction Diarrhea Incontinence Flatulence Hemorrhoids

Bowel Diversions

Three types of colostomies

Loop Colostomy End Colostomy Double-Barrel Colostomy

Ileostomy

Bowel Diversions

Single (End) Colostomy

Bowel Diversions

Loop Colostomy

Bowel Diversions

Double Barrel Colostomy

Bowel Diversions

Assessment of Bowel Function

Nursing History Physical Assessment Fecal Characteristics Laboratory/ Diagnostic Tests

Fecal specimens Guaiac test Diagnostic tests
Direct visualization Indirect visualization

Nursing Diagnosis

Constipation Diarrhea Bowel Incontinence Pain Self-Care Deficit- Toileting Body Image Disturbance Risk for/ Impaired Skin Integrity

Plan and Implementation

Promotion of regular bowel habits Promotion of normal defecation Digital removal of stool Maintenance of proper fluid/ food intake Promotion of regular exercise Promotion of comfort

Plan and Implementation (continued)

Use of enemas
Cleansing enemas
Tap water- hypotonic Normal saline- isotonic Fleets- hypertonic Soap Suds- intestinal irritation

Oil Retention enemas Carminative Return flow or Harris flush Medicated

Plan and Implementation (continued)

Care of Ostomies
Pouching of Ostomies

Plan and Implementation (continued)

Irrigating an ostomy