Unit-12 Meeting elimination needs

• General objective

- At the end of the session,B.sc nursing 1 st year students will be

able to explain about common problems in bowel and bladder.
Specific objectives

-At the end of the session,B.Sc nursing 1 st year students will be

able to:

1. list the common problems in bowel and bladder.

2. define constipation.
3. explain the causes of constipation.
4. list the signs and symptoms of constipation.
Specific objectives cont’d...

5. state the complications of constipation.

6. explain the ways to prevent constipation.
7. describe the measures to relieve constipation.
Common problems in bowel and bladder

1. Constipation
2. Diarrhoea
3. Urinary incontinence
4. Urinary retention
Constipation
Definition

• Constipation is the infrequent or difficult evacuation of

hard stool requiring much use of supportive muscles.

• The delayed and difficult evacuation of stool is known as

constipation.In this condition,the stool may be hard and
there may be no stool for 2 or more days.
Causes of constipation

• Inadequate or irregular diet

• Inadequate fluid intake
• Old age
• Pregnancy
• Hormonal disorders
• Inadequate exercise
Causes cont’d....

• Drugs
• Post diarrhoeal effect
• Disease of Colon
• Irregular bowel habit
 Local causes
• Hemorrhoids
Local causes cont’d..

• Fistula in ano
Local causes cont’d...

• Anal fissures
Local causes cont’d...

• Tumor or malignancy of anal canal

• Fecal impaction
Signs and symptoms of constipation

1. Pain in abdomen, bloating,cramps

2. Abdominal distension
3. Lethargy
4. Infrequent bowel movement/difficulty having bowel
movement
5. Passing dry , hard stool
Sign and symptoms cont’d...

6. Vomiting
7. Decreased appetite
8. Coated tongue
9. Insomnia
10.Headache
Complications of constipation

1. Anal fissures
-Break or tear in the skin of anal canal.

2.Hemorrhoids
-Hemorrhoids are dilated ,engorged veins in the lining of the
rectum.
Ways to prevent constipation

1. Encourage the patient to take plenty of fluids.

2. Encourage the patient to have regular bowel habits.

3. Encourage the patient to eat food containing more fibres

such as vegetables,fruits etc.
Ways to prevent cont’d...

4. Advice the patient to have regular exercise schedule.

5. Provide privacy to the patient during defecation.

6. Advice the patient to avoid the use of laxatives,

suppositories and enema in regular basis.
Measures of relieving constipation

1. Foods and fluids

2. Laxatives
3. Suppositories
4. Enema
1.Food and fluids

• Patient should be encouraged to take adequate fluid intake.

• This helps to soften fecal material so that it is easy to pass

stool during bowel elimination.

• Encourage the patient to eat food containing more roughage

such as vegetables, fruits.
Foods and fluids cont’d....

• Getting enough fiber in diet makes stool bulkier and softer so

it’s easier to pass.
• Good fiber source includes:
1. whole grains found in cereals,breads,brown rice etc.
2. fruits like banana ,papaya,orange ,berry etc.
3. green leafy vegetables and other vegetables as cauliflower,
cabbage,carrot etc.
Food and fluids cont’d...

• Limit foods that are high in fat and low in fiber .

• Avoid foods that can make constipation worse such as

chips,crackers, noodles,dairy products,red meats etc.

• Avoid alcohol .
2.Laxatives
Laxatives cont’d...
• These are the drugs that promote evacuation of bowels.

• Laxatives are best taken short term only.

• Laxatives shouldn’t be the first choice to relieve constipation.

• Ease off laxatives when no longer need them.Stopping them too

abruptly can affect colon’s ability to contract.
Types of laxatives

1. Bulk-forming laxatives
2. Lubricant laxatives
3. Osmotic laxatives
4. Stimulant laxatives
5. Stool softners
Types cont’d...

1.Bulk-forming laxatives
- These agents retain fluid in the stool and increase stool
weight and consistency.
- It makes the stool bigger and softer.

2.Lubricant laxatives
- It aid in the passage of stools by its lubricating action
throughout the intestines.
Types cont’d ...

3.Osmotic laxatives
- It help fluids more through intestines;provide carefully
because it can cause electrolyte imbalance.

4.Stimulant laxatives
- These stimulate the muscles that line the gut, helping them
to pass stool to the back passage.
- It take 6-12 hours to work.
Types cont’d...

5. Stool softeners

- This type of laxative works by letting water into stool to

soften it and make it easier to pass.
- Having softer stool can prevent from having to strain during
bowel movements.
3.Suppository

• Rectal suppositories are solid forms of medication.

• It is small ,narrow at one end,that is put in the rectum.Once

it’s inside,it melts or dissolves and releases its
medication.So,it tends to work quickly.
Suppository cont’d...

• Rectal suppositories can deliver many types of medicines.

• For instance ,they may contain glycerine to treat constipation

or acetaminophen to treat fever.
4.Enema
- Enema is the instillation of fluid into the colon through the
rectum by using rectal tube.
Post test questions

1. What is constipation?
2. What are the causes of constipation?
3. What are the measures to relieve constipation?
Assignment

• Write about laxatives.

References

1. Pathak,S &Devkota,R.(2010).”A Textbook of Fundamental

of Nursing”.(1st ed.).Vidyarthi Prakashan.
2. Subedi,D.(2015).”Textbook of Fundamental of Nursing”.
(2nd ed.).Makalu Publication House.
3. Bashir,A.(2022). Laxatives –StartPearls.retrived from;
https://www.ncbi.nlm.nih.gov
4. Cheney,K.(2023,April 17).Rectal Suppository:
Positions,Tips,Side effects.Healthline .retrieved from;
https://www.healthline.com