. STUDY GUIDE FOR CHAPTER 34 NURSING CARE FOR PATIENTS WITH LOWER GASTROINTESTINAL DISORDERS Answers found on pgs. 745-749 unless otherwise indicated What consist of the lower GI system? ‘What is the main functions of each? What happens there? Pg. 688 ‘Your patient ask you what is constipation? What would you as the nurse tell them? How does constipation happen? ‘Your patient tells you they have not used the bathroom (had a bowel movement) in two weeks. This type ‘of prolonged constipation is called? 6. Apatient in the doctors’ office where you work complains of constipation. They also have their med list with them. What medicine classes on that list may have contributed to their constipation? [As a nurse we need to know that rectal and anal conditions such as hemorrhoids or fissures may cause constipation because of, Metabolic and neurologic conditions such as esac Es ASEH enna as crn eneeEEy_onscESeESEEEESETEEEOD interfere with normal bowel nerve supply or function 9. Which cancer could cause constipation? a, Throat b. Bone Colon d. Prostate 10. John Doe asked you the nurse what is the best way to prevent constipation? What would you tell him? 111. You are teaching your patient on the uses of laxatives and how often they should be used. You know your teaching was effective when your patient tells you a. Laxatives should never be used because they cost too much Use laxatives every time you since you're getting constipated too stay regular Use laxatives occasionally to prevent complications 12, List 7 signs and symptoms of constipation. 13. How is constipation diagnosed? 14, Which of the following are therapeutic measures to relieve constipation? (select all that apply) 2. Reading a book b. Stool softeners Laughing d. High-fiber diet e. Exercise f. Strengthening of abdominal muscles 15. Name 2 more therapeutic measures for constipation, 16. Your patient was admitted to the hospital to have surgery for a fractured hip. They received hydromorphone Q3hrs post operation X 3days. Your patient starts to complain of having to straining while trying to have a bowel movement. You as the nurse knows that straining can lead to 3 system. complications. What are the 3 systems that can be affected? 17. Your patient’s physician notes in his chart that he has a megacolon. What is the physician saying about your patient? 18. You arrive at work and have to have a bowel movement but your swamped with a mass casualty situation; so you repeatedly ignore the urge to relieve yourself. What is this called? 19, Whats diarrhea?20. Michael doe a resident ofthe nursing home where you work has had 3 incidents of being found in puddles ‘of watery feces. As the nurse taking care of him; you know that the most common reasons Michael might bbe having these watery stool is that he may have picked up what? 21. ist 6 most common infectious agents 22. Weas nurses should know that there are many causes of diarthea. On page 747 second column 2 paragraph lets us know what some of these are. 23, 2 residents inthe nursing home. 1 has Crohns disease, and the other has Ulcerative Colitis. We “understand that these two residents may have frequent runny stools because these two disease may do what? 24, What is osmotic diarrhea? 25. To learn how to help prevent diarrhea we must read prevention on page 747, 36. Your patient tells you that she went ut lastnight and ate at a new unfamiliar restaurant and have been ‘experiencing darrhea, stomach cramps, and extreme thirst; you also note that her stomach is distended and she has intestinal rumbling. It is a good possibility that your patient has what? 27. Sam cook presented today with a fever, weakness and elevated BUN, and Creatinine levels and complains Cf blood in his watery stool It is safe to say that Sam is what? 28, Read and review table 34.2 (criteria for regular bowel function) Read page 746 (nursing process for the patient with constipation) What is so important about this paragraphs? Review and know nursing diagnosis, planning and implementations. for constipation and diarrhea13. Pr 15. 16. Vv. 18 1, 20, 2. 2. 24. ‘MY ANSWERS FOR CHAPETER 34 STUDY GUIDE Small intestines, large intestines, rectum, and anus ‘A. 90% of digestion and absorption of food occurs; absorption of nutrients and minerals from food Absorbs water from the remaining indigestible food matter and transmit the useless waste material from the body made up of the colon and rectum Final section of large intestines, stores fecal matter until body is ready to eliminate 4d. The opening at the lower end of the digestive tract; controls the expulsion of feces ‘Abnormal infrequency of defecation and abnormal hardening of stot Feces are held for a prolonged time in the rectum and more water is absorbed which makes feces drier ‘and harder and more difficult to pass Obstipation Narcotics, tranquilizers, antacids with aluminum ‘Associated pain Diabetes Mellitus, Multiple Sclerosis, Lupus Erythematosus, Scleroderma c Regular exercise and diet high in fiber and fluids c ‘Abdominal distention Indigestion Rectal pressure Feeling of incomplete emptying Straining at stool Hard, dry stool Intestinal rumbling, History, physical examination Bdef 2-Biiters fluid daily, and bulk forming agents Cardiac, neurologic, and respiratory Large colon Laxation ‘Occurs when fecal matter passes through the intestines rapidly, resulting in decreased absorption of ‘water, electrolytes, and nutrients and causing frequent, watery stool ‘Abacterial or viral infection E.coli, eampylobacter jejuni, shingella spp, c. dif, giardia spp, and salmonella spp Impair absorption of the intestines Diarrhea results from ingestion of laxatives or other agent that prevent absorption of water or nutrients in the intestines. 26. Food poisoning, 27, Dehydrated from many loose stools due to an infection 28.