What are the seven parts of the large intestine in order from start to end?
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What are the seven parts of the large intestine in order from start to end?
What are the three primary responsibilities of the large intestine?
What is the clinical term for the expulsion of faeces from the anus and rectum?
Defecation (or bowel movement)
During the process of defecation, where do peristaltic waves move faeces to stimulate the sensory nerves?
Sigmoid colon and rectum
Which sphincter relaxes automatically to allow faeces to move into the anal canal?
Internal anal sphincter
Which sphincter is relaxed voluntarily by an individual seated on the toilet to allow defecation?
External anal sphincter
Which three muscle groups assist in the expulsion of faeces through contraction?
What is the typical composition percentage of water and solids in normal faeces?
75% water and 25% solid materials
Which pigments are chiefly responsible for the normal brown colour of stool?
Stercobilin and urobilin (derived from bilirubin)
Which bacterium normally present in the large intestine helps determine the final colour of faeces?
Escherichia coli (E. coli)
What is the common cause of clay or white-colored stool?
Absence of bile pigment
What are three possible reasons for black or tarry stool?
Upper GI tract bleeding (e.g., melena), iron supplements, or a diet high in red meat/dark green vegetables.
What does bright red stool often indicate?
Lower GI tract bleeding (e.g., hemorrhoids) or certain foods/dyes.
Which stool shape is an indicator of an obstructive condition in the rectum?
Narrow, pencil-shaped stool
According to the Bristol Stool Chart, which two types represent constipation?
Type 1: Separate hard lumps Type 2: Lumpy and sausage-like
According to the Bristol Stool Chart, which two types are considered normal?
Type 3: Sausage shape with cracks on surface Type 4: Smooth, soft sausage or snake-like
Which Bristol Stool Chart type represents inflammation and diarrhea?
Type 7: Liquid consistency with no solid pieces
What does the clinical abbreviation "BO x 1" represent in bowel documentation?
Bowel open 1 time
What is the standard abbreviation for a small amount of brownish, hard stool?
BHS (S)
What does the abbreviation "YSS (M)" signify on a patient's chart?
Yellowish, soft stool, moderate amount
What does "GLS (L)" represent in terms of bowel documentation?
Large amount of greenish, loose stool
What are two possible medical causes for yellowish stool?
Excess fat or small intestine infection
At what age range do toddlers typically begin to learn bowel control?
18-24 months
What are three physiological factors in the elderly that affect bowel elimination?
What dietary combination is recommended to facilitate healthy bowel elimination?
High-fiber diet + 2-3 liters of fluid intake daily
How does regular physical activity affect bowel elimination?
Regular exercise improves GI motility and increases abdominal muscle tone.
Which psychological condition can directly increase GI motility and lead to diarrhea?
Anxiety (e.g., in Irritable Bowel Syndrome)
What are four common symptoms of Irritable Bowel Syndrome (IBS)?
What are three types of medications known to cause constipation by decreasing GI motility?
How can a Barium Enema diagnostic procedure affect bowel elimination post-procedure?
Barium may cause constipation if left over in the intestines.
What complication often occurs for 3-5 days after direct manipulation of the bowel during surgery?
Paralytic ileus (temporary stoppage of peristalsis)
Which common class of medication can lead to diarrhea as a side effect by altering intestinal flora?
Antibiotics
Which stool specimen is ordered when a bacterial infection is suspected?
Stool for culture and sensitivity (Stool for culture)
Which diagnostic stool test is used to detect the presence of parasites?
Stool for ova & cyst (O&P)
What is the name of the screening test for hidden blood in the stool, often used to screen for colon cancer?
Fecal Occult Blood Test (FOBT) or Stool for Occult Blood
What is the primary difference in coverage between a colonoscopy and a sigmoidoscopy?
Colonoscopy examines the entire length of the colon, while sigmoidoscopy examines only the lower third.
What are two additional procedures that can be performed during an endoscopy?
What are two common methods for cleansing the bowel before a colonoscopy?
Klean-prep or a fluid diet (sometimes Fleet enemas)
What are the two techniques mentioned for removing polyps from the mucosa?
Cold snare polypectomy and Hot snare polypectomy
What are five imaging diagnostic methods used for bowel assessment?
Abdominal X-ray (AXR), Barium enema, Abdominal ultrasound, MRI scan, and Abdominal CT scan.
How can the success of bowel preparation be determined visually by looking at toilet contents before a colonoscopy?
The stool should transition from dark brown or green to yellow liquid (clear or light brown liquid contents).
Which type of constipation is defined by having 2 or more symptoms like straining, hard stools, or <3 defecations/week for at least 3 months?
Chronic Constipation
What type of constipation has a sudden onset, lasts for several days, and may be related to medication or dehydration?
Acute Constipation
What are two objective physical signs of constipation upon assessment?
Abdominal distention and hypoactive bowel sounds.
What are three common lifestyle factors contributing to constipation?
Insufficient fiber and fluid intake, immobility, and ignoring the urge to defecate.
What is the ideal angle of the hip to keep the rectum straight and facilitate easier defecation?
35 degrees (squatting position with feet elevated)
When a patient must use a bedpan, what nursing intervention helps with positioning for defecation?
Elevate the head of the bed to at least 30 degrees.
What is the specific pathway for performing an abdominal massage to stimulate the colon?
Start at the lower left abdomen, move up to the ribs, across the upper abdomen, and down the right side.
How should an abdominal setting exercise be performed for constipation?
Tightening and holding abdominal muscles for 10 seconds, repeating 5-10 times, 4 times a day in a supine position.
What are the two primary aims of a bowel training program?
Establish a regular time for elimination (e.g., 1 hour after a meal) and improve stool consistency.
What are two potential complications of the digital removal of stool?
Irritation of the rectal mucosa and bleeding.
Which class of laxative increases fluid or solid bulk in the intestine and requires sufficient fluid intake to be effective?
Bulk-forming agents (e.g., Metamucil)
Which class of laxative delays the drying of stool by allowing more water and fat to be absorbed into the stool?
Stool softeners (e.g., Docusate sodium)
Which class of laxative irritates the intestinal mucosa or stimulates nerve endings to cause rapid propulsion of contents?
Stimulant agents (e.g., Senokot, Dulcolax)
Which class of laxative draws water into the intestine through osmosis to soften the stool and increase peristalsis?
Osmotic agents (e.g., Lactulose)
Which class of laxative works by drawing water into the intestine to soften stool and stimulate peristalsis through active ingredients?
Saline laxatives (e.g., Oral Fleet)
Besides relieving constipation, what are two clinical purposes for administering an enema?
To prevent contamination by faecal material during surgery and to promote visualization during endoscopy.
Which type of enema is retained in the bowel longer to lubricate stool and prevent water absorption?
Oil-based enema
In what position should a patient be placed for an enema, and why?
Left lateral position with legs flexed. This facilitates the flow of solution by gravity into the sigmoid and descending colon.
What is the preparation step for the rectal tube or suppository before insertion?
Lubricate the tip (suppository) or about 2 inches (5 cm) of the enema tube.
What are the standard insertion depths for a suppository and an enema tube in an adult?
Suppository: 2-3 cm Enema tube: 7-10 cm
How long should a patient be encouraged to retain an enema before defecating?
At least 10-15 minutes.
Which three gases are produced as a result of the breakdown of carbohydrates by bacteria in the large intestine?
Hydrogen, carbon dioxide, and methane.
What are five common food or lifestyle sources that cause increased flatulence?
What is the clinical definition of diarrhea?
Passage of 3 or more loose or watery stools per day.
What are four serious complications of severe or prolonged diarrhea?
Which two electrolyte imbalances are of particular concern during diarrhea as water and electrolytes are expelled?
Hypokalemia (low potassium) and Hypomagnesemia (low magnesium).
Which two common nutritional deficiencies or intolerances are frequent causes of diarrhea?
Lactase deficiency (milk carton crossed out) and Gluten intolerance (grain crossed out).
What is the most critical initial nursing assessment for a patient experiencing severe diarrhea?
Check vital signs for signs of dehydration.
What type of bowel sounds are expected upon auscultation in a patient with diarrhea?
Hyperactive bowel sounds.
Which medication can be used as prophylaxis for Traveler's Diarrhea but is contraindicated for children and those with aspirin allergies?
Bismuth subsalicylate (e.g., Pepto-Bismol).
What are two common pharmacologic agents used to treat diarrhea by slowing intestinal motility?
Antimotility medications like Loperamide (Imodium) and Diphenoxylate hydrochloride (Lomotil).
What are two dietary modifications and one supplement recommended for patients with diarrhea?
Probiotics (e.g., yogurt or supplements) and a low-fiber, low-lactose diet (avoiding raw fruit/milk).
What are four primary causes of bowel incontinence?
Which exercise is used as part of a bowel training program to improve muscle tone?
Kegel exercises to strengthen pelvic floor muscles.
What is the normal expected color and appearance of a healthy stoma?
Pink to red and moist.
What do stoma colors like pallor, cyanosis, or black indicate?
Pallor/cyanosis: Poor blood supply Black: Necrosis
What is the difference between an ileostomy and a colostomy?
Ileostomy: Small intestine stoma Colostomy: Large intestine stoma
When changing a stoma bag, how much larger should the opening be cut compared to the stoma size? Why?
2 mm larger than the stoma size. This prevents skin irritation from faecal matter (effluent).
How should the peristomal skin and stoma be cleaned?
Warm water and gently drying (avoid soap/lotions/scrubbing).
What are the 5 key steps for changing a stoma pouch?
What are the standard replacement intervals for drainable vs. non-drainable stoma pouches?
Change every 3-7 days for drainable pouches; once or twice daily for non-drainable pouches.
What are the three recommended steps for peristomal skin care during an appliance change?
