Deck 49: Fecal Elimination

Question 1

You learn that Mrs. Brown's stools have been liquid, in very small amounts, and at infrequent intervals, generally occurring when She feels the urge to defecate. What additional data are important to obtain from her?

Answer 1

Mrs. Emma Brown is an old lady who lives alone in a low income housing complex for adults. Her eating patterns are irregular and generally consist of only toast and soup meals.
She also suffers from insomnia and performs little exercise. She is suffering from constipation. She has reported liquid stools of small amounts and at infrequent intervals. The additional information about the client that should be obtained is her previous medications, the diet that she has been following and the timing and patterns of her bed rest.
These are the causative factors of constipation and assessment of these factors is the primary step in planning for improved bowel elimination. Evaluation of client's medication profile is necessary to check if the occurrence of constipation is due to irregular eating patterns or as a side effect of drugs such as antacids and narcotics.

Question 2

Clients should be taught that repeatedly ignoring the sensation of needing to defecate could result in which of the following?
1) Constipation
2) Diarrhea
3) Incontinence
4) Hemorrhoids

Answer 2

Diarrhea is characterized by an increased frequency of defecation and passage of liquid feces. This condition is opposite of constipation as in this case the fecal contents are rapidly moved out of the large intestine.
Incontinence occurs when the client is unable to voluntarily control the fecal and gaseous discharge. It is generally related to impaired anal sphincter functioning. Hemorrhoids occur when severe drying of the stool occurs. They involve swelling of the blood vessels of the rectum.
Hence, the options 2, 3 and 4 are incorrect.
Avoiding the urge to defecate for a long time can lead to constipation due to accumulation of feces and loss of natural urges. In this condition the stool may appear dry and hard or there may be absence of stool. It occurs due to slow movement of feces out of the intestine which allows additional reabsorption of fluid from the large intestine.
Hence, the correct answer is option
.

Question 3

What nursing intervention is most appropriate Before making suggestions to correct or prevent the problem she is experiencing?

Answer 3

Mrs. Emma Brown is an old lady who lives alone in a low-income housing complex for adults. Her eating patterns are irregular and generally consist of only toast and soup meals. She also suffers from insomnia and performs the little exercise. She is suffering from constipation. She has reported liquid stools of small amounts and at infrequent intervals.
The nursing interventions that are most appropriate prior to any suggestions for correction and prevention of client's problems are as follows:
1. Evaluating the diet that she has been following and the timing and patterns of her bed rest. These are the causative factors of constipation and assessment of these factors is the primary step in planning for improved bowel elimination.
2. Evaluation her medication profile is necessary to check if the occurrence of constipation is due to irregular eating patterns or as a side effect of drugs such as antacids or narcotics.
3. The client should be encouraged to increase her fluid intake unless it is contraindicated. This will promote proper stool consistency by increased absorption of sufficient amounts of liquid.
4. The client should be instructed to take a high fiber diet as fibers are good absorbents of water along with a sufficient amount of fluids. Hence, this will increase the softness of the stool and also will speed up the passage of the bowel through the intestines.

Question 4

Which statement provides evidence that an older adult who is prone to constipation is in need of further teaching?
1) "I need to drink one and a half to two quarts of liquid each day."
2) "I need to take a laxative such as Milk of Magnesia if I don't have a BM every day."
3) "If my bowel pattern changes on its own, I should call you."
4) "Eating my meals at regular times is likely to result in regular bowel movements."

Question 5

What suggestions can you give her about maintaining a regular bowel pattern?

Question 6

A client is scheduled for a colonoscopy. The nurse will provide information to the

Question 7

Explain why cathartics and laxatives are generally contraindicated for people in Mrs. Brown's situation?

Question 8

The nurse is most likely to report which finding to the primary care provider for a client who has an established colostomy?
1) The stoma extends 1/2 in. above the abdomen.
2) The skin under the appliance looks red briefly after removing the appliance.
3) The stoma color is a deep red-purple.
4) The ascending colostomy delivers liquid feces.

Question 9

Which goal is the most appropriate for clients with diarrhea related to ingestion of an antibiotic for an upper respiratory infection?
1) The client will wear a medical alert bracelet for antibiotic allergy.
2) The client will return to his or her previous fecal elimination pattern.
3) The client will verbalize the need to take an antidiarrheal medication pm.
4) The client will increase intake of insoluble fiber such as grains, rice, and cereals.

Question 10

A client with a new stoma who has not had a bowel movement since surgery last week reports feeling nauseous. What is the appropriate nursing action?
1) Prepare to irrigate the colostomy.
2) After assessing the stoma and surrounding skin, notify the surgeon.
3) Assess bowel sounds and administer antiemetic.
4) Administer a bulk-forming laxative, and encourage increased fluids and exercise.

Question 11

The nurse assesses a client's abdomen several days after abdominal surgery. It is firm, distended, and painful to palpate. The client reports feeling "bloated." The nurse consults with the surgeon, who orders an enema. The nurse prepares to give what kind of enema?
1) Soapsuds
2) Retention
3) Return flow
4) Oil retention

Question 12

Which of the following is most likely to validate that a client is experiencing intestinal bleeding?
1) Large quantities of fat mixed with pale yellow liquid stool
2) Brown, formed stools
3) Semisoft black-colored stools
4) Narrow, pencil-shaped stool

Question 13

Which nursing diagnoses is/are most applicable to a client fecal incontinence? Select all that apply.
1) Bowel Incontinence
2) Risk for Deficient Fluid Volume
3) Disturbed Body Image
4) Social Isolation
5) Risk for Impaired Skin Integrity

Question 14

A student nurse is assigned to care for a client with a sigmoidostomy. The student will assess which ostomy site?