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Intestinal Elimination Disorders

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Causes allergies, cancer, stress, malabsorption, impactions, tube feedings, viral ... Complete obstruction, if untreated, may lead to necrosis, shock, and death ... – PowerPoint PPT presentation

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Title: Intestinal Elimination Disorders


1
Intestinal Elimination Disorders
  • NPN 200
  • Medical Surgical I

2
Diarrhea and Constipation
  • Diarrhea
  • Define the frequent passage of loose, liquid
    stool
  • Causes allergies, cancer, stress,
    malabsorption, impactions, tube feedings, viral
  • Symptoms cramping, nausea, urgency
  • If continues may lead to dehydration, and
    decreased nutrition
  • Nurses role assess stool for color and
    consistency, determine onset and exposure to
    virus and dietary habits or changes, any bleeding
  • Assess for weight loss, skin turgor, abd
    tenderness, perneal irritation
  • Treatment is based on the cause

3
Diarrhea and Constipation
  • Constipation
  • Defined hard, dry, infrequent stools
  • Cause ignoring the urge , frequent laxative
    use, dietary (not enough fiber or fluid), lack of
    activity, surgery, drugs, age changes in the
    intestines
  • Complications problems with heart, hemorrhoids,
    fecal impaction
  • Nursing actions assess for problem, blood,
    mucus, impaction
  • Interventions laxatives, enemas, remove
    impaction, work with diet and fluid intake,
    regular habits

4
Obstruction
  • Partial or complete blockage of the intestinal
    lumen
  • Decreased or absent peristaltic movement of
    contents due to mechanical or neurological
    disorders
  • Leads to dilation, loss of tone, pressure on
    vessels with loss of blood flow, ischemia and
    death of tissue
  • Complete obstruction, if untreated, may lead to
    necrosis, shock, and death
  • Can occur after abdominal surgery

5
Obstruction
  • Causes
  • Adhesions form prior surgery
  • Tumors and carcinoma
  • Foreign bodies fruit pits, gallstones, worms
  • Compression of intestinal wall from stenosis,
    intussusception (telescoping), volvulus, tumors,
    atresia

6
Obstruction
  • Symptoms for small bowel
  • Subjective
  • Nausea / vomiting
  • Colicky pain
  • Drowsiness
  • Thirst
  • Aching
  • Dry mucus membranes
  • Intestinal spasms
  • Malaise and fatigue
  • Objective
  • Vomiting
  • Constipation
  • Abd distention
  • Borborugmi (gurgling)

7
Obstruction
  • Symptoms for large bowel
  • Subjective
  • Constipation
  • Colicky abd pain in spasms
  • Hypogastric pain
  • nausea
  • Objective
  • Constipation
  • Leakage of liquid stool
  • Intestinal spasms
  • Fecal vomiting
  • Severe abd pain

8
Obstruction
  • Diagnostic tests
  • HP
  • Flat plate of abdomen
  • UGI
  • Barium enema
  • E-lytes, CMP, amlyase

9
Obstruction
  • Assessment
  • Past medical history
  • Abd tenderness and distention
  • N/V
  • BM history
  • Skin turgor and moisture
  • Vitals
  • Rectal bleeding or drainage

10
Obstruction
  • Medical treatment
  • NG tube
  • Labs
  • IV
  • Possible surgery

11
Obstruction
  • Nursing interventions
  • Pain control
  • I/O
  • Insert and care for NG
  • Assess bowel sounds
  • Monitor vitals
  • Watch for rupture sudden sharp pain, rigidity,
    fever
  • Watch respiratory function HOB , O2 if needed,
    watch for acidosis or alkalosis
  • Prepare for surgery

12
Obstruction
  • Surgical care
  • TCDB
  • NG care
  • Monitor labs
  • Pain RX
  • IVs and antibiotics
  • Early ambulation
  • May have colostomy needs teaching

13
Abdominal Hernia
  • Protrusion of an organ or structure through and
    abnormal opening
  • Categories
  • Reducible
  • Irreducible
  • Incarcerated
  • Types
  • Umbilical
  • Inguinal
  • Femoral
  • Incisional

14
Abdominal Hernia
  • Causes
  • Congenital weakness in containing wall
  • Weakness because of infections or aging
  • Increased intra-abdominal pressure pregnancy,
    heavy lifting, obesity or straining
  • Improper closing in the peritoneal sac in male
    clients

15
Abdominal Hernia
  • Subjective symptoms
  • Presence of abdominal mass after lifting,
    straining, etc.
  • Possible pain
  • Swelling relieved by lying down
  • Sharp steady pain in groin
  • Severe pain and nausea (strangulated)
  • anorexia

16
Abdominal Hernia
  • Objective symptoms
  • Palpable mass in inguinal, femoral, or umbilical
    area
  • Signs of obstruction
  • Vomiting
  • Irreducible mass
  • Diminished bowel sounds
  • Shock
  • Increased temp
  • Bloody stools
  • Undescended testicle or hydrocele in infants

17
Abdominal Hernia
  • Diagnosis
  • History and physical
  • Medical treatment
  • Surgical repair lap or open
  • Herniorrhaphy muscle repair
  • Hernioplasty reinforcement with patch
  • Truss if not able to have surgery

18
Abdominal Hernia
  • Post- op care
  • Routine
  • Home care
  • Restrict lifting for 6-8 weeks
  • Prevent constipation
  • Hold off on sexual activity
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