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Foundations Of Professional Nursing (NUR 3130) CH 37 Bowel Elimination

John Marsh
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Nova Southeastern University

Foundations of Professional Nursing (NUR 3130)

Fundamentals of Nursing: the Art and Science of Nursing Care

2. CH 37 Bowel Elimination

Chapter 37 – Bowel Elimination
Factors affecting elimination:
 Developmental considerations
 Infants- characteristics of stool and frequency depend on formula or breast feedings
 Breast milk is easier for the intestines to break down and absorb.
 Breastfed babies have more frequent stools, and the stools are yellow to golden and loose and
usually have little odor.
 With formula or cow’s milk feedings, the infant’s stools vary from yellow to brown, are pastelike
in consistency, and have a stronger odor because of the decomposition of protein.
 Infants have no voluntary control over bowel elimination.
 Toddler- physiologic maturity is first priority for bowel training.
 Child, adolescent, adult- defecation patterns vary in quantity, frequency, and rhythmicity
 Older adult- constipation is often a chronic problem; diarrhea and fecal incontinence may result
from physiologic or lifestyle changes.
 Daily patterns
 Food and fluid TEST QUESTION
 A high fiber diet (whole grains and bran, dried peas and beans and fresh fruits and vegetables)
and a daily fluid intake of 2,000 to 3,000 Ml facilitate bowel elimination
 Constipating foods: processed cheese, lean meat, eggs, pasta
 Foods with laxative effect: certain fruits and vegetables (e.g., prunes), bran, chocolate, spicy
foods, alcohol, coffee
 Gas-producing foods: onions, cabbage, beans, cauliflower
 Activity and muscle tone
 Exercise increases GI motility and muscle tone, whereas inactivity decreases both
 Pts. On prolonged bedrest or those with decreased mobility are prime candidates for constipation
 Lifestyle, psychological variables
 Stress > either result in diarrhea or constipation
 Pathologic conditions
 Diarrhea may result from pathologic conditions such as diverticulitis, infections, malabsorption
syndrome, neoplastic disease (tumors), diabetic neuropathy, hyperthyroidism, and uremia
 Constipation may result from diseases of the colon or rectum and injury to or degeneration of the
spinal cord and megacolon
 Severe abdominal cramping and watery or bloody diarrhea may be an indication of microbial
 Medications
 Medications with Mg such as OTC antacids can cause diarrhea
 Aspirin, anticoagulants – Potential to cause GI bleeding, pink to red to black stool
 Iron salts—black stool from the oxidation of iron
 Antacids—white discoloration or speckling in stool
 Antibiotics—green-gray color related to impaired digestion
 Because antibiotics are used so extensively in the health care setting, many pts. are at risk for
infection with Clostridium difficile, a hospital acquired infection, which cause diarrhea and
abdominal cramping.



Foundations Of Professional Nursing (NUR 3130) CH 37 Bowel Elimination

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