fecal elimination

FECAL ELIMINATION

CONCEPTS Defecation Feces Factors that Affect Defecation Fecal Elimination Problems (Constipation,

Fecal Impaction, Diarrhea, Bowel Incontinence, Flatulence)

Enema Ostomy and Ostomy Management Changing a Bowel Diversion Ostomy Appliance

Defecation or Bowel Movement Expulsion of feces or stool from the anus

and rectum FECES- made about 75% of water and

25% solid materials

Characteristics of Normal and Abnormal Feces

CHARACTERISTICS

NORMAL

Color ADULT: brownINFANT: yellow

Consistency Formed, soft, semisolid, moist

Shape Cylindrical about 2.5 cm in diameter in adults

Amount Varies with diet (100-400g/day)

Odor Aromatic: affected by ingested food and person’s own bacterial flora

Frequency varies; usual range 1-2/day to every 2-3 days.

Factors that Affect Defecation Developmental stage Diet Fluid Activity Defecation habits

Fecal Elimination Problems Constipation Fecal Impaction Diarrhea Bowel incontinence Flatulence

Copyright 2008 by Pearson Education, Inc.

Constipation Decreased frequency of defecation Hard, dry, formed stools Straining at stools Painful defecation Causes include:

Insufficient fiber and fluid intake Insufficient activity Irregular habits


Nursing Interventions Have adequate fluid intake -1.5-2L High- fiber diet. Establish regular pattern of defecation Respond immediately to urge to

defecate Minimize stress. Have adequate activity & exercise. Assume sitting or semi squatting

position Administer laxatives as ordered


Fecal Impaction Mass or collection of hardened feces in

folds of rectum Passage of liquid fecal seepage and no

normal stool Causes usually:

Poor defecation habits Constipation


Manual extraction or fecal disimpaction as ordered.

Increase fluid intake. Sufficient bulk diet. Adequate activity & exercise.

Nursing Interventions


Diarrhea Passage of liquid feces and increased

frequency of defecation Spasmodic cramps, increased bowel

sounds Fatigue, weakness, malaise, emaciation Major causes:

Stress, medications, allergies, intolerance of food or fluids, disease of colon


Replace fluid & electrolyte losses. Provide good perianal care. Promote rest. Diet

Small amt of bland foods Low fiber diet BRAT (banana,rice am, apple, toast) Avoid excessively hot/cold foods. Potassium-rich foods/fluids

(banana,gatorade)

Nursing Interventions


CAUTION:Do not administer antidiarrheal at the start of diarrhea. It is the body’s protective mechanism to rid itself of bacteria & toxins.


Bowel Incontinence Loss of voluntary ability to control fecal

and gaseous discharges Generally associated with:

Impaired functioning of anal sphincter or nerve supply

Neuromuscular diseases Spinal trauma Tumor


Flatulence Excessive flatus in intestines Leads to stretching and inflation of

intestines Can occur from variety of causes:

Foods Abdominal surgery Narcotics


Nursing Interventions Avoid gas- forming foods. Provide warm fluids to drink. Early ambulation among postoperative

clients. Adequate activity & exercise. Limit carbonated beverages, use of

drinking straws & chewing gum. Carminative enema as ordered.


Measures to Maintain Normal Fecal Elimination Patterns

Privacy Timing Nutrition and fluids Exercise Positioning

BOWEL DIVERSION OSTOMIES

Ostomy TYPES: 1. Gastrostomy 2. Jejunostomy 3. Ileostomy 4. Colostomy


Stoma Care for Clients with an Ostomy Normal stoma should appear red and may

bleed slightly when touched Assess the peristomal skin for irritation

each time the appliance is changed Treat any irritation or skin breakdown

immediately Keep skin clean by washing off any

excretion and drying thoroughly Protect skin, collect stool, and control odor

with an ostomy appliance


Changing a Bowel DiversionOstomy Appliance: Skill 49-2

THANK YOU!

fecal elimination

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