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77 Cards in this Set
- Front
- Back
use laxatives cautiously with patients who are
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pregnancy, breast feeding, anemia or after sugery on anus or perineum.
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safest least irritating laxative
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bulk forming laxative
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agent used for chronic constipation and to relieve mild watery diarrhea, in ibs, diverticular disease
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bulk forming laxative
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can cause esophageal or bowell obstruction if not mixed with at leaset 240cc's of water or juice and swallowed quickly.
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bulk forming laxatives
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types of bulk forming laxatives include
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Psyliium ( metamucil, naturacil)
methlcellulose (cologel, hydrolose) polycarbophil calcium (mitrolan) |
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Laxative that can not be mixed through a tube because it forms a gelatin
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bulk forming laxative
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Lower surface tension of feces, allowing water and fat to penetrate' also increase secretion of water by intestine
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stool softner
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when are stool softners used
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short term therapy to relieve stranin on defecation (hemmorioids perianal or prostate surgery pregnancy)
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names of stool softners
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colace docusate Na
surfak docusate Ca dialose docusate K+ |
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Emollient or fecal mositening agent is also know as
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Stool softners
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dilute stool softners with
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milk or fruit juice to decrease throat irritation
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used to empty bowel for endoscopic exam, suspected poisoning, stool specimen
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Saline cathartics
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Contraindicated in clients with kidney dysfunction
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saline cathartics
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contain salt prepartion not absorbed by intestines that creates an osmotic effect that draws water into intestinal luman producing fluid distention leading to peristalsis.
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saline cathartics
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saline cathartics include
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milk of magnesia, fleet enema
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on contact with mucosa of colon, irritates mucosa to increase motility. Decreases absorption in small bowel and colon.
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Stimulant cathartics.
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what Cathartic is used for acute constipation, preparation of radiologic exam?
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stimulant cathartic
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Side effects of stimulant cathartics.
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nausea, cramping loose stools, fluid and electrolyte imbalance, rectal irritation.
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Not to be taken with milk or antacids because it dissolves the tabs coating.
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stimulant cathartics.
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kinds of stimulant cathartics are
and when not to take them |
doxidan, correctol, exlax,
at bed time. the take 2-6 hours to work. |
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penetrates and coats fecal mass and prevets excessive absorption of water
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lubricant laxatives
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Down side of lubricant laxatives
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can leak and seep from rectum causing anal pruritis.
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colonic bacteria metabolized galactose and fructose to organic acids.
increased fluid accumulation distion peristalisis with in 24 to 72 hours. |
lactulose
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decreased blood ammonia level in chronic liver disease
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lactulose
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side effects of lactulose
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gas cramps belching flatulence.
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mix lactulose with
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water juice or milk
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cleans bowls for colonscopy with low incidence of N,m V or bloating
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polyethylene glycol
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isotonic solution so fluids and electrolytes are neikther absorbed nor secreted in gi tract.
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polyethylene glycol
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defining characteristics of constipation
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dry hard stool, straining, painful defecation, abd distention, palpable abd mass rectal pain.
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causes of constipation
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low fiber diet. hi animal fats and refind sugars
irregular bowel habits, ignoring urge fluid intake less than 1500cc |
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assessments for constipation
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monitor bowel elimination
asculate bowel sounds palpate abdomen |
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diagnostic tests for constipation
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Stool for occult blood, guiac
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things not to do before occult blood test that give false +
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no rare red meat. horsradish, iron anticoagulants, asa, nsaid 3 days before can give false +
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things that give a false neg to occult blood test
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vitamine c 24h before, do not mix stook and urine.
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Tests UGI series is NPO when
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After 12am and MOM after test to ecacuate barium.
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TESTS THAT CAN BE DONE FOR CONSTIPATION
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CAT SCAN OF ABD, COLONSCOPY, OSMOTIC LAXATIVE, ENCOURAGE PT TO EXPEL FLATULANCE.
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INTERVENTIONS FOR CONSTIPATION
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exercise, activity
1500cc2000cc fluids high fiber diet use RR after eating when duodenocolic reflex works best |
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Enema types 5
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fleet
saline soap suds tap water oil retention |
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enema that is made from hypertonic solution
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FLEETS
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enema that is the safest. 2 tsp salt in 500 ccs water
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saline
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Emema that irritates bowel mucosa
5ml of castile soap in 1L water |
Soap Suds
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enema that is hypotonic with potential for water intoxication so never give to children , alters cardica or renal funcion patients
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Tap water
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Enema that Softens feces, caots rectal mucosa to facilitate expulsion and specifically given for impaction
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Oil Retention
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bowel traning includes
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stool softners, buling agent, suppositorys, rehab for spinal coard injury, planned time for using rr
client leans forward. massaging stomach |
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inability to evacuate stool voluntarily
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fecal impaction
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evidence of fecal impaction
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no stool for 3-5 days, followed by liquid stool. may be incontinent and not perceive urge.
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Risk of fecal impaction is greater with people who are
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cognitive impaired, immobilized
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Fecal impactions defining characteristics are
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rectal/abd fullness, bloating, urge to defecate but no stool, n,v
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interventions for fecal impaction are
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oil enemas
digital removal change in bowel habits review meds, add buling agent |
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frequent evacuation of water stools with loss of fluid and electrolytes increased mucus.
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diarrhea
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Defining characteristics of diarrhea
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abd cramps
urge to evacuate increased stools change in color increased BS 30per min burning at anus due to irritation |
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causes of diarrhea
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emotional stress
intestinal infection food allergies greasy spicey food tube feeding with inadequate water antibiotics, magnesium antacids, laxatives colitis chrons disease gastrectomy, colon resection |
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interventions for diarrhea
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balanced electrolyte/glucose solutions
if diarrhea 3-4 days no milk no spicey fatty foods antidiarrheal meds given for longer then 2 days. |
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over the counter meds for diarrhea
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immodium
pepto bismol kaopectate magnesium |
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immodium (loperamide)
does what? side effect? dose |
-opiod that decreases gi motility by stopping movements in the gut.
side effects are dizzy, dry mouth , skin rash. no more then 8mg with 2-3 mg as inital. |
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kaopectate (attopulgite) does what?
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Gi absorbent and protective agent
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pepto bismol does what?
dose? enhances what? |
inhibits gi secretions and syntheses of prostaglandin that produces intestinal inflamation and hypermotility. supresses growth of helicobactor pylori that causes ulcers.
Dose is 30 ccs or 2 tbsp. q30-60min enhances effect of anticoagulant. |
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prescription antidiarrheals are
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synthetic opiods
opiods |
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antidiarrheal opids work by
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lowering bowel motility.
reduce pain and rectal spasms increase reabsorption of water |
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synthetic opiods for diarrhea are
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lomotil (diphenoxylate & atropine)
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inhibits intestinal propulsive motility thus decreasing transit time
S.E. drowsiness, dizy rash dry mouth abd distress |
Lomotil
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take up or attach to another substance and coats wall of gi tract.
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absorbents
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absorbs bacteria or toxins and passes them out with stool.
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absorbents
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questran (cholestyramine) absorbs bile acids to reat increased cholestrol and also used to treat diarrhea
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absorbents
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involuntary elimination of bowel contents associated with neurologic mental or emotional impairments
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fecal incontinence
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causes of fecal incontinence
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cerevral cortx or scaral cord injury or disease.
tube feeding/diet changes fecal impaction gi disorgers infectious disease |
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interventions for fecal incontinence
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bowel management programs
briefs bulk forming agents to normalize stool andidiarrheal agent if ordered maintain hydration treat infectious disease if cause precent impaction. |
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accumulation of gas in GI tract
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Flatulence
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causes for flatulence
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swolling air
smoking, carbonated bevs.gum chewing rapid food ingestion or drink ingestion colonic irritationi hi fber goods. onions cabbage lugumes |
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interventions for flatulence
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increase activity
alter diet simethicone rectal dube return flow enema |
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abdominal distention is from
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accumulation of excessive amounts of flatus or liquid or solid intestinal contents
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causes for abdominal distention
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inactivity, constipation, fecal impactioin, tumors
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interventions for abd distention
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activity, give reglan, ng decopression for ileus
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Colostomy is a
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diversion of the colon
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ileostomy is a
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diversion of the ileum that produces liquid stool
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Stomas should be?
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beefy red, not being serous red
be above skin level not tucked inward |
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if stoma is tucked inward or is syanotic, what do you do
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call surgeon immediatly
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